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The value of bitewing radiographs in the management of carious primary molars - the impact on treatment planning

British Dental Journal (2023)Cite this article

Abstract

Introduction Bitewing radiographs (BWs) with visual examination (VE) are critical for the early detection of caries in primary molars. However, their influence on treatment planning is not extensively studied. Given they involve exposure to ionising radiation, it is essential to understand their impact on treatment decisions.

Aim To explore the impact of BWs in the management of carious primary molars.

Design Cross-sectional study.

Materials and methods A total of 30 children (mean age 6.2 years) referred for caries management in a dental hospital setting were recruited. One of six paediatric dental specialists performed VEs and scored pre-BW treatment needs (TN) for each primary molar, followed by reviewing the BWs, re-scoring TN and recording their opinion on treatment modality. Data were assessed using descriptive analyses. Five treatment planning descriptors detailing the reasons for change were identified.

Results In total, 240 primary molars were examined. BWs resulted in an overall change in treatment plan for 24/30 (80.0%) children, with the majority (20/30; 66.7%) becoming more invasive. General anaesthesia was the commonest proposed modality (13/30; 43.3%) children), followed by inhalation sedation (10/30; 33.3%) and local anaesthesia (6/30; 20.0%), with only one child (3.3%) in the ‘no analgesia' modality.

Conclusion BWs play an important role in treatment planning carious primary molars.

Key points

  • Describes the impact of bitewing radiographs on treatment planning of carious primary molars.

  • Discusses the effect of different treatment modalities on overall treatment plan.

  • Explores the possible treatment planning descriptors behind the changes to the treatment plan pre- and post-bitewings.

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References

  1. Leal S C. Minimal intervention dentistry in the management of the paediatric patient. Br Dent J 2014; 216: 623-627.

  2. Scottish Dental Clinical Effectiveness Programme. Prevention and Management of Dental Caries in Children. 2018. Available at https://www.sdcep.org.uk/media/2zbkrdkg/sdcep-prevention-and-management-of-dental-caries-in-children-2nd-edition.pdf (accessed October 2023).

  3. Taylor G K, Macpherson L M. An investigation into the use of bitewing radiography in children in Greater Glasgow. Br Dent J 2004; 196: 563-568.

  4. Templeton A R, Young L, Bish A et al. Patient-, organisation-, and system-level barriers and facilitators to preventive oral health care: a convergent mixed-methods study in primary dental care. Implement Sci 2016; 11: 5.

  5. Maguire A, Clarkson J E, Douglas G V et al. Best-practice prevention alone or with conventional or biological caries management for 3to 7yearolds: the FiCTION three-arm RCT. Health Technol Assess 2020; 24: 1-174.

  6. Faculty of General Dental Practice UK. Selection Criteria for Dental Radiography. Available at https://cgdent.uk/selection-criteria-for-dental-radiography/ (accessed June 2023).

  7. Public Health Scotland. National Dental Inspection Programme (NDIP) 2022: Report of the 2022 Basic Inspection Programme of Primary 1 Children. 2022. Available at https://ndip.scottishdental.org/wp-content/uploads/2023/02/national-dental-inspection-programme-2022-10-25.pdf (accessed June 2023).

  8. Anwar A, Keightley A J, Roebuck E M, Turner S. The value of bitewing radiographs in the management of carious primary molars. Br Dent J 2021; 231: 575-579.

  9. Finucane D. Rationale for restoration of carious primary teeth: a review. Eur Arch Paediatr Dent 2012; 13: 281-292.

  10. Pontes L R, Novaes T F, Lara J S et al. Impact of the radiographic method on treatment decisions related to dental caries in primary molars: a before-after study. Clin Oral Investig 2019; 23: 4075-4081.

  11. Leal S C, Barros B V, Cabral R N, Ferrari J C, de Menezes Abreu D M, Ribeiro A P. Dental caries lesions in primary teeth without obvious cavitation: Treatment decision-making process. Int J Paediatr Dent 2019; 29: 422-428.

  12. Diniz M B, Lima L M, Eckert G, Zandona A G, Cordeiro R C, Pinto L S. In vitro evaluation of ICDAS and radiographic examination of occlusal surfaces and their association with treatment decisions. Oper Dent 2011; 36: 133-142.

  13. Jablonski-Momeni A, Stucke J, Steinberg T, Heinzel-Gutenbrunner M. Use of ICDAS-II, Fluorescence-Based Methods, and Radiography in Detection and Treatment Decision of Occlusal Caries Lesions: An In Vitro Study. Int J Dent 2012; DOI: 10.1155/2012/371595.

  14. Royal College of Surgeons of England. UK National Clinical Guidelines in Paediatric Dentistry: Guideline for the Use of General Anaesthesia (GA) in Paediatric Dentistry. 2008. Available at https://www.rcseng.ac.uk/-/media/files/rcs/fds/publications/guideline-for-the-use-of-ga-in-paediatric-dentistry-may-2008-final.pdf (accessed October 2023).

  15. Uhlen M M, Valen H, Karlsen L S et al. Treatment decisions regarding caries and dental developmental defects in children - a questionnaire-based study among Norwegian dentists. BMC Oral Health 2019; 19: 80.

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Acknowledgements

We would like to thank the staff of the Department of Paediatric Dentistry, Edinburgh Dental Institute, along with participating patients and their parents, for all their help and contribution to the study.

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Authors and Affiliations

  1. Postgraduate Trainee in Paediatric Dentistry, Edinburgh Dental Institute, Edinburgh, UK

    Aneeka Anwar

  2. Consultant in Paediatric Dentistry, Edinburgh Dental Institute, Edinburgh, UK

    Alexander J. Keightley & Elizabeth M. Roebuck

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  1. Aneeka Anwar
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  2. Alexander J. Keightley
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  3. Elizabeth M. Roebuck
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Contributions

Aneeka Anwar, Alexander J. Keightley and Elizabeth M. Roebuck conceived the presented idea. Aneeka Anwar collected the data. All three authors contributed to the design, analysis of the results and the writing of the manuscript.

Corresponding author

Correspondence to Aneeka Anwar.

Ethics declarations

The authors declare no conflicts of interests.

Ethical approval for the study was obtained from the East of Scotland Research Ethics Committee (REC reference no. 18/NW/1080). The study participants and their parents or guardians with parental right and responsibility gave consent to participate in the study and to have the data used as part of the research.

Data is available from the corresponding author upon reasonable request.

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Anwar, A., J. Keightley, A. & M. Roebuck, E. The value of bitewing radiographs in the management of carious primary molars - the impact on treatment planning. Br Dent J (2023). https://doi.org/10.1038/s41415-023-6496-z

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  • DOI: https://doi.org/10.1038/s41415-023-6496-z

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