Systems, devices, and methods are described for providing, among other things, an intra-oral x-ray imaging system configured to reduce patient exposure to x-rays, reduce amount of scatter, transmission, or re-radiation during imaging, or improve x-ray image quality. In an embodiment, an intra-oral x-ray imaging system includes an intra-oral x-ray sensor configured to communicate intra-oral x-ray sensor position information or intra-oral x-ray sensor orientation information to a remote x-ray source.