Bitewings – An Essential Diagnostic Tool


Bitewings are indispensable diagnostic tools for detecting dental caries and gum disease. Their noninvasive nature enables you to keep a close watch on your oral health while warding off potentially life-threatening infections. What do you consider about رادیوگرافی دنداپزشکی.

To assess the reliability of horizontal and vertical bitewing images for caries and furcation detection, intra-observer and inter-observer kappa coefficients were computed.

Diagnostic X-rays

Bitewings provide a more focused view of each tooth’s crown in a tiny area of the mouth. They can detect decay between teeth and detect changes to bone density caused by gum disease; additionally, they allow dentists to assess dental restoration fit as well as existing filling conditions more accurately.

Digital bitewing radiographs emit far less radiation than film radiographs and should, therefore, be considered safer. However, since fetuses remain susceptible to radiation exposure from either type of radiograph, dentists should only employ bitewings when essential – for instance, at 6-month recall visits for ongoing gum disease cases.

Horizontal overlap is the most frequently seen error when exposing bitewings. It occurs when adjacent premolar cusps don’t line up nearly perfectly on a radiograph. This usually results from improper detector placement or horizontal angulation, which can usually be achieved by moving either the tube head or receptor-holding device closer to the mesial or distal position on its base.

Other types of X-rays a dentist might order are panoramic radiographs, periapical radiographs, and more advanced 3D cone beam computed tomography (CBCT). CBCT offers more comprehensive views of teeth and associated structures in the mouth than bitewings do.

Preventive X-rays

Bitewing X-rays offer dentists a fast and efficient method for inspecting the surfaces of your teeth. By showing both upper and lower sides in one view, bitewings enable dentists to easily spot cavities between your teeth as well as damage caused by gum disease or bone loss, detect cavities between your teeth as well as detect recurrent decay or existing fillings or crowns that need maintenance, as well as detect cavities between fillings or crowns that need to be addressed immediately.

If a dental cavity (commonly referred to as dental caries) is detected early and isolated to its outer enamel layer, it may be reversed with fillings. Once it spreads beyond this barrier, however, only root canals and tooth extraction may provide any real hope of stopping its progress, and in many instances, these more aggressive measures may become necessary if caught late enough.

To prevent dental caries from spreading, bitewing X-rays must be conducted at least annually. While the frequency may depend on factors like your age and risk for dental issues, it should occur as often as possible. Modern high-speed X-ray technology uses optimized collimation to decrease radiation exposure while increasing accuracy, providing a win-win solution between you and your dentist.

Early Detection of Dental Caries

Dental caries (tooth decay), commonly referred to as tooth decay, is a widespread and persistent disease in which bacteria cause tooth enamel to gradually break down over time, leading to infections and the possible loss of your teeth if left untreated. If caught early enough with bitewings by your dentist, they may be able to remove infected parts and install fillings before they reach inner layers where symptoms arise, such as pain.

Traditional methods for diagnosing proximal and inter-proximal caries lesions were visual and tactile examinations. However, these methods can be time-consuming and subject to variation between examiners, making accurate diagnoses difficult to achieve.

Bitewing radiographs have proven themselves an invaluable diagnostic tool for the early diagnosis of caries. Their higher sensitivity compared to periapical radiographs allows for earlier detection of early carious lesions on proximal surfaces as well as histological diagnosis (MID). Radiographs also allow dentists to quickly and accurately assess lateral caries and restorer quality with bitewing radiographs, with bitewing holders increasing accuracy for caries detection and long-term monitoring of lesions. Research conducted has utilized pre-trained CNN models converted into deep learning architecture to detect dental caries within bitewing images.

Prevention of Gum Disease

Bitewings are unique x-rays in that they provide a view of both upper and lower teeth simultaneously, making them the ideal way to detect decay between the teeth, new or recurrent cavities under existing fillings, bone loss due to periodontal disease, and any bone loss from periodontal treatment. Early detection helps avoid severe toothaches and costly therapies.

Caries often begin in the enamel layer, but left untreated, they can penetrate the dentin and nerves to cause significant pain. Bitewing X-rays help detect early dental caries before more intensive procedures such as dental fillings or root canal therapy are needed.

In recent years, we have witnessed an improvement in panoramic X-ray quality, enabling dentists to view critical tooth structures and anatomy with far less radiation exposure. By employing the SCARA movement of their X-ray machines and opening contacts on sensors, manufacturers like Planmeca have created systems that produce high-quality panoramic bitewing images – and can, therefore, be used as an alternative to intraoral bitewings, thereby decreasing patient discomfort while decreasing unnecessary exposure to X-rays.