Value of bitewings radiographs for detecting approximal caries in 6-year-old children in the Netherlands

Background.  When diagnosing caries using clinical judgment only, the prevalence of approximal caries is highly underestimated. Yet, surveys on this topic predominantly included adolescents and young adults.
Aim.  To determine the additional diagnostic value of bitewing radiographs in 6-year-old children and to detect approximal dentin caries in the primary dentition.
Design.  A total of 50 children were assessed both clinically (dmfs, oral hygiene) and radiographically by two experienced dentists. The relation between dmfs-scores and amount of plaque was established using Pearson’s correlation coefficients at a significance level of 0.05.
Results.  In nine patients (18%) it was impossible to make radiographs. Bitewing radiography appeared to have an additional effect of 97% when only caries in dentin is considered. The additional value for detecting inadequate restorations was 600%. Furthermore, the dmfs was highly correlated to the amount of plaque found.
Conclusion.  Although not possible to achieve in all 6-year-old children, bitewing radiographs can reveal a considerable amount of carious surfaces and inadequate restorations, which appear clinically sound or adequate.