OPG vs Intraoral X-Ray: Differences & When Each Is Used

Dentists use two fundamentally different categories of dental X-ray: the OPG (orthopantomogram), which is an extraoral panoramic X-ray that captures the entire mouth in one image, and the intraoral X-ray, which places a small sensor inside the mouth to photograph 2-4 teeth at extremely high resolution. Choosing between them - or knowing when both are needed - depends on what the dentist is looking for, how much anatomical coverage is required, and whether fine detail or broad overview matters more for the diagnosis.

This guide provides a definitive comparison of OPG vs intraoral X-rays, including all three intraoral subtypes (periapical, bitewing, and occlusal). Every section covers clinical indications, radiation exposure, cost in Dubai, patient comfort, and real-world scenarios to help you understand exactly which dental X-ray type is appropriate for your situation. All content is reviewed by a diagnostic radiologist for clinical accuracy.

OPG vs Intraoral X-Ray: Quick Overview

The simplest way to understand the difference between an OPG and an intraoral X-ray is to think of them as a wide-angle lens versus a macro lens. The OPG (panoramic X-ray) is the wide-angle shot: it sweeps the X-ray beam around the outside of your head in a 15-to-20-second arc and produces a single flat image showing both jaws from ear to ear, all teeth, the temporomandibular joints, the maxillary sinuses, and the surrounding bone. The intraoral X-ray is the macro shot: a small digital sensor or phosphor plate is placed inside your mouth, directly against the teeth, and a focused X-ray beam is fired for less than one second to produce a tiny, ultra-sharp image of just 2 to 4 teeth and the immediately surrounding bone.

Neither type is universally "better." They serve different diagnostic purposes and are frequently used together. The OPG gives the dentist a roadmap of the entire oral and maxillofacial region, identifying areas that warrant closer investigation. The intraoral X-ray then zooms in on those areas with the resolution needed to make a definitive diagnosis. Understanding when each is appropriate helps patients avoid unnecessary imaging and ensures the right diagnostic information reaches their dental team.

"I think of the OPG as the opening chapter of the diagnostic story," says Dr. Osama Elzamzami, Consultant Radiologist at DCDC. "It tells me what is happening across the entire jaw in one glance. The intraoral X-ray is the close-up paragraph - it fills in the fine print that the panoramic view cannot resolve."

Types of Intraoral X-Rays (Periapical, Bitewing, Occlusal)

Before comparing the OPG to intraoral X-rays, it is important to understand that "intraoral X-ray" is an umbrella term covering three distinct types, each designed for a specific diagnostic task. All three place a sensor inside the mouth, but the sensor angle, positioning, and diagnostic purpose differ significantly.

Periapical X-Ray

A periapical X-ray captures the entire tooth from crown to root tip, plus 2-3 mm of bone beyond the root apex. It is the go-to image for assessing root canal anatomy, detecting periapical abscesses and granulomas, evaluating root fractures, measuring bone loss around individual teeth, and checking the fit of posts or implant abutments. A periapical image covers 2-3 teeth per exposure. When a dentist needs to see every millimeter of a single tooth and its surrounding bone, the periapical is the definitive choice.

Bitewing X-Ray

A bitewing X-ray captures the crowns and upper root portions of the upper and lower teeth simultaneously. The patient bites down on a small tab ("wing") that holds the sensor in place, aligning the upper and lower teeth in the same frame. Bitewings are the gold standard for detecting interproximal (between-teeth) cavities, monitoring the fit of existing fillings and crowns, and assessing early alveolar bone loss in periodontal disease. A standard bitewing series consists of 4 images (2 left, 2 right) covering the premolars and molars on both sides.

Occlusal X-Ray

An occlusal X-ray uses a larger sensor placed on the biting surface of either the upper or lower teeth. The patient gently bites down to hold the sensor flat. Occlusal X-rays capture a broader area than periapical or bitewing images and are primarily used in pediatric dentistry to assess developing teeth, identify supernumerary (extra) teeth, detect salivary gland stones, evaluate cleft palate, and locate foreign bodies in the jaw. They provide a bird's-eye view of one dental arch.

With these three types defined, the comparison against the OPG becomes much clearer. The OPG covers a far wider field of view than any intraoral X-ray, but each intraoral subtype delivers higher resolution for its specific diagnostic task.

When OPG Is the Better Choice

The OPG is the preferred imaging choice whenever the clinical question requires a broad anatomical overview rather than fine detail of a single tooth. Its ability to capture the entire maxillofacial region in one low-dose exposure makes it indispensable in the following scenarios.

Impacted Wisdom Teeth

The OPG is the standard-of-care imaging study for evaluating wisdom teeth. It shows whether third molars are impacted, partially erupted, or fully erupted, and reveals their angulation relative to adjacent teeth and their proximity to the inferior alveolar nerve canal. This information is critical for oral surgeons to plan extraction and minimize nerve injury risk. A single OPG replaces the multiple periapical images that would be needed to visualize all four wisdom teeth individually.

Orthodontic Treatment Planning

Orthodontists require a panoramic view of all erupted and developing teeth, root positions, and bone levels before starting braces or clear aligner therapy. The OPG reveals missing teeth, supernumerary teeth, ectopic canines, and root resorption across both arches in a single image, forming an essential part of the orthodontic treatment record alongside cephalometric radiographs.

Dental Implant Assessment

Before placing implants, clinicians need an overview of available bone height, nerve canal position, and sinus proximity. The OPG provides this initial assessment efficiently. For complex implant cases requiring three-dimensional measurements, a CBCT scan follows, but the OPG remains the essential first step.

Jaw Fractures and Facial Trauma

In emergency departments and oral surgery practices, the OPG is the first-line imaging study for patients with suspected mandibular fractures, condylar fractures, or midface injuries. It identifies fracture lines across the entire mandible in seconds, guiding surgical decision-making far more efficiently than a series of small intraoral images.

TMJ (Jaw Joint) Disorders

Patients with jaw clicking, locking, or chronic facial pain benefit from an OPG because it displays both temporomandibular joints simultaneously, revealing condylar flattening, osteophytes, erosion, or dislocation. Intraoral X-rays cannot visualize the TMJ at all.

New Patient Screening and Baseline Records

Many general dentists request an OPG as part of a new patient comprehensive examination. A single panoramic image provides a complete baseline that can be compared against future scans to track bone changes, disease progression, or treatment outcomes over months and years.

Patient scenario: A 32-year-old woman visited DCDC with bilateral jaw pain and difficulty opening her mouth wide. Her previous dentist had taken periapical X-rays of the painful teeth but found nothing abnormal. A single OPG at DCDC revealed bilateral condylar erosion consistent with TMJ degenerative joint disease - a finding that intraoral X-rays are physically unable to capture. "The OPG showed the full picture in 15 seconds," explains Dr. Osama Elzamzami. "The TMJ joints are outside the reach of any intraoral sensor, so the panoramic view was the only way to make this diagnosis from conventional X-ray alone."

When Intraoral X-Ray Is Preferred

Intraoral X-rays are the preferred choice whenever the clinical question demands the highest possible resolution of a specific tooth, a small group of teeth, or the bone immediately surrounding them. The sensor's proximity to the anatomy eliminates magnification and distortion, producing sharper images than any extraoral technique can achieve.

Detecting Early Cavities

Bitewing X-rays are the gold standard for detecting early interproximal cavities (between teeth) that are too small to appear on an OPG. Studies consistently show that bitewings detect early enamel caries at a significantly higher rate than panoramic images. If your dentist suspects a developing cavity between your premolars or molars, a bitewing series is the definitive diagnostic tool.

Root Canal Assessment

Before, during, and after root canal treatment, the endodontist relies on periapical X-rays to measure canal length, verify file placement, assess obturation quality, and detect periapical healing. The periapical image provides the submillimeter detail required for these measurements, which the OPG cannot match.

Monitoring Individual Restorations

When a dentist needs to evaluate the margins of a crown, check for recurrent decay beneath an existing filling, or assess the fit of a post-and-core restoration, a periapical or bitewing image of that specific tooth delivers the resolution needed. The moderate detail of an OPG may miss subtle marginal gaps or early secondary caries.

Periodontal Bone Level Assessment

While the OPG can show generalized bone loss, periodontists prefer a full-mouth periapical series (14-20 images) for precise measurement of bone levels around every tooth. The periapical's higher resolution allows millimeter-accurate assessment of vertical and horizontal bone defects that guide surgical and non-surgical periodontal treatment planning.

Pediatric Dental Assessment

Occlusal X-rays are particularly valuable in pediatric dentistry for visualizing developing tooth buds, detecting extra (supernumerary) teeth, and evaluating trauma to the anterior teeth. In very young children who cannot tolerate the OPG machine's positioning requirements, occlusal and periapical X-rays taken in the dental chair may be the only practical option.

Radiation Comparison

Radiation dose is one of the most common concerns patients raise when their dentist orders any X-ray. The good news is that all dental X-ray types - both OPG and intraoral - deliver extremely low radiation doses that fall far below any threshold associated with measurable health risk. However, there are meaningful differences in how these doses add up, depending on how many images are taken.

A single OPG delivers approximately 10-20 µSv (microsieverts) of effective radiation dose. This is equivalent to 1-2 days of natural background radiation that every person absorbs simply from living on Earth. A single periapical X-ray delivers approximately 1-8 µSv, and a single bitewing delivers approximately 1-5 µSv. On a per-image basis, the intraoral X-ray delivers less radiation than the OPG.

However, the critical factor is the number of images needed. A single OPG covers the entire mouth. To achieve comparable coverage with intraoral X-rays requires a full-mouth series of 14-20 periapical and bitewing images, which delivers a combined dose of approximately 35-170 µSv - significantly more than a single OPG. This means the OPG is actually the lower-dose option when a comprehensive view of both jaws is needed.

For comparison against everyday radiation exposure:

• Single OPG X-ray: 10-20 µSv (equivalent to 1-2 days of background radiation)
• Single periapical X-ray: 1-8 µSv (equivalent to a few hours of background radiation)
• 4-image bitewing series: 4-20 µSv (equivalent to about 1 day of background radiation)
• Full-mouth intraoral series (14-20 images): 35-170 µSv (equivalent to 5-26 days of background radiation)
• Dubai-to-London flight (cosmic radiation): 40-80 µSv
• Average annual background radiation: approximately 2,400 µSv per year

"When patients ask me which X-ray has less radiation, I always clarify: less per image, or less per diagnostic task?" says Dr. Osama Elzamzami. "A single bitewing has less radiation than an OPG. But if you need to see the whole mouth, one OPG at 14 µSv is far less than 18 intraoral films totaling over 100 µSv. The right question is always what clinical information we need, and then we choose the lowest-dose pathway to get it."

Cost Comparison in Dubai

The cost of dental X-rays in Dubai varies depending on the type of imaging, the facility, whether a consultant radiologist report is included, and whether the patient is using insurance or paying out of pocket. The following ranges reflect typical self-pay pricing at diagnostic centers and dental clinics in Dubai as of 2026.

From a cost-per-coverage perspective, the OPG is significantly more economical when a comprehensive view is needed. A single OPG at AED 150-300 covers both jaws and all teeth, while a full-mouth intraoral series achieving similar (though more detailed) anatomical coverage costs AED 500-1,200. However, if the dentist only needs to check one or two teeth, a single periapical at AED 50-150 is more cost-effective than ordering an OPG.

Most dental insurance plans in Dubai cover diagnostic X-rays when clinically justified and accompanied by a referral. OPG scans are almost universally covered under DHA-compliant insurance policies. Intraoral X-rays are also covered, though insurers may limit the number of images reimbursed per visit. Self-pay patients at DCDC can access competitive pricing without a referral. For a detailed breakdown of OPG pricing, see our guide on OPG X-ray cost in Dubai.

Which Dental X-Ray Do You Need?

The answer depends entirely on the clinical question your dentist is trying to answer. Here is a practical decision guide based on common clinical scenarios:

• You are a new patient and your dentist wants a baseline record: OPG is the most efficient single image. It provides a complete overview that can be supplemented with targeted intraoral X-rays if problem areas are identified.
• Your dentist suspects a cavity between two back teeth: Bitewing X-rays are the best choice. They detect interproximal caries earlier and more reliably than an OPG.
• You need a root canal: A periapical X-ray of the affected tooth is essential before, during, and after the procedure.
• Your wisdom teeth are causing pain: An OPG is the standard imaging study. It shows all four wisdom teeth, their angulation, and their relationship to the nerve canal in a single image.
• You are starting orthodontic treatment: An OPG is required as part of the orthodontic record. It may be combined with a cephalometric X-ray for treatment planning.
• You need a dental implant: An OPG provides the initial overview. A CBCT may follow for three-dimensional bone measurements in complex cases.
• You have jaw pain or TMJ clicking: An OPG is the appropriate first-line image. It is the only conventional X-ray that can visualize both TMJ joints.
• Your child has delayed tooth eruption: An OPG or occlusal X-ray reveals developing tooth buds and identifies supernumerary teeth or other obstructions.
• Your periodontist is assessing gum disease severity: A full-mouth periapical series provides the most detailed bone-level assessment around every tooth.
• You had facial trauma and may have a jaw fracture: An OPG is the first-line imaging study for mandibular fractures.

In many clinical situations, the dentist will order both an OPG and selected intraoral X-rays. This combination approach - panoramic overview plus targeted detail - delivers the most complete diagnostic information while keeping the total radiation dose and cost as low as reasonably achievable.

"The best dental X-ray is the one that answers the clinical question with the least radiation and the most useful information," says Dr. Osama Elzamzami. "There is no single type that is always superior. A skilled clinician matches the imaging to the problem, and that is exactly what we do at DCDC for every patient."

Mga Madalas Itanong

Final Thoughts

The OPG and intraoral X-ray are not competing technologies - they are complementary diagnostic tools that serve different clinical needs. The OPG excels at delivering a comprehensive panoramic overview of both jaws, all teeth, the TMJ joints, and surrounding structures in a single low-dose exposure. Intraoral X-rays - periapical, bitewing, and occlusal - excel at delivering the highest-resolution images of individual teeth and small areas of bone. The best diagnostic outcomes occur when the right type is matched to the clinical question, and in many cases, both are used together.

If your dentist has recommended a dental X-ray and you are unsure which type you need, Doctors Clinic Diagnostic Center in Dubai Healthcare City offers both digital OPG and intraoral imaging with same-day consultant radiologist reporting. Walk-ins are welcome, and no referral is needed for self-pay patients. To learn more about OPG imaging specifically, read our complete guide on what is an OPG X-ray, or explore our OPG X-ray services.

Isinulat ni

Dr. Osama Elzamzami

Tingnan ang Profile

Diagnostic Radiology

MD, FRCR

Dr. Osama Elzamzami is a Consultant Radiologist specializing in diagnostic imaging including X-ray, CT, MRI, OPG, CBCT, and ultrasound at DCDC Dubai Healthcare City. With extensive experience in dental and maxillofacial radiology, he provides expert reporting for panoramic, periapical, bitewing, and cone-beam imaging studies.

Related Articles

• What Is an OPG X-Ray? Guide to Panoramic Dental Imaging
• OPG X-Ray Cost in Dubai: Updated Prices & Insurance Guide
• OPG X-Ray Results Explained: How to Read Your Report