Child with Transitional Dentition

For new patients with a mixed or transitional dentition, it is important to consider risk factors for dental caries. Caries incidence varies among children and higher caries patterns are associated with some racial and ethnic groups and lower-income families.^1,18,19As such, posterior bitewings are indicated (Figure 1).

Figure 1. Child Bitewing Survey.

Although atypical, if clinical evidence of periodontal disease is observed in this age group, selected periapicals and bitewing radiographs are indicated to determine the extent of periodontitis and alveolar bone involvement.

Periapical or panoramic imaging is useful for the purposes of evaluating tooth development. Panoramic imaging also is useful to assess craniofacial trauma. Intraoral imaging is preferred over panoramic imaging in the evaluation of dentoalveolar trauma, root shape, root resorption and pulpal pathosis.

Occlusal imaging may be used independently or in combination with panoramic imaging in the following situations:

• an unsatisfactory panoramic image is due to an abnormal incisor relationship.

• for localization of tooth position.

• the clinical examination provides a reasonable expectation of pathosis.