The dental radiation guidelines underwent important changes in 2025, reflecting the rapid evolution of imaging technology, increased awareness about patient safety, and new evidence published in dental journals and regulatory codes. Below is an overview of the latest recommendations and what has changed, with references to high-impact sources for professionals and dental teams.
Removal of Routine Lead Shielding
A major update is ending the routine use of lead aprons and thyroid collars for all patients. Leading organizations say shielding is obsolete because modern X-rays, collimation, and targeted exposures limit stray radiation. Shielding can block diagnostic views, causing repeat exposures and risk. Focus now is on clinical necessity, correct technique, and less repeat imaging.
Emphasis on Justification and Optimization
Guidelines directly emphasize a tri-level principle for all exposures:
Justification: Only clinically indicated radiographs are permitted; blanket scheduling or insurance-based protocols are discouraged.
Optimization: Use the lowest reasonable dose required for quality images and always the fastest receptor technology (digital sensors over film).
Diagnostic Reference Levels (DRLs): Research advocate for DRL benchmarks, especially in CBCT, to monitor and control radiation doses according to procedure type and patient demographics.
Digital Imaging, Rectangular Collimation, and Reducing Repeats
Digital imaging is now the standard, and film use is discouraged. Rectangular collimation should match sensor size to minimize exposure. Operator retraining and use of beam-restricting technology are required. Reducing repeats and avoiding errors has also been advocated for. Our device, Tarsier X, helps in the accurate positioning of tube heads, thus reducing errors.
CBCT Use and DRL (Diagnostic Reference Level) Establishment
CBCT should be used only when standard X-rays are insufficient. Each scan must be clearly justified and documented. DRL monitoring is essential for children and vulnerable patients.
Regulatory and Training Requirements
Stricter enforcement now requires updated documentation, operator recertification, and maintenance logs for all radiology stations. Enhanced error reporting, accurate patient identification, and written consent for exposures are also mandated to improve transparency and reduce unnecessary scans.
Updated Pediatric Protocols
For children and special care patients, intraoral radiography remains the gold standard. CBCT and extraoral imaging require even stricter protocols for indication and dose minimization. Radiographs should never be prescribed except for substantial clinical suspicion or treatment monitoring, reinforcing the ALARA (as low as reasonably achievable) principle.
Dental professionals should immediately review clinic protocols and update team training to align with the latest 2025 radiation safety standards. The shift away from routine shielding, stronger protocols for CBCT, rigorous justification, digital imaging, new documentation requirements, and focus on continuous education are the major game changers this year.
Sources
[1] Radiation Protection in Dental Radiology http://www.iaea.org/publications/14720/radiation-protection-in-dental-radiology
[2] ADA Releases Updated Recommendations to Enhance … https://www.ada.org/about/press-releases/ada-releases-updated-recommendations-to-enhance-radiography-safety-in-dentistry
[3] Advances in Radiation Protection in Oral and Dental … https://fbt.tums.ac.ir/index.php/fbt/article/view/852
[4] Evaluating radiation safety knowledge and practices in … https://pmc.ncbi.nlm.nih.gov/articles/PMC12220185/
[5] 2025 Safety Standards for Dental Equipment: What’s New https://www.uptimehealth.com/blog/2025-safety-standards-for-dental-equipment-whats-new
[6] Radiation safety compliance September 19, 2025 https://dcnz.org.nz/resources-and-publications/updates/new-folder-page-4/radiation-safety-compliance
[7] Assessment of Knowledge towards Radiation Protection … https://pmc.ncbi.nlm.nih.gov/articles/PMC9221917/
[1] Radiation Protection in Dental Radiology http://www.iaea.org/publications/14720/radiation-protection-in-dental-radiology
[2] ADA Releases Updated Recommendations to Enhance … https://www.ada.org/about/press-releases/ada-releases-updated-recommendations-to-enhance-radiography-safety-in-dentistry
[3] Advances in Radiation Protection in Oral and Dental … https://fbt.tums.ac.ir/index.php/fbt/article/view/852
[4] Evaluating radiation safety knowledge and practices in … https://pmc.ncbi.nlm.nih.gov/articles/PMC12220185/
[5] 2025 Safety Standards for Dental Equipment: What’s New https://www.uptimehealth.com/blog/2025-safety-standards-for-dental-equipment-whats-new
[6] Radiation safety compliance September 19, 2025 https://dcnz.org.nz/resources-and-publications/updates/new-folder-page-4/radiation-safety-compliance
[7] Assessment of Knowledge towards Radiation Protection … https://pmc.ncbi.nlm.nih.gov/articles/PMC9221917/
