Dental practitioners in the United States are exposing more than 400 million dental radiographs per year. Major national studies have indicated that improvements in radiographic quality is needed. Quality assurance (QA) programs used in medical radiology are designed to produce radiographs that are of high quality, use the least amount of radiation, and are produced at minimum cost. Preliminary recommendations are presented from the Quality Assurance Committee of the American Academy of Dental Radiology as an outline for establishing preventive maintenance of x-ray systems and a preliminary method for determining appropriate QA monitoring levels for dentistry. Included are recommendations for three stages of dental radiology QA. These are preliminary ratings and are expected to change as more dental QA information becomes available.