Sign In Radiographs are an important aspect of the paediatric department and being aware of which radiographs to take, and when, is vital in providing the best treatment to patients. In this topic we will cover the type of radiographs you should be aware of and when they are justified.
The recommended interval between oral health reviews should be determined specifically for each patient and tailored to meet his or her needs, on the basis of an assessment of disease levels and risk of or from dental disease.
For patients under the age of 18 NICE guidance states that a recall period of 3, 6, 9 or 12 months should be assigned. At the recall appointment, the disease risk of the patient should be re-assessed and changed if required. At each appointment, the preventative strategy should be reviewed and appropriate preventative advice and treatment given.
Dietary habits and tooth brushing practice should be reviewed and action plans should be made. Any early carious lesions managed with prevention only should be reviewed and fissure sealants should be examined for wear and leakage.
The Faculty of General Dental Practitioners (FGDP) Selection Criteria for Dental Radiography sets out guidance for the frequency of bitewing radiographs to diagnose dental caries for both the primary and permanent dentition.
| CARIES | FREQUENCY OF BITEWING RADIOGRAPHS | ||
|---|---|---|---|
| High | 6 monthly – Until no new or active lesions or until moved into a new risk category. | ||
| Medium | 12 monthly – Until no new or active lesions or until moved into a new risk category. | ||
| Low | 12 – 18 for primary dentition 24 months for permanent dentition More extended radiographic recall intervals may be appropriate if there is evidence of continued low risk. |
Bitewing radiographs are essential for an accurate diagnosis unless posterior contacts are open. Bitewing radiographs show the furcation area of primary molars and this is where we expect to see pathology if it is present.
Lateral Oblique Views are extra oral views and are useful in children who cannot tolerate intraoral views and are not tall or cooperative enough for a DPT on a BW setting.
Periapical radiographs are most useful in cases of dental trauma.
A DPT radiograph may be necessary for the following:
- Assessment of the developing dentition – including the presence of permanent successors and the developmental stage of lower second permanent molars (when considering the prognosis of lower first permanent molars)
- Assessing for any other anomalies – such as supernumerary teeth and pathology.
DPT on a Bitewing setting is useful for caries diagnosis in young children who cannot tolerate intraoral bitewing radiographs.
It may also be used for:
1. Assessing root formation on primary molars
2. The presence/absence of premolars
3. The developmental stage of permanent molars.
Upper standard occlusal radiographs are useful to show anterior caries in children who cannot tolerate periapical views.
They may also be used to:
1. Assess anomalies such as supernumerary teeth
2. To show traumatic injury such as root fracture
Horner, K. and Eaton, K. (2018). Selection criteria for dental radiography. London: Faculty of General Dental Practitioners
National Institute of Health (2004). Dental checks: intervals between oral health views. [online]. Available from: https://www.nice.org.uk/guidance/cg19
See also Consent
