PREDICTION OF THE NEED FOR BITEWING RADIOGRAPHY IN DETECTING CARIES IN THE PRIMARY DENTITION

In recent literature some controversy has been reported regarding the prescription of bitewing radiography for caries diagnosis, particularl y in children. While the low prevalence of caries justified the decisi on not to take radiographs, it has also been reported that the benefit s of detecting slowly progressing, clinically undetectable lesions cou ld outweigh the ''costs'' of radiography. It was the aim of this study to investigate whether specific risk factors could predict the presen ce of additional dentinal lesions (ADL) in the primary dentition on ra diographs which could not be detected by visual inspection. Bitewing r adiographs were taken in 182 children aged 5 yr. Risk factors for ADL were identified and appropriate rating scales were designed. Sensitivi ties, specificities and relative risks expressing the relation between scale values and ADL were computed for each of the risk factors and d irect and stepwise discriminant analyses were performed. The results i ndicate that particularly the presence of lactobacilli and mutans stre ptococci in saliva and the detection of three or more discolored ename l lesions or dentinal lesions were good predictors of ADL. It is sugge sted that these risk factors be used in the timing of bitewing radiogr aphy in children with a primary dentition.