Requirements for supplemental periapical radiographs following No. 0 and No. 2 bite-wings.

The purpose of this study was to determine the need for supplemental periapical radiographs in planning restorative services and pulp treatment for primary molars when a child’s bite-wing radiographs were taken with No. Oor No. 2-size film. Forty-eight good quality bite-wing radiographs were selected from patients 5-7 years of age and sorted into four groups containing 12 films classified according to film size (No. 0 or No. 2) and caries severity (minfmal severe). Six dentists independently read the films on two occasions under standard viewing conditions. They were asked to indicate whether additional periapical radiographs would be needed to plan treatment for the child’s primary molars. The results revealed a highly significant interaction between film size and caries severity in determining the need for supplemental periapical radiographs. Children with severe caries whose bite-wing radiographs were taken with No. 0 film required significantly more periapical radiographs than did the other two groups. When a child’s cooperative ability permits, bite-wing radiographs should be exposed using No, 2 film -especially when extensive carious lesions are noted in the primary molars. This protocol will minimize the need to expose supplemental periapical radiographs.. A bite-wing examination is the most frequently performed radiographic examination for children2 Bitewing radiographs are the most accurate means presently available to detect interproximal carious lesions in children2 -3 Concerns about the potential harmful effects of low-dose ionizing radiation make it imperative that dentists obtain the maximum diagnostic in* Portions of this manuscript were presented at the 62nd IADR/ AADR Annual Session, March, 1984, in Dallas, Texas. DDS, MS Ronald A. Bell, DDS, MEd formation with every exposure. 4-5 Guidelines offered by the American Dental Association and the American Academy of Pediatric Dentistry prescribe that radiographs be exposed only as indicated by the findings of a clinical examination, however, these guidelines do not offer functional suggestions for common clinical situations. 6,7 Bite-wing radiographs can be made with No. 0, No. 1, or No. 2 films. 8 The No. 0 film is popular for children because of its small size. The purpose of this study was to determine the need for supplemental periapical radiographs to plan treatment for primary molars when bite-wing radiographs were taken with No. 0 or No. 2 films.