The Additional Information of Bitewing Radiographs in the Detection of Established or Severe Dentinal Decay in 14-Year Olds: A Cross-Sectional Study in Low-Caries Population

Aim. To reveal the additional value of radiographic bitewings (BW) in detection of caries and in comparing the occurrence of clinically undetected severe decay between 14-year olds with and without clinically observed dentinal caries in a low-caries prevalence population. Design. The cross-sectional study used 363 pairs of radiographs read by one examiner without knowledge of the clinical findings. The yield was analyzed on a tooth surface level by cross tabulating the clinical and radiographic information and on an individual level by counting the number of yield surfaces for all subjects. Mann-Whitney U test was used. Results. On a tooth surface level, the contribution of BW was the greatest on the occlusal surfaces of the first molars, where established or severe dentinal decay was registered in BW in 11% of clinically sound surfaces and in 40% of established cavitated enamel lesions. On an individual level, 53% of subjects benefited from BW. The subjects clinically DMFS > 0 benefited more than the clinically DMFS = 0 subjects (P = .004), nearly 60% in relation to 47%, respectively. Conclusions. In a low-caries prevalence population a remarkable portion of both clinically DMFS = 0 and DMFS > 0 14-year olds benefit from BW examination. Most of the benefit is obtained on the occlusal surfaces of the first and the second permanent molars.