DIFFERENCES IN CARIES RECORDING WITH AND WITHOUT BITEWING RADIOGRAPHS- A STUDY ON 5-YEAR-OLD CHILDREN IN THE COUNTY OF BOHUSLAN, SWEDEN

In Sweden, when caries prevalence was much higher, bitewing radiograph s (bwg's) were taken on all school children at their annual examinatio n. It has been argued that bwg's should also be taken on 4- to 6-year- olds, with approximal surfaces in the molar area in contact (Stecksen- Blicks & Wahlin 1983). However, discussion about radiation-risk in com bination with low caries prevalence seem to have made Swedish dentists reluctant to take radiographs on pre-school children. The aim of this study was to find out If there was a difference in caries recording w hen information from bwg's was added to that from clinical examination . Therefore 180 5-year-old children were randomly selected to constitu te a test group examined both by the dentists who see the patients at the annual examination and do not use bwg's and by two of the authors, who had access to bwg's.No statistically significant difference in ca ries prevalence was noted from the registrations made by the clinician s and the authors when bwg's were not used (x=1.8 versus 2.0). When th e authors had access to bwg's they considered 1.8 more surfaces to be carious compared to when bwg's were not used (x = 3.8 versus 2.0). Of these, 1.0 surfaces were open lesions and 0.8 were incipient lesions. The difference was statistically significant (p <0.001) as tested by p aired t-test. Extreme differences were noted in single cases. It was c oncluded that clinical examination only, underestimates the correct ca ries status.