Navigating the maze of CBCT regulations across the U.S. can be daunting. This guide is designed to be your 3D journey companion, outlining for each state the key paperwork and registration portals that dental practices must use to remain compliant. Whether you’re updating your facility registration, submitting required forms, or ensuring proper shielding installations, the state-by-state summaries and glossary below will help you stay informed and compliant.
Glossary of Key Terms
Cone Beam Computed Tomography (CBCT): A type of dental/medical imaging scanner that uses a cone-shaped X‑ray beam to produce 3D volumetric images. CBCT units are regulated as X‑ray devices and must comply with state safety standards for equipment registration and operator training.
ALARA (As Low as Reasonably Achievable): A radiation safety principle that directs practitioners to keep exposure as far below regulatory limits as possible through optimized techniques and proper shielding.
NCRP Report No. 147: Guidance from the National Council on Radiation Protection and Measurements outlining methods for calculating required barrier thickness (e.g., lead or concrete) for X‑ray and CBCT facilities.
Shielding Plan: A detailed report that specifies the radiation shielding (e.g., lead lining) required for an X‑ray/CBCT installation; typically reviewed and approved by a qualified expert prior to installation.
Registration vs. Licensing: While the terms are sometimes used interchangeably, “registration” typically involves listing a device with the state, whereas “licensing” is a formal permission to operate radiation-producing equipment. Both processes require periodic renewal.
Inspection: A periodic evaluation by state radiation control personnel to ensure that an X‑ray/CBCT facility complies with all safety, performance, and operator credential requirements.
Dosimetry Badge: A wearable device used to monitor radiation exposure for personnel working with or near X‑ray/CBCT equipment.
Radiation Safety Officer (RSO): An individual designated to oversee a facility’s radiation protection program, ensuring that registration, operator training, shielding, and quality assurance measures are maintained.
The following table includes links for each U.S. State to the agencies and regulations relevant to CBCT installation, registration, and inspection. Then we provide a brief overview of each state's requirements and guidelines.
Table: U.S. State Resources for Dental CBCT Regulations
State | Regulatory Authority & Resources |
Alabama | |
Alaska | |
Arizona | |
Arkansas | |
California | |
Colorado | |
Connecticut | |
Delaware | |
Florida | |
Georgia | |
Hawaii | |
Idaho | |
Illinois | |
Indiana | |
Iowa | |
Kansas | |
Kentucky | |
Louisiana | |
Maine | |
Maryland | |
Massachusetts | |
Michigan | |
Minnesota | |
Mississippi | |
Missouri | |
Montana | |
Nebraska | |
Nevada | |
New Hampshire | |
New Jersey | |
New Mexico | |
New York | |
North Carolina | |
North Dakota | |
Ohio | |
Oklahoma | |
Oregon | |
Pennsylvania | |
Rhode Island | |
South Carolina | |
South Dakota | |
Tennessee | |
Texas | |
Utah | |
Vermont | |
Virginia | |
Washington | |
West Virginia | |
Wisconsin | |
Wyoming |
Summary of Requirements by State
Alabama
Dental practices must register their X‑ray equipment with the Alabama Dept. of Public Health. For dental CBCT systems (typically operating above 70 kVp), industry‐accepted practice is to use a primary barrier with at least 0.5 mm lead‐equivalent shielding and 0.25 mm in adjacent areas. Personnel whose anticipated exposure exceeds 10% of the 5‑rem annual limit must wear dosimetry badges. Inspections are performed annually with semiannual QA tests.
Alaska
All dental X‑ray equipment must be registered with the Alaska Radiation Control Program. Although Alaska does not publish separate CBCT shielding numbers, a Qualified Expert will typically recommend following federal standards (≈0.5 mm lead-equivalent primary, 0.25 mm secondary). Staff expected to exceed 0.5 rem per year must wear dosimetry badges. Annual inspections and QA evaluations are required.
Arizona
Dental CBCT systems in Arizona must be registered with the Dept. of Health Services. The Arizona Administrative Code expects that for units above 70 kVp the shielding plan—typically prepared by a Qualified Medical Physicist—follows the common standard (0.5 mm primary, 0.25 mm secondary). Personnel with projected exposures above 10% of the limit must use dosimetry badges; equipment is inspected annually with some QA aspects evaluated semiannually.
Arkansas
Arkansas requires dental radiographic equipment registration with its Dept. of Health. For dental CBCT, a shielding review by a Qualified Expert is required when updating or installing new equipment. In practice, most installations follow the standard of 0.5 mm lead-equivalent primary shielding and 0.25 mm for scatter areas. Dosimetry badges are mandatory when exposures exceed 10% of the 5‑rem limit; annual inspections and semiannual QA tests are typical.
California
California’s Radiologic Health Branch (Title 17 CCR) requires that all dental radiographic equipment be registered. For CBCT systems operating above 70 kVp, a primary barrier of at least 0.5 mm lead-equivalent shielding and 0.25 mm for adjacent areas is generally expected. Personnel whose anticipated occupational exposure exceeds 10% of the 5‑rem annual limit must wear dosimetry badges. Inspections occur annually, with quarterly or semiannual QA evaluations.
Colorado
In Colorado, dental practices must register their X‑ray equipment with the Colorado Dept. of Public Health & Environment. While no separate CBCT shielding numbers are published, Qualified Medical Physicists typically recommend using 0.5 mm lead-equivalent for primary barriers and 0.25 mm for secondary barriers. Dosimetry badges are required if staff exposure is expected to exceed 0.5 rem; annual inspections and QA tests (some semiannual) are required.
Connecticut
Connecticut mandates registration of all dental X‑ray equipment with the Dept. of Public Health. Although Connecticut’s regulations do not provide separate numeric values for CBCT shielding, facilities are expected to follow federal and manufacturer guidelines. If a staff member’s estimated exposure exceeds 10% of the occupational limit, dosimetry badges must be worn; inspections and QA tests are performed annually.
Delaware
In Delaware, all dental radiographic equipment must be registered with the Division of Public Health. For dental CBCT, while specific shielding numbers are not published, manufacturers’ recommendations (≈0.5 mm primary, 0.25 mm secondary) should be followed. Personnel expected to exceed the threshold must use dosimetry badges, and annual inspections and QA evaluations are required.
Florida
Florida requires registration of all dental X‑ray equipment via its Dept. of Health. For CBCT systems, adherence to federal standards is expected (commonly 0.5 mm lead-equivalent for primary, 0.25 mm for secondary areas). If projected occupational exposure is above 0.5 rem, dosimetry badges are mandatory; inspections are annual with routine QA tests performed.
Georgia
Georgia mandates that dental radiographic equipment be registered with the Dept. of Public Health. For CBCT units operating above 70 kVp, manufacturers’ recommendations (0.5 mm primary, 0.25 mm secondary) are generally used. Personnel with anticipated exposures above 10% of the limit must wear dosimetry badges; annual inspections and QA evaluations are required.
Hawaii
Hawaii requires dental X‑ray equipment registration with the Dept. of Health. Although specific dental CBCT shielding numbers are not published, industry practice (0.5 mm lead for primary, 0.25 mm for secondary) is followed. Staff whose exposure is projected to exceed 10% of the annual limit must wear dosimetry badges; annual inspections and QA evaluations are mandated.
Idaho
Idaho mandates registration of all dental radiographic equipment with the Dept. of Health and Welfare. For CBCT, although explicit state numbers are not provided, facilities follow manufacturer/federal guidelines (≈0.5 mm primary, 0.25 mm secondary). Dosimetry badges are required if expected exposure exceeds 10% of the occupational limit; inspections and QA tests are performed annually.
Illinois
Illinois requires registration and annual inspection of dental radiographic equipment. For CBCT units, manufacturers’ guidelines (approximately 0.5 mm lead-equivalent for primary barriers and 0.25 mm for secondary) are followed. Personnel with anticipated exposures above 0.5 rem must wear dosimetry badges; QA tests are typically conducted semiannually as part of the annual inspection cycle.
Indiana
Indiana requires dental practices to register all radiographic equipment with the Dept. of Health. For CBCT systems, while state regulations do not specify numerical shielding values, facilities are expected to follow manufacturer and federal standards. If anticipated occupational exposure exceeds 10% of the 5‑rem limit, dosimetry badges are required; inspections and QA evaluations occur annually.
Iowa
Iowa mandates registration and annual inspection of dental radiographic equipment. Although specific CBCT shielding numbers are not published in Iowa’s regulations, most facilities follow manufacturer recommendations (typically 0.5 mm for primary, 0.25 mm for scatter). Dosimetry badges are required if a staff member’s exposure is estimated above 0.5 rem; annual QA evaluations are required.
Kansas
Kansas requires that dental radiographic equipment be registered and inspected. For dental CBCT, a shielding plan review by a Qualified Expert is required. Although the state does not publish fixed numeric values, industry practice is to use 0.5 mm lead-equivalent for primary and 0.25 mm for secondary barriers. Dosimetry badges are mandatory for personnel exceeding exposure thresholds; QA testing is performed semiannually with annual inspections.
Kentucky
Kentucky mandates that dental radiographic equipment be registered with the Cabinet for Health and Family Services and inspected annually. For CBCT, while no separate state shielding numbers are published, facilities follow manufacturer/federal guidelines (≈0.5 mm primary, 0.25 mm secondary). Personnel expected to exceed 10% of the occupational dose must use dosimetry badges; annual QA testing is required.
Louisiana
Louisiana requires dental radiographic equipment registration with the Dept. of Health. For CBCT systems, manufacturers’ guidelines (usually 0.5 mm lead-equivalent for the primary barrier) are followed. If staff exposure is projected to exceed 10% of the 5‑rem limit, dosimetry badges are required; annual inspections and QA evaluations are mandated.
Maine
Maine mandates registration and annual inspection of dental radiographic equipment. Although specific dental CBCT shielding values aren’t separately provided, facilities typically follow the standard (≈0.5 mm primary, 0.25 mm secondary). Dosimetry badges are required if estimated exposures exceed regulatory thresholds; QA tests are performed annually.
Maryland
Maryland requires registration and annual inspection of all dental radiographic equipment. For CBCT units, while the state does not publish unique shielding numbers, federal guidelines are followed (generally 0.5 mm lead-equivalent for primary areas). Personnel whose anticipated exposure is above 10% of the limit must wear dosimetry badges; annual QA evaluations are conducted.
Massachusetts
Massachusetts mandates registration and annual inspections for dental radiographic equipment. For CBCT systems, facilities are expected to follow federal recommendations (≈0.5 mm lead-equivalent for primary barriers and 0.25 mm for secondary). Personnel with projected exposures above 10% of the limit must use dosimetry badges; QA evaluations occur quarterly/semiannually and at least annually overall.
Michigan
Michigan requires that dental radiographic equipment—including CBCT systems—be registered and inspected annually. According to the Michigan LEO Dental CT Shielding Guidelines, facilities should follow manufacturer specifications (typically 0.5 mm lead-equivalent for primary barriers). Personnel with potential exposures above 10% of the occupational dose must wear dosimetry badges; QA evaluations are performed annually.
Minnesota
Minnesota mandates registration and annual inspection of dental X‑ray equipment. Specific CBCT shielding values aren’t separately provided; however, facilities follow manufacturer/federal guidelines. Dosimetry badges are required if projected exposure exceeds 10% of the limit; QA testing is performed annually.
Mississippi
Mississippi requires that dental radiographic equipment be registered and inspected annually. While specific CBCT shielding values are not separately provided, standard practices (≈0.5 mm primary, 0.25 mm secondary) are followed. Personnel exceeding 10% of the occupational limit must use dosimetry badges; QA evaluations occur annually.
Missouri
Missouri mandates registration and periodic inspection of dental radiographic equipment. For dental CBCT, a radiation safety survey and shielding plan review (by a Qualified Expert) are required. Although specific state numbers aren’t published, facilities generally adopt 0.5 mm lead-equivalent primary shielding. Dosimetry badges are required when exposure exceeds 10% of the limit; QA tests are performed annually.
Montana
Montana requires registration and annual inspection of dental radiographic equipment. Specific numerical shielding values for CBCT are not published; however, manufacturers’ recommendations (≈0.5 mm primary, 0.25 mm secondary) are used. Personnel with anticipated exposure above 10% of the dose limit must wear dosimetry badges; annual QA evaluations are required.
Nebraska
Nebraska mandates that dental practices register their X‑ray equipment and undergo annual inspections. Although specific CBCT shielding values are not separately published, facilities follow manufacturer/federal guidelines (≈0.5 mm primary, 0.25 mm secondary). Dosimetry badges are required if projected exposures exceed 0.5 rem; QA tests are performed annually.
Nevada
Nevada requires registration and annual inspection of dental radiographic equipment. For dental CBCT, while specific shielding values are not separately provided, facilities adhere to industry standards (≈0.5 mm lead for primary, 0.25 mm for secondary). Personnel whose exposure exceeds 10% of the annual limit must wear dosimetry badges; annual QA evaluations are mandated.
New Hampshire
New Hampshire requires registration and annual inspection of dental X‑ray equipment. Although no separate numerical shielding values for CBCT are published, facilities are expected to follow federal standards. If projected occupational exposure exceeds 10% of the limit, dosimetry badges are required; QA evaluations occur annually.
New Jersey
New Jersey has detailed guidance for dental CBCT through its alternate Quality Assurance Program. A shielding plan must be reviewed by a Qualified Medical Physicist, with many facilities using approximately 0.5 mm lead-equivalent for primary barriers. Dosimetry badges are mandatory for personnel with exposures above 10% of the limit; Medical Physicist QC surveys are required initially and annually.
New Mexico
New Mexico requires that all dental radiographic equipment be registered and inspected annually. Although the state does not publish separate CBCT shielding numbers, facilities follow manufacturer/federal guidelines. Dosimetry badges are required if anticipated exposure exceeds 10% of the limit; QA evaluations are conducted annually.
New York
New York mandates that dental radiographic equipment—including CBCT systems—be registered and inspected annually. While the state does not list separate shielding values for CBCT, facilities generally follow federal guidelines (≈0.5 mm lead-equivalent primary, 0.25 mm secondary). Dosimetry badges are required if exposures exceed 10% of the limit; QA evaluations occur annually.
North Carolina
North Carolina requires that dental X‑ray equipment be registered and inspected annually. Specific numerical shielding requirements for CBCT are not published; however, manufacturers’ and federal standards (≈0.5 mm primary, 0.25 mm secondary) are followed. If staff exposure exceeds 10% of the occupational limit, dosimetry badges are mandated; annual QA evaluations are required.
North Dakota
North Dakota requires registration of all dental radiographic equipment with the Dept. of Health, and inspections are conducted annually. Although specific CBCT shielding values are not published, facilities follow manufacturer guidelines (≈0.5 mm primary, 0.25 mm secondary). Dosimetry badges are required if estimated exposure exceeds the threshold; QA testing is performed annually.
Ohio
Ohio mandates that dental radiographic equipment be registered and inspected. For CBCT units, while the state does not publish unique shielding numbers, facilities are expected to follow federal guidelines (≈0.5 mm primary, 0.25 mm secondary). Notably, dental inspections in Ohio are scheduled every 5 years, and personnel exceeding 10% of the annual limit must wear dosimetry badges; QA testing is performed as specified.
Oklahoma
Oklahoma requires registration and annual inspection of dental radiographic equipment. For CBCT systems, while specific shielding values are not explicitly provided, facilities follow manufacturer and federal guidelines (≈0.5 mm primary, 0.25 mm secondary). If projected exposure exceeds 10% of the occupational limit, dosimetry badges are required; annual QA evaluations are mandated.
Oregon
In Oregon, dental practices must register all X‑ray equipment and undergo annual inspections. Although state documents do not list separate dental CBCT shielding values, industry standards (≈0.5 mm primary, 0.25 mm secondary) are followed. Personnel with estimated exposures above 10% of the limit must wear dosimetry badges; QA evaluations occur annually.
Pennsylvania
Pennsylvania mandates registration and annual inspection of dental radiographic equipment. For dental CBCT, while specific shielding numbers are not separately provided, facilities follow manufacturer and federal guidelines (≈0.5 mm primary, 0.25 mm secondary). Staff exceeding 10% of the occupational exposure limit must wear dosimetry badges; annual QA evaluations are required.
Rhode Island
Rhode Island requires that dental radiographic equipment be registered and inspected annually. Although specific CBCT shielding values are not published separately, federal standards (≈0.5 mm primary, 0.25 mm secondary) are assumed. Personnel whose exposure is projected to exceed 10% of the limit must use dosimetry badges; QA evaluations occur annually.
South Carolina
South Carolina requires dental X‑ray equipment to be registered and inspected annually. For dental CBCT, while specific numerical shielding values are not provided, facilities are expected to follow federal and manufacturer guidelines (≈0.5 mm primary, 0.25 mm secondary). Personnel with anticipated exposures above the threshold must wear dosimetry badges; QA testing is performed annually.
South Dakota
South Dakota mandates that dental practices register their X‑ray equipment and participate in annual inspections. Although specific shielding values for dental CBCT are not separately detailed, manufacturers’ guidelines (≈0.5 mm primary, 0.25 mm secondary) are used. Dosimetry badges are required if projected exposure exceeds 10% of the annual limit; QA evaluations occur annually.
Tennessee
Tennessee requires registration and annual inspection of dental radiographic equipment. For CBCT systems, facilities are expected to adhere to federal standards (≈0.5 mm lead-equivalent primary, 0.25 mm secondary). Personnel exceeding 10% of the occupational dose limit must wear dosimetry badges; annual QA evaluations are required.
Texas
Texas mandates that all dental radiographic equipment be registered and inspected annually. For CBCT units, while Texas does not publish separate shielding numbers, manufacturers’ guidelines (≈0.5 mm primary, 0.25 mm secondary) are followed. If staff exposure is expected to exceed 10% of the annual limit, dosimetry badges are required; comprehensive QA testing is performed annually.
Utah
Utah requires that dental radiographic equipment be registered and inspected annually. Specific numerical shielding requirements for CBCT are not separately published; however, facilities follow manufacturer and federal guidelines (≈0.5 mm primary, 0.25 mm secondary). If anticipated exposure exceeds 10% of the limit, dosimetry badges must be worn; QA evaluations occur annually.
Vermont
Vermont mandates registration and annual inspection of dental radiographic equipment. Although specific CBCT shielding values are not separately detailed in state regulations, facilities typically follow federal standards (≈0.5 mm primary, 0.25 mm secondary). Personnel exceeding 10% of the occupational limit must wear dosimetry badges; annual QA evaluations are required.
Virginia
Virginia requires that dental radiographic equipment be registered and inspected annually. For CBCT systems, while specific shielding numbers are not published separately, facilities are expected to follow federal guidelines (≈0.5 mm for primary barriers, 0.25 mm for secondary). Dosimetry badges are required for personnel with projected exposures above 10% of the limit; annual QA evaluations are mandated.
Washington
Washington mandates registration and annual inspection of dental radiographic equipment. Although the state does not publish separate shielding values for dental CBCT, facilities follow federal recommendations (≈0.5 mm primary, 0.25 mm secondary). Personnel whose exposure is projected to exceed 10% of the occupational limit must wear dosimetry badges; QA evaluations are performed annually.
West Virginia
West Virginia requires registration and annual inspection of dental radiographic equipment. Specific dental CBCT shielding values are not published separately; instead, facilities use manufacturer/federal guidelines (≈0.5 mm primary, 0.25 mm secondary). Personnel exceeding 10% of the dose limit must wear dosimetry badges; QA evaluations are performed annually.
Wisconsin
Wisconsin mandates registration and annual inspection of dental radiographic equipment. For CBCT systems, although state-published shielding numbers are not provided separately, facilities follow the standard (≈0.5 mm lead-equivalent primary, 0.25 mm secondary). Personnel with anticipated exposures above 10% of the annual limit must use dosimetry badges; QA testing is conducted annually.
Wyoming
Wyoming requires dental practices to register their X‑ray equipment and participate in annual inspections. Although specific dental CBCT shielding values are not published separately, facilities follow manufacturer/federal guidelines (commonly 0.5 mm primary and 0.25 mm secondary). Personnel expected to exceed 10% of the dose limit must wear dosimetry badges; QA evaluations occur annually.
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