Everything You Need to Know about X-rays and Starting Your Orthodontic Treatment

Treatments & Care

An Orthodontist holding an x-ray of a patients jaw and teeth.

X-rays are an important clinical evaluation tool for orthodontists. Orthodontists need to know as much information about what’s below the gum line as above. X-rays are the only way of seeing the tooth roots and jaw bones. They assist an orthodontist in preparing a plan for your treatment. Find out all there is to know about x-rays and orthodontics.

What is Dental Radiography?

Most people know dental radiography as x-rays. These x-rays use low levels of radiation to capture images of teeth, bones and gums. X-rays are used by dentists and orthodontists to assess the health of your mouth. 

When are Orthodontic X-rays Needed? 

We all need dental x-rays throughout our life as part of maintaining good oral health. But x-rays are particularly beneficial before, during and post orthodontic treatment. 

Prior to Orthodontic Treatment

X-rays make up an important part of the clinical evaluation toolbox for an orthodontist. A patient’s treatment plan is devised using the information from x-rays, examination, photos and moulds. An x-ray can determine if there are any underlying oral health problems. Oral problems such as gum disease must be treated before starting any orthodontic treatment.  

More complex 3-dimensional x-rays such as a cone beam scan may be requested to assess unerupted or teeth trapped in the jaw, jaw joint problems, airway dimensions and individuals who may need combined surgery and orthodontics to correct significant jaw structure problems.

During Orthodontic Treatment 

It’s common that another set of x-rays are taken towards the end of treatment. The x-rays can provide the orthodontist with important information for a bracket realignment or to check on the position of teeth and their roots. 

The final stage of braces is the finishing phase where the orthodontist makes small adjustments to improve a patient’s smile. X-rays help an orthodontist check the teeth are in the correct position and helps with the fine amendments made in the last six to nine months of treatment.   


Once you have completed your treatment, the orthodontist will want to evaluate the results. These post-treatment x-rays will help devise a retention strategy. 

If you have unerupted wisdom teeth, it’s also important to monitor their progress in case one is impacted or infected. You don’t want to risk your new smile because you didn’t keep up with regular dental check-ups and x-rays.  

What Dental Radiography (X-rays) Tell Us

X-rays provide a range of information for an orthodontist including:

Wisdom Teeth 

It’s important to know how large wisdom teeth are, where they are and if they are close to eruption before orthodontic treatment begins.  


Jaw Growth 

The bones of the jaw stop growing when we’re adolescents. If the orthodontist is considering phase one treatment for a child, an x-ray may confirm if their jaw is still growing. Once a child’s jaw is full size, and the palate has fused, orthodontists can’t use an expander plate to widen their jaw. A widened jaw provides more room to reduce the chance of overcrowding. 

Impacted Teeth 

One of the most common causes of loss of teeth is because of impaction. When a tooth doesn’t come through the gum completely, it may become infected or rub against another tooth. We need an x-ray to detect earlier on if a tooth is impacted. 

Position of Teeth

Knowing the position of teeth above and below the gums assist with the diagnosis and preparation of an orthodontic treatment plan. An x-ray can reveal the proximity of teeth to nerves and sinuses. An orthodontist uses x-rays to look for any malformed, missing or extra teeth. Abscesses, cysts and some tumours that are hidden, may be seen on x-rays. 

Oral Disease Including Gingivitis

X-rays reveal any decay that may hide between teeth or under fillings. An x-ray can also identify bone loss caused by gum disease. It’s important for an orthodontist to know the health of the gums, teeth and bone before moving teeth. 

Why are X-Rays Needed? 

Most of the information about a patient’s teeth isn’t visible to an orthodontist through a normal examination. The roots of teeth are below the gum line and an x-ray is the only way to find out how they look and where they’re positioned in relation to the surrounding teeth. X-rays also tell an orthodontist if a tooth is at risk of being damaged by another tooth.   

Some common x-rays used for orthodontics are:


The x-ray is taken with the patient in a bite position to show how the upper and bottom teeth line up. It gives an orthodontist information about an overbite and any problems or abnormalities with the floor of the mouth and palate. 


To take a panoramic x-ray, the machine rotates around the head to get a look at the jaw and teeth. 

Cephalometric Projections 

These x-rays look at the teeth in relation to the jaw and profile of a patient. They assist orthodontists with teeth realignment. 

Cone Beam CT-This is a complex 3-dimensional x-ray that enables the clinician to view more detailed aspects of the dental structures, the jaw joints, airways and detailed assessment of the jaw geometry. This is requested in specific instances.

FAQ’s About X-Rays  

Below are some questions patients have regarding x-rays and starting orthodontic treatment. 

Do You Take the X-rays at the Clinic?

No, we refer our patients to a dental radiographer for x-rays. This usually occurs after your first consultation and before the treatment plan is prepared but may be in a different order depending on your case.  

Are X-rays Dangerous? 

No, dental x-rays only use low levels of radiation. The amount of radiation you receive during dental x-rays is similar to the exposure you receive on a short aeroplane flight. Pregnant women are advised to avoid or limit dental x-rays but they are considered safe for the rest of the population.     

What Happens If X-rays Reveal I Need Surgery? 

X-rays help in deciding whether a patient needs surgery on their jaw or mouth. If the doctor recommends surgery, he will refer you to an oral and maxillofacial surgeon based on the surgery you require.

Considering Orthodontic Treatment for Your Child?

There are many advantages to starting orthodontic treatment for children at a young age. Improve your child's smile and book an appointment!


Do X-rays Help Decide If I Need Tooth Extractions or Not?

Yes, x-rays help your orthodontist decide if you need any teeth extracted before you start your orthodontic treatment. Extractions are required in roughly half of all orthodontic cases. If the doctor recommends extractions, you will be referred back to your dentist or an oral surgeon, depending on your case. 

Is the Cost of X-rays Covered by Private Health Insurance?

Yes, most private health insurers cover dental x-rays. Contact the dental radiographer for the item numbers so you can quote them to your insurer. 

If you have any queries about x-rays, braces or aligners, make a no-obligation appointment at The Orthodontists by calling (08) 9364 8020 or booking an appointment online.

Category: Treatments & Care