Adult Dentate Patient
Like other new patients in this category, adult dentate or partially edentulous patients need to be evaluated for proximal and recurrent carious lesions as caries risk and their associated risk factors may change over time. Posterior bitewings can be used for this purpose (Figure 3).
Figure 3. Posterior Bitewing Radiographs
Periodontal disease and root caries increase with age.1,20,21 Previous experience with periodontal disease and its treatment are important to explore if the new adult patient does not present with signs or symptoms of active disease.1 Selected intraoral imaging may be necessary to assess the patient’s current periodontal status.
Panoramic imaging may be useful in conjunction with posterior bitewings if periapical pathosis or unerupted teeth are suspected, partially erupted teeth are observed, carious lesions are present or clinical facial swelling is evident.22
In summary, an individualized radiographic examination comprised of posterior bitewings and selected periapical images or posterior bitewings and a panoramic image are recommended when indicated. If the patient presents with clinical evidence of generalized oral disease or a history of extensive dental treatment, a full mouth survey is preferred (Figure 4).
Figure 4. Full Mouth Series of Radiographs