New 2026 guidance published in The Journal of the American Dental Association highlights when dental imaging—such as X-rays, cone-beam CT (CBCT), and MRI—should be used, including for people with temporomandibular disorders (TMD).
The key takeaway for patients: imaging should not be routine for TMD. A careful medical history and clinical examination remain the most important first steps in diagnosis. Imaging should be used only when it is likely to help clarify the cause of symptoms or guide treatment decisions.
When imaging is appropriate, the type matters. MRI is the preferred tool for evaluating soft-tissue problems, such as disc displacement or inflammation. CBCT scans may be helpful for assessing bone changes, such as arthritis or joint degeneration, but should be used sparingly to limit radiation exposure.
Overall, the guidance reinforces a thoughtful, patient-centered approach that avoids unnecessary imaging while ensuring patients receive the right test at the right time.
What Patients Should Know:
- TMD is usually diagnosed through a clinical exam and patient history, not imaging alone
- Imaging should be ordered only when it will affect care decisions
- MRI is best for soft-tissue problems
- CBCT is used for specific bone-related concerns, not routine screening
- Patients have the right to ask why an imaging test is needed and how it will help
Source: American Dental Association and American Academy of Oral and Maxillofacial Radiology patient selection for dental radiography and cone-beam computed tomography. Benavides, Erika et al. The Journal of the American Dental Association, Volume 157, Issue 1, 20 – 35.e5 https://jada.ada.org/article/S0002-8177(25)00631-2/fulltext