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Continuing Dental Education

Mastering Intraoral and Panoramic Radiographic Techniques and Interpretation – part 1 – a live webinar

UW Oral Radiology Faculty - Drs. Peggy Lee and Andrew Nalley

lecture icon Lecture

Part 1 - April 22 and Part 2 - May 20


Course Description

Dental radiography involves the use of ionizing radiation and thus it is essential that all dental personnel maintain knowledge of radiographic techniques and radiation safety to perform clinical procedures.

This course will review current knowledge of radiation safety, ALARA principle and protection as well as dose reduction technique as well as digital sensor usage. Proper use of handheld portable X-ray device (Nomad) will be discussed. We will review sensor and tube head placement technique and allow time for progressive self assessment throughout the course.

This course will also review concepts of panoramic radiography. We will discuss problems commonly associated with panoramic technique and review steps for positioning a patient for panoramic radiography. This part of the course will focus on common errors that are often seen on the panoramic image which decrease the diagnostic quality and provide solutions on how to correct these errors. Examples of how position errors affect image interpretation will be discussed.

Course Objectives

As a result of attending this class, you will be able to:

  • Know the myths and facts of cancer related to dental radiographs
  • Know how to limit radiation dose to patients and personnel
  • Use digital sensor positioners and adapt sensor placement to improve patient comfort
  • Perform infection control procedures
  • Evaluate the images for diagnostic quality and learn how to correct the errors.
  • Apply techniques to eliminate cone cut, overlapping, elongation and foreshortening
  • Determine when it is necessary to re-take a radiograph
  • Know the correct indications for use of handheld devices and use handheld portable X-ray device (Nomad) correctly
  • Interpret pathology presented in the intraoral radiographs
  • Understand how panoramic radiograph principles affect image presented
  • Avoid common position errors and be able to correct these errors if they occur.
  • Understand how position errors may mimicking or obscure pathology
  • Identify frequently overlooked structures presented in the panoramic radiographs
  • Detect, and understand the limitation of, sinus and TMJ pathology presented in panoramic radiographs

Course Outlines

Part 1 (Saturday, April 22, 2023; 8:30am-12:00pm) Intraoral 2D radiography

    • 8:30- 9:20. Limiting Radiation Dose to patients and personnel- why and how
    • 9:30 — 9:55 Sensors- advantage and limitations. Infection controls. Common sensor artifacts
    • 10:00 – 10:25 Common errors in intraoral radiographs- when to retake and how to correct mistakes
    • 10:30- 11:00 Hand Held Portable X Ray device (Nomad) – myth and facts.
    • 11:05- 11:30 Intraoral radiographs interpretation – pathology.
    • 11:30- 12:00 Summary and Discussion

    Part 2 (Saturday, May 20, 2023; 8:30am-12:00pm) Panoramic Radiographs

    • 8:30- 9:00 Understanding principles that affect image presentations
    • 9:05- 10:00 Correct patient positioning. Frequent technical errors.
    • 10:05- 10:30 How technical errors mimicking/obscure pathology
    • 10:40- 11:10 Frequently overlooked findings
    • 11: 15- 11:30 Assessing TMJ Pathology
    • 11:35 – 12:00 Summary and Discussion


Dr. Peggy LeePeggy Lee is the head of the oral radiology division at the UW Dental School. Dr. Lee has a broad background in both clinical and basic science. After graduating from dental school, she completed her M.S.D. in Oral Medicine at UW. She earned her Ph.D. in the Department of Microbiology at the UW Medical School studying HIV, followed by postdoctoral research in immune system development.

Dr. Lee returned to the UW Dental School in 2004 to teach radiology and re-focused her research on clinical and translational studies. She was instrumental in developing the Oral Radiology Residency program at the UW and now serves as program director. In addition to training radiology residents, she also teaches radiology (including 2D and 3D imaging) for predoc dental students and specialty graduate students.

Dr. Lee has carried out multiple research projects on subjects including TMD, appropriate usage of screening radiographic examination, and sleep apnea. More recently, she has collaborated with the ultrasound engineer to study applications of ultrasound imaging including identifying thin cortical bone related to orthodontic treatment, 3D ultrasound to monitor changes in masticatory muscle after Botox treatment for TMD pain patients, and fusion 3D ultrasound with CBCT images for nerve imaging. She also had a research grant, in collaboration with the UWMC Diagnostic Imaging Sciences Center, applying functional MRI to identify brain activity markers associated with chronic TMD pain.

Dr. Lee has been a member and officer of the IADR Diagnostic Science Group, the AAOMR Research and Technology Committee, and currently serves on the Research Advisory Committee at University of Washington School of Dentistry. She is a reviewer for Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, JADA, and the Journal of Dentomaxillofacial Radiology. Dr. Lee has published numerous peer-reviewed articles and has given presentations at national and international conferences, continuing dental education courses, and study clubs on CBCT applications in implant planning and oral facial disorders.

Dr. Andrew NalleyAndrew Nalley originally grew up in Houston, Texas where he also received his degree at the University of Texas School of Dentistry. Upon graduating, he joined a private practice for 5 years, where he utilized CBCT and developed an increasing interest in the field of radiology. To pursue his passion, Dr. Nalley moved to Seattle to attend the Oral and Maxillofacial Radiology residency program at the University of Washington. He is currently working on his research on TMJ findings on CT and MRI in hopes to expand the knowledge surrounding TMJ. After completing residency, he stayed on as faculty as the dental radiology clinic director at the University of Washington. Although Dr. Nalley’s passion remains in radiology, he also loves general dentistry and works part time at a private practice in the Seattle area. Outside of dentistry and radiology, Dr. Nalley enjoys spending time outdoors, hiking, and photography.


  • The staff of the University of Washington Office of Continuing Dental Education have no relevant financial relationships to disclose.

Course Logistics

Saturday, April 22, 2023 (part 1) and Saturday, May 6, 2023 (part 2)

Zoom live webinar

The whole dental team

Course: 9:00am – 12:00pm

TUITION for April 22, and then again for May 20:
$79/Team members (dental hygienist, dental assistant, office staff)
$116/Current Dental Alumni Member

* This course is eligible for a 10% tuition discount if you are a current member of the UW Dental Alumni Association.

3 hours


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The University of Washington is an ADA CERP Recognized Provider.
ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.

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The University of Washington is a member of the Association for Continuing Dental Education.

University of Washington designates this activity for 3 continuing education credits.