An Update on Bitewing Radiography Technology

Category: Radiology and Digital Imaging, Digital Imaging (CBCT/CBVT), Digital Imaging (Extraoral)
Author(s): Brad Potter, DDS, MS
Target Audience: Dental Assistants, Dental Hygienists, Dentists
Course Topic: Radiography
Cost: $29.00
ADA Credits: 2
AGD Credits: 2

The discovery of X-rays by Röntgen, and early work by dentists, including Dr. C. Edmund Kells, led to significant developments and improvements over time in the ability of clinicians to diagnose medical and later dental conditions. Since these early developments, advances in oral radiography have resulted in a wide range of diagnostic options and improved capabilities for the detection of pathological lesions and other anomalies.

Educational Objectives

The overall goal of this article is to provide the reader with information on the use of radiography for caries detection. On completion of this article, the participant will be able to:

  1. Review the types of oral radiographs used for caries detection
  2. Define sensitivity and specificity
  3. Contrast and compare the methodology and results for radiographic caries detection
  4. List and describe the methods by which radiation exposure is reduced as well as the relative radiation exposure with different radiographic methodologies for caries detection


Unfortunately, dental caries continues to be a primary oral health issue, which requires a comprehensive consideration of caries risks, preventative oral health care by the patient and dental professional, and a series of clinical techniques to determine the presence and extent of caries involvement. Total patient care requires radiographic assessment of dental disease and is considered an essential tool in this assessment. Bitewing radiographs remain the primary diagnostic image for intraoral caries assessment with periapical imaging and extraoral imaging being used as adjunctive tools. Both film-based and digital intraoral bitewing images continue to provide the necessary resolution and evidence-based accuracy for diagnosis, while extraoral techniques require further study.