Dental Imaging Utilization, Cumulative Exposure and Radiation Dose Patterns in CBCT-Referred Children and Adolescents: A Retrospective Audit

Background: Optimizing radiographic use in children is essential to balance diagnostic benefit against radiation risk. This audit evaluated imaging utilization, cumulative exposure, and adherence to justification principles among CBCT-referred children and adolescents. Methods: A retrospective audit was conducted within Dubai Health, including 149 children aged 5–17 years identified through CBCT examinations performed during a one-year retrieval period (January–December 2025), whose complete historical dental imaging records were reviewed. Data included modality, frequency, inter-examination intervals, cumulative exposure, radiation dose metrics, and clinical justification. Descriptive statistical analysis was performed. Results: A total of 839 examinations were analyzed across five examinations. OPG was most frequent (n = 231), followed by BW (n = 200), IOPA (n = 167), CBCT (n = 158), and CEPHALO (n = 83). IOPA demonstrated the highest frequency and variability, including repeated short-interval imaging, whereas CBCT and CEPHALO were infrequent and rarely repeated. A clear dose hierarchy was observed (CBCT >> OPG > CEPHALO), with CBCT showing greater variability. Justification rates were high, particularly for CBCT and BW (100%), while OPG was lower (88.3%). A small subset exhibited higher cumulative imaging (up to ~19 examinations), increasing with age. Conclusions: Among CBCT-referred children and adolescents, imaging practices demonstrated strong adherence to indication-based use. These findings should be interpreted within the context of a CBCT-referred cohort and may not be generalizable to all pediatric dental patients.