The effect of bitewing radiography on estimates of dental caries experience among children differs according to their disease experience
Abstract
Background
Radiography 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.
Methods
A 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).
Results
Of 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.
Conclusions
Taking 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.
Comments