Caries Lesion Diagnosis: Bitewing Radiography

For much of the last century, the conventional method for caries detection and treatment planning in dentistry relied on a combination of visual, tactile, and radiographic assessments.^37,39 The difficulty of detecting proximal lesions at an early stage through clinical examination resulted in the increased use of radiographic exams, particularly bitewing radiographs.⁸ Bitewing radiographs help detect lesions that are hidden from a clinical visual examination, such as when a lesion is hidden by an adjacent tooth, as well as help the dental professional estimate how deep the lesion is.¹¹ However, the American Dental Association (ADA) in 2024 published evidence-based recommendations focusing on radiation safety, the use of appropriate imaging techniques, and strategies for minimizing radiation exposure.⁴¹ Digital radiography is replacing radiography based on film due to the advantage of being more efficient as well as using a lower radiation dose.^11,40,41 It also does not require wet chemicals in the processing of the image.^11,40