Radiographic Examination of the Recall Patient

Bitewing radiography, primarily for the purpose of detecting interproximal caries, is the only time-based type of radiographic examination included in the guidelines. The recommended intervals are based on research regarding the rate of caries progression through tooth structure and factors that indicate the patient may be at increased risk for caries. Risk factors associated with caries development include poor oral hygiene, high frequency sucrose exposure, and low fluoride intake. The ADA provides further information on caries risk in their document, Caries Risk Assessment and Management,24 and assessment form resources are available to facilitate risk determination in children, Caries Risk Assessment Form (Age 0-6)25 and Caries Risk Assessment Form (Age >6).26

Table 3 summaries the radiographic recommendations for recall patients with clinical caries or those who are at increased risk for caries. In addition, the recall patient who presents with no clinical caries or who is at low risk for caries is also addressed.

Table 3. Radiographic Examination of the Recall Patient Based on Caries Risk.1
Recall Patient Recommendations Based on Caries Risk
Recall Patient Child with Primary Dentition Child with Mixed Dentition Adolescent with Permanent Dentition Adult Dentate Partially Dentate Adult Edentulous
With Clinical Caries or Increased Caries Risk Bitewings at 6 to12 month intervals if contacts are closed Bitewings at 6 to12 month intervals if contacts are closed Bitewings at 6 to12 month intervals if contacts are closed Bitewings at 6 to18 month intervals Not Applicable
With No Clinical Caries or Low Caries Risk Bitewings at 12 to 24 month intervals if contacts are closed Bitewings at 12 to 24 month intervals if contacts are closed Bitewings at 18 to 36 month intervals Bitewings at 24 to 36 month intervals Not Applicable