These updates directly affect dental practices using x-ray or CBCT equipment. Fines for non-compliance are now fixed, and enforcement will be more consistent across the city. It is every dentist’s responsibility to ensure their practice is fully up to date before any inspection occurs.

• Standardized Fines: The Health Department has set clear, fixed amounts for violations. Most fines will range from $500 to $1,000 per incident. If you do not respond to a summons, the penalty will automatically double.
• Applies to Dental X-ray and CBCT: If your practice uses dental x-ray or cone beam CT (CBCT) units, you must follow all safety, maintenance, and quality assurance guidelines. The new penalty schedule specifically lists violations related to dental radiography.
• Record Keeping is Essential: You are required to keep detailed records of equipment maintenance, quality assurance checks, and radiation dose measurements. Missing or incomplete records can result in fines.
• Qualified Personnel Only: Only staff who are properly licensed and trained may operate dental x-ray equipment. Allowing unqualified individuals to use this equipment is a violation and subject to penalties.
• Equipment Maintenance: Make sure all x-ray equipment is in good working order. Issues like missing safety features, unsecured parts, or faulty exposure controls are now clearly defined as violations.

• Most dental offices need just one permit to cover all their standard dental x-ray machines.
• 3D units (CBCT), require a separate permit due to their classification—even though they are technically not as dangerous as medical CTs.
• Permits are not transferrable. If you sell or dispose of a machine, you must cancel the permit using a disposition form (available from the Health Department at orh@health.nyc.gov) and inform the city who is taking the machine.
• If you add a new machine, it must be inspected within a few weeks of installation.

• Before anyone is allowed to take x-rays, they must receive training covering at least 5-6 core topics, such as x-ray tube positioning, image processing, operator safety, radiation protection, radiographic protocols, and regulatory requirements.
• Every x-ray operator must have a documented evaluation each year, and these records must be kept on file for inspection.

• Every facility must have a copy of Article 175, the CRESCO report, the current permit posted, and documentation of all training and evaluations available for inspection.

• Review your compliance with all radiation safety, permit, and recordkeeping requirements.
• Make sure all staff operating x-ray equipment are properly trained and, if required, certified.
• Ensure all documentation, permits, and required postings are up to date and accessible.
• Schedule inspections for any new equipment as soon as possible.