Factors influencing the selection of panoramic radiography in general dental practice.

Objectives: To identify factors influencing dentists' decisions to take panoramic radiographs and to determine dentists' perceptions of the value of panoramic radiographs in the diagnosis of common dental pathologies.

Methods: Questionnaire of dentists with access to panoramic radiography equipment in 22 randomly selected Family Health Service Authorities in England and Wales. Dentists were asked to score 17 factors for their influence upon panoramic use, compare the relative diagnostic value of panoramic and intraoral radiographs for diagnosis of common dental pathologies and state their principal reasons for taking panoramic radiographs.

Results: The response rate to the questionnaire was 73.3%. The factors most likely to influence dentists to take a panoramic radiograph were 'planning oral surgery', 'facial trauma', 'periodontal disease', 'heavily restored dentition' and 'patient first attendance'. Dentists' opinions on the diagnostic usefulness of panoramic radiographs were in broad agreement with those in the scientific literature. The main reasons for taking panoramic radiographs were as a 'general screen' and as a 'view for unerupted or impacted teeth'.

Conclusions: There are areas where dentists' prescription of panoramic radiographs is in disagreement with recent guidelines. Successful implementation of these guidelines would be likely to lead to a substantial reduction in the numbers of panoramic radiographs taken by GDPs.