Do I have to get a panoramic X-ray?

Yes, a panoramic image is the basic diagnostic record that shows all of your teeth plus the supporting bone, the jaw joints, impacted wisdom teeth, and lesions inside the jawbone in a single view. Bone loss, inflammation at a root tip, and cysts cannot be seen by eye and are difficult to detect without it. It is essential in particular 1) before surgery such as an implant or an extraction, 2) to check the position of wisdom teeth, and 3) to diagnose gum disease. The dose is only about 0.01 to 0.02 mSv, comparable to everyday background radiation, so the burden is small.