Taking radiographs can be tricky, but it doesn’t have to be. Here’s a thorough guide to successful radiographs every time. For starters, just think of yourself as a photographer and your patient as the model.

This article originally appeared in Dental Assisting & Office Manager Digest – by Claire (Founder and CEO of SmarterDA Dental Assisting Exam Prep)

Tongue not touching palate during exposure (55.7%)


I often compare a radiographic exposure to a photoshoot session when I talk with our SmarterDA (dental assisting exam prep) users. The cameraperson, or photographer, is the clinician, and the model is the patient. To create the best effect, the photographer (clinician) needs to provide excellent instructions.

Why panoramic radiographs are needed

Panoramic radiography can be used in the following situations:

• For general surveys of oral health
• To determine the best radiographic supplements for surgical procedures
• For initial and progressive evaluations of orthodontic treatment
• For information about pediatric growth and development
• To review chronological dental eruptions and the axes of permanent tooth eruption
• To evaluate cystic or neoplastic lesions
• To measure the dimensions for implantology
• For historical documentation
• To evaluate the temporomandibular joint, and
• To detect the presence of foreign bodies.(1)


Ranking of panoramic radiograph errors

According to the research conducted on positioning errors and published in “Imaging Science in Dentistry,” about 90% of panoramic images were presented with errors while only about 10% were error free. The ranking of positioning errors are as follows: (2)

• Tongue not touching palate during exposure (55.7%)
• Slumped position (35%)
• Patient positioned back (30%)
• Patient positioned forward (18.3%)
• Chin tipped high (17.9%)
• Head turned to one side (17.4%)
• Chin tipped low (16.2%)
• Head tilted to side (12.7%)
• Patient movement during exposure (1.6%)


Extraoral panoramic errors: a perfect summary for dental assistants

This article summarizes how to detect panoramic radiographic errors, and how to provide instructions about correcting them. The goal is to successfully pass the dental assisting board exams, and also to become the superstar dental assistant everyone wants on their team!

chart of panoramic radiographic errorschart of panoramic radiographic errors chart of panoramic radiographic errors

As you can see, small details can make a difference. As a dental professional, it is important to minimize the exposure to radiographs, therefore, avoid retakes.

radiograph rules


Dental radiology is a subject we must master to pass DANB’s RHS® exams and regional exams. But it’s practice is even more important. A dental assistant is crucial to the success of a dental office and optimal radiographs are one of the primary duties of the dental assistant. We hope that we provided you with a quick summary of the panoramic radiographic errors.

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The Author:

StudentRDH Claire Jeong is an entrepreneur striving to promote success through education. She founded SmarterDA, which offers review courses for certification exams for dental assisting students. The online platform delivers content of the highest quality through the latest e-learning technology. Jeong has a master’s degree in administration from Boston University and a dental hygiene degree from Forsyth School of Dental Hygiene in Boston. She also advocates for efficacy in learning and in life through her articles, speeches, and business. Contact her atClaireJ@StudentRDH.com.
1. De Senna BR, Dos Santos Silva VK, França JP, Marques LS, Pereira LJ. Imaging diagnosis of the temporomandibular joint: critical review of indications and new perspectives. Oral Radiol. 2009; 25:86–98.
2. Dhillon M, Raju SM, Verma S, Tomar D, Mohan RS, Lakhanpal M, et al. Positioning errors and quality assessment in panoramic radiography. Imaging Sci Dent. 2012; 42:207–212.