CHICAGO, January 5, 2026 — The first dental X-ray recommendations published by the ADA in more than a decade confirm that dental X-rays should be ordered only when clinically necessary to minimize both patients’ and dental professionals’ exposure to radiation. These new recommendations are also the first from the ADA to address both 2-D (planar) and 3-D (cone beam computed tomography [CBCT]) imaging and specific clinical scenarios to inform their use during patient visits.
Published jointly today in the January issue of The Journal of the American Dental Association and online ahead of print in Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, the recommendations significantly update and expand upon 2012 dental radiography patient selection and safety recommendations, with a strong focus on how to determine which patients are candidates for dental X-rays and frequency in routine dental check-ups. The recommendations were developed by an expert panel established by the ADA Council on Scientific Affairs and endorsed by the American Academy of Oral and Maxillofacial Radiology (AAOMR).
“Dental imaging is an important diagnostic tool that can help improve oral and overall health outcomes when used appropriately,” said Dr. Erika Benavides, D.D.S., Ph.D., lead author and Clinical Professor in the Department of Periodontics and Oral Medicine at the University of Michigan School of Dentistry. “You wouldn’t get an X-ray of another part of your body unless the doctor believed there was reason to order one after an examination. Similarly, dental X-rays should be ordered only after first examining the patient’s medical and dental histories, prior X-ray images, and current clinical exam findings.”
The recommendations also outline clinical considerations and scenarios for issues like cracked teeth, endodontics, implant planning and placement, temporomandibular disorders (TMD), and more.
“These updated clinical recommendations honor what we have used and learned and chart a clear, path forward for patient care and effective use of radiation in dentistry,” said Dr. Trishul Allareddy, B.D.S., M.B.A., M.S., co-author, Professor at the University of North Carolina Adams School of Dentistry, and AAOMR immediate past president.
This paper is the second of two publications addressing diagnostic imaging in dentistry. The first set of recommendations focusing on radiation safety and regulatory issues was published in 2024. It found that thyroid collars and lead abdominal aprons are no longer necessary due to low levels of X-ray radiation and optimization of dental X-ray techniques, building upon AAOMR’s patient shielding recommendations issued in 2023.
“Dental X-rays are safe. In some cases, a dental X-ray delivers less radiation than a single day of the natural radiation we are all exposed to just by living in the world,” said Dr. Benavides. “Yet it is important to follow the ALARA (As Low As Reasonably Achievable) principle recognized in both dentistry and medicine to minimize exposure over a patient’s lifetime and only order X-rays when clinically necessary. The ADA and AAOMR encourage all dentists and their teams to review these recommendations and talk with their patients about any questions they may have.”
To view the complete recommendations, visit JADA.ada.org.