Bitewing radiographs are indicated primarily to detect or monitor interproximal caries if the proximal surfaces of the teeth cannot be visually or tactilely examined. Occlusal caries, crestal alveolar bone level and secondarily for eruption patterns, caries and restoration proximity to pulp spaces, primary molar furcation pathology and developmental anomalies may also be detected with bitewing radiographs. The frequency of bitewing radiographic examination is based on caries risk assessment. As the risk status may change over time, the radiographic recall interval may change. A patient with a high caries risk assessment will require bitewing radiographs more frequently (every 6 months) than a patient with a low caries risk assessment (12-24 months). Orientation of the film packet may be vertically or horizontally positioned. Placement of the film packet reveals the coronal halves of the maxillary and mandibular teeth, interproximal contacts and portions of the interdental septa, beginning at distal of the canine and proceeding posteriorly to the mesial half of the last erupted molar. One to two films may be necessary depending on the tooth and jaw size.
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