The implementation of an X-ray Quality Assurance (QA) program is a legal requirement in Europe as stipulated in the EU Council Directive 97/43/EURATOM (MED). A review of the literature has identified that European countries are performing some level of QA testing of their dental X-ray equipment, although the type and level to which testing is performed can differ. The European SENTINEL co-ordination action proposed to collate a survey of equipment data for both conventional and digital dental X-ray installations among the SENTINEL partners. The European QA results confirm that systems can be operated below tolerance, and in some cases significantly so, while still in clinical use. This can occur despite servicing of equipment. The results have emphasised the fact that there is a requirement for the medical physics/engineering professions to become more closely involved in the management of dental radiology equipment. This also includes their involvement in the development and delivery of appropriate training courses for dentists and suppliers of dental radiology equipment.