Imaging selection
Choose bitewing, periapical, occlusal, panoramic or cross-sectional imaging according to the question and expected management impact.
Understand
Different modalities answer different questions: bitewings for proximal caries and bone levels, periapicals for roots and apices, panoramic for a broad overview, and CBCT for selected 3D problems.
Assess
Start with the clinical question, inspect existing records and choose the smallest suitable field and lowest appropriate exposure.
Apply
Do not order a routine series by habit. If imaging will not change management, reconsider whether it is needed; if it is inadequate, explain what additional view would help.
Key distinctions
The ideal image is the least burdensome modality that answers the question at sufficient quality. Bitewings and periapicals often have better fine detail than a panoramic view. A panoramic image gives context for jaw anatomy but has geometric limitations. CBCT adds 3D information for selected problems but is not a routine safety blanket.
Think through a case
A periapical image may answer a single-tooth endodontic question better than a panoramic image. CBCT is considered only if a defined 3D uncertainty remains.
The distinction to remember
Do not start with the most technologically advanced modality; start with the clinical question.
Test your recall
What is the first step before selecting an image?
Show answer
Define the diagnostic question.