The objective of this study was to assess the capability of graduating dental students to identify the causes of undiagnostic panoramic images and to interpret anatomic landmarks on panoramic films. Seventeen dental schools were represented by 311 students. A radiology faculty member at each institution completed a questionnaire that addressed lecture time and experience provided to students in panoramic radiography. The faculty member administered a test instrument comprised of several panoramic radiographs that demonstrated one or more labeled anatomic structures, technical errors, or projection artifacts and multiple choice questions that addressed each entity. The mean percentage correct for the tested population on the entire test instrument was 72.9%. The mean percentage correct for questions addressing anatomy, error and artifact recognition, and error correction was 84.0%, 61.4% and 45.2%, respectively. Factors that significantly (p < 0.05) affected student performance were the number of lecture hours provided, whether or not students took panoramic radiographs of patients, and the method of student selection as participants. Laboratory or self-study projects and the number of panoramic radiographs (> or = 1) taken of patients did not significantly affect student performance on the test instrument.