I took my child to an orthodontist for a consultation. Before my son saw the doctor he had two x-rays taken, a panoramic x-ray and a cone beam x-ray. I didn’t think this was necessary. Is that typical?

As a parent, I would also express concern with two x-rays during an initial consultation. I understand the need for a recent panoramic x-ray, as that is typically needed for exams. My concern is unnecessary exposure to radiation. I believe a cone beam x-ray or a cephalometric x-ray should only be taken after the initial exam if the doctor feels it is necessary. There should be a difference between protocol for an initial exam and protocol for final diagnosis records. The latter is done after the doctor determines there is a need for additional records and has discussed it with the parent.

Q: I am use to getting dental x-rays where they put the film in your mouth. My orthodontist took an x-ray with a machine that circled my head. It produced an x-ray of all of my teeth and jaw. Why take this x-ray?

Dr. Herman's Answer: The x-ray is called a panorex and is taken by most orthodontists and dentists. It is used to look for missing teeth, extra teeth and pathology in your jaw bone, like a tumor. As a screening x-ray it is taken by dentists every 2-3 years in non-adult patients and about every 5 years for adults. Orthodontists and your dentist find that the panorex is the best way to assess if wisdom teeth are coming in straight or are impacted. As an orthodontist, I also use the panorex to check for movement of stuck teeth, other than wisdom teeth, or to assess if the roots of teeth are getting straight or are still slanted.