Differences in caries recording with and without bitewing radiographs. A study on 5-year old children in the County of Bohuslän, Sweden.

: In Sweden, when caries prevalence was much higher, bitewing radiographs (bwg's) were taken on all school children at their annual examination. 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 combination 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 when information from bwg's was added to that from clinical examination. Therefore 180 5-year-old children were randomly selected to constitute 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 carries prevalence was noted from the registrations made by the clinicians and the authors when bwg's were not used (x = 1.8 versus 2.0). When the 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 paired t-test. Extreme differences were noted in single cases. It was concluded that clinical examination only, underestimates the correct caries status.