The name derives from the small tabs upon which a patient bites to hold the x-ray film or sensor in place. Bitewing radiographs are among the easiest and most accurate to take, giving distortion-free results necessary for the accurate assessment and diagnosis of dental decay between the teeth. In children and adolescents, they also show developing permanent teeth.
Taken with the film or sensor place in a vertical direction (vertical bitewings), these radiographs also show bone volume and density, for evaluation of periodontal health (“peri” – around; “odont” – tooth). Bitewing images usually consist of four films, two on each side, which are necessary to capture all the back teeth — premolars and molars. Often only one bitewing image per side is required in smaller children.
The frequency with which bitewing x-rays should be taken is not one-size-fits-all; it is a clinical decision that should be made by you and Dr. Mandeep Kanwar after evaluating the risks, benefits and alternatives. It will dependent upon a number of factors including: age, which in the case of children and adolescents will reflect the stage and state of development of the teeth; and the risk of tooth decay, in itself part of a number of other clinical factors. From a periodontal standpoint, it will also include periodic monitoring and evaluation of bone levels in the assessment of periodontal health.
It is not uncommon practice to have bitewing radiographs taken as often as every six to twelve months during childhood or adolescent development, or for adults with high decay rates. The alternative is that tooth decay can go undetected and progress rapidly, requiring extensive repair or even tooth loss. And that will warrant more x-ray exposure (beyond bitewings) necessary to facilitate even more extensive assessment and diagnosis necessary for tooth replacement. Longer intervals between bitewing x-ray examinations are indicated when the risk of caries (tooth decay) and periodontal disease is low.