---
title: "Orthodontic X-Rays & Radiation UK | OPG, Ceph & CBCT"
url: https://virtualconsultant.online/guides/orthodontic-xray-radiation-uk
description: "What radiation dose do orthodontic X-rays involve? OPG, lateral cephalogram, and CBCT explained — including the ALARA principle, patient rights."
updated: 2026-08-17T00:00:00Z
publisher: Virtual Consultant Online
---

X-Rays

Safety

Records

# Orthodontic X-Rays and Radiation UK — What You Need to Know

Orthodontic records typically include at least one panoramic X-ray (OPG) and often a lateral cephalogram. The radiation doses involved are very low — but understanding the justification for each scan and your right to question it is part of informed consent.

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## Why orthodontic X-rays are required

X-rays form part of the orthodontic diagnostic record because they reveal information that cannot be obtained from a clinical examination alone. A panoramic X-ray shows the position, angulation, and developmental stage of all teeth — including unerupted, impacted, and wisdom teeth — as well as the roots, bone levels, and signs of pathology such as cysts. A lateral cephalogram shows the skeletal relationship of the upper and lower jaws and allows precise measurement of jaw angles, which informs treatment planning for both orthodontics and orthognathic surgery. X-rays also identify whether teeth are present, how many roots they have, and whether root resorption has occurred previously. The decision to take any X-ray must be clinically justified on an individual basis.

## OPG (panoramic X-ray) — radiation dose and what it shows

The OPG, or orthopantomogram, is a panoramic X-ray that sweeps around the jaw to produce a single flattened image of all upper and lower teeth, the jaws, and the TMJ. It is the most commonly requested orthodontic X-ray. The effective radiation dose from an OPG is approximately 14 to 24 microsieverts (µSv) — roughly equivalent to one to two days of background radiation from natural sources. For context, a chest X-ray delivers around 14 µSv and a transatlantic flight delivers around 80 µSv. The OPG is considered a low-dose examination that is well justified for orthodontic assessment. It does not provide a reliable measure of tooth inclination in three dimensions, which is why it is supplemented by other records in complex cases.

## Lateral cephalogram — dose and clinical use

The lateral cephalogram is a standardised side-profile X-ray of the skull and jaw, taken with the patient in a reproducible position using a cephalostat. It allows the clinician to trace and measure skeletal and dental angles — including the ANB angle (upper to lower jaw relationship), the incisor inclination, and vertical facial proportions. The radiation dose is approximately 3 to 6 µSv — lower than the OPG. Cephalometric analysis is particularly important in patients with skeletal discrepancies, Class II or Class III malocclusion, and where orthognathic surgery is being considered. It may also be taken at mid-treatment or post-treatment to evaluate changes. Not every patient requires a lateral cephalogram; its use should be clinically justified for the individual.

## CBCT — when it is justified versus OPG

Cone beam computed tomography (CBCT) produces a three-dimensional image of the jaws, teeth, and surrounding structures. It is used in orthodontics when conventional 2D imaging cannot provide sufficient information — typically for impacted teeth (especially canines), assessment of root proximity before tooth movement, evaluation of bony defects, and surgical planning. The radiation dose from a CBCT varies significantly depending on field of view and scan protocol, but a small-field CBCT delivers approximately 70 to 400 µSv — several times higher than an OPG. Because of this, CBCT should only be used when conventional X-rays have been shown to be inadequate and when the additional diagnostic information will change clinical management. The FGDP and Public Health England guidelines state clearly that CBCT is not a first-line investigation and must be justified on a case-by-case basis.

## ALARA principle and UK regulatory guidance

The ALARA principle — As Low As Reasonably Achievable — governs radiation use in UK dental practice. Under the Ionising Radiation (Medical Exposure) Regulations 2017 (IR(ME)R), every X-ray must be individually justified by a referrer and authorised by a practitioner, and the dose used must be the minimum necessary to obtain diagnostic quality images. Practices must have documented protocols for each type of X-ray, use digital detectors where possible (which significantly reduce dose compared to film), and carry out regular equipment quality assurance. Patients should be told why an X-ray is being taken. Routine X-rays taken at fixed intervals without individual clinical justification do not comply with ALARA or IR(ME)R requirements.

## Patient rights — can you decline an X-ray, and pregnancy considerations

You have the right to refuse any X-ray, and a clinician must respect your decision. However, you should be aware that declining a clinically justified X-ray may limit the clinician's ability to plan treatment safely — for example, not knowing the position of an impacted tooth carries its own risk. Discuss your concerns and ask for the justification for each X-ray before agreeing. For pregnant patients, dental X-rays — including OPGs — can be taken if clinically necessary, as the abdomen is remote from the primary beam and the radiation dose is very low. A lead apron is not routinely required for dental X-rays under current UK guidance but may be offered. Elective orthodontic X-rays are typically deferred until after the first trimester where possible, though in most cases the risk is considered negligible.

## Useful related pages

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[Orthodontics and Pregnancy UK](https://virtualconsultant.online/guides/orthodontics-and-pregnancy-uk)

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This guide is for general information only. It is not a diagnosis, treatment plan, or substitute for advice from a registered dentist or orthodontist.

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### Frequently Asked Questions

Is the radiation from orthodontic X-rays dangerous?

The doses involved in orthodontic X-rays are very low. An OPG delivers approximately 14 to 24 µSv — less than two days of background radiation. Radiation risk is proportional to dose, and at these levels the risk is considered negligible. The clinical benefit of accurate diagnosis far outweighs the small theoretical risk for the vast majority of patients.

Why do I need a panoramic X-ray for orthodontics?

A panoramic X-ray (OPG) allows the orthodontist to see all your teeth — including those not yet erupted, impacted teeth, root lengths, bone levels, and any pathology such as cysts or abnormal root shapes. This information cannot be obtained from looking in your mouth and is essential for safe treatment planning.

What is the radiation dose from an OPG compared to a standard dental X-ray?

A periapical (single tooth) X-ray delivers around 1 to 8 µSv. An OPG, which covers the entire dental arch and jaws, delivers approximately 14 to 24 µSv. Both are very low-dose examinations. A full-mouth series of periapical X-rays can deliver a combined dose higher than a single OPG.

Should I be concerned about CBCT radiation?

CBCT delivers a higher dose than conventional 2D X-rays — typically 70 to 400 µSv depending on the scan protocol — and should only be taken when 2D imaging has been shown to be insufficient and the information will change clinical management. It is not a routine orthodontic record. If a CBCT is recommended, ask your clinician to explain why a conventional X-ray is not adequate in your case.

Can I refuse orthodontic X-rays?

Yes. You can decline any X-ray. The clinician must explain why it is recommended and what information it will provide. Declining a clinically indicated X-ray may affect the safety or accuracy of treatment planning. It is reasonable to ask for the justification and discuss any concerns before deciding.

Are X-rays safe during pregnancy?

Dental X-rays including OPGs use very low doses and target the jaw, not the abdomen. The risk to a developing foetus is considered negligible. UK guidance allows dental X-rays during pregnancy if clinically necessary. Elective orthodontic records are typically deferred until after the first trimester where possible, but if treatment is urgent, X-rays can be taken safely.

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Citation details

Title Orthodontic X-Rays & Radiation UK | OPG, Ceph & CBCT

Publisher Virtual Consultant Online

Published 2024-06-01

Updated 2026-08-17

URL [https://staging.virtualconsultant.online/guides/orthodontic-xray-radiation-uk](https://staging.virtualconsultant.online/guides/orthodontic-xray-radiation-uk)