The effect of bitewing radiography on estimates of dental caries experience among children differs according to their disease experience

Abstract

BackgroundRadiography is a regularly used and accepted adjunct to visual examination in the diagnosis of dental caries. It is assumed that not using radiographs can lead to underestimation of dental caries experience with most reports having involved studies of young adults or adolescents, and been focused on the permanent dentition. The aim of this study was to determine the relative contributions of bitewing radiography and clinical examination in the detection of dental caries in primary molars and to determine whether those contributions differ according to caries experience.MethodsA cross-sectional study was conducted, involving examinations undertaken in dental clinics. Bitewing radiographs taken at the time of the clinical examination were developed and read later, with the data from those used at the analysis stage to adjust the caries diagnosis for the mesial, occlusal and distal surfaces of the primary molar teeth. Children’s clinically determined dmfs score was used to allocate them to one of three caries experience groups (0 dmfs, 1–8 dmfs, or 9+ dmfs).ResultsOf the 501 three-to-eight-year-old children examined, nearly three-quarters were younger than six. Caries prevalence and mean dmfs after clinical examination alone and following radiographs were 63.1% and 4.6 (sd, 6.2), and 74.7% and 5.8 (sd, 6.5) respectively. Among children with a dmfs of 1–8, the number of lesions missed during the clinical examination was greater than the number of 106 (25.6%) in children with a dmfs of 9+. In the 185 children with no apparent caries at clinical examination, 124 lesions were detected radiographically, among 58 (46.8%) of those.ConclusionsTaking bitewing radiographs in young children is not without challenges or risks, and it must be undertaken with these in mind. Diagnostic yields from bitewing radiographs are greater for children with greater caries experience. The findings of this study further support the need to consider using bitewing radiographs in young children to enhance the management of lesions not detected by a simple visual examination alone.Trial registrationACTRN12614000844640.

Degree of Concordance Between Cone Beam Computerized Tomography (Cbct) And 2d Digital Radiography System Used for Caries Diagnosis: An Observational Study

“…The Open Dentistry Journal, 2023, Volume 17 7 One of the characteristics of our sample was that it was mostly composed of incipient caries lesions, which generated little variability in the data, an aspect that made it difficult to achieve a higher degree of agreement.…”

“…Interproximal caries is difficult to diagnose due to its location below the contact zone which prevents visualization. The indicated method for this is bitewing radiography, which is more sensitive than visual inspection [7], however, for occlusal caries to be detected with a bitewing radiograph, the lesion must have affected the middle third of the dentin [8].…”

Prescription of bite-wing and panoramic radiographs in pediatric dental patients

“…1 Imaging of interproximal surfaces provides dentists with a tool for indirect visualization that can assist with the detection of dental caries that may be otherwise overlooked from a clinical exam alone. 2 Previous studies have shown that clinical examination without the use of radiographic imaging can lead to a significant underestimation of caries detection. 2 The American Dental Association (ADA) guidelines for dental radiographic examinations state that bitewing examination is the most effective means for detecting carious lesions located on interproximal surfaces.…”

“…2 Previous studies have shown that clinical examination without the use of radiographic imaging can lead to a significant underestimation of caries detection. 2 The American Dental Association (ADA) guidelines for dental radiographic examinations state that bitewing examination is the most effective means for detecting carious lesions located on interproximal surfaces. 3 Dentists generally begin prescribing bitewings for pediatric patients once the posterior mesiodistal contacts are closed and they are unable to directly visualize the interproximal surfaces of primary dentition.…”

Ultrastructure and properties of primary carious molars treated using the Hall Technique

“…The premature loss of teeth also has profound consequences in terms of eating, speaking, and social behaviour in general 2 . In the primary dentition, molar teeth are most frequently affected by carious lesions, and in some populations, the proximal surfaces are the most commonly affected 3 . The standard treatment methods for caries involve non‐invasive and invasive approaches.…”