The value of bitewing radiographs in the management of carious primary molars - the impact on treatment planning.

Introduction Bitewing radiographs (BWs) with visual examination (VE) are critical for the early detection of caries in primary molars. However, their influence on treatment planning is not extensively studied. Given they involve exposure to ionising radiation, it is essential to understand their impact on treatment decisions.Aim To explore the impact of BWs in the management of carious primary molars.Design Cross-sectional study.Materials and methods A total of 30 children (mean age 6.2 years) referred for caries management in a dental hospital setting were recruited. One of six paediatric dental specialists performed VEs and scored pre-BW treatment needs (TN) for each primary molar, followed by reviewing the BWs, re-scoring TN and recording their opinion on treatment modality. Data were assessed using descriptive analyses. Five treatment planning descriptors detailing the reasons for change were identified.Results In total, 240 primary molars were examined. BWs resulted in an overall change in treatment plan for 24/30 (80.0%) children, with the majority (20/30; 66.7%) becoming more invasive. General anaesthesia was the commonest proposed modality (13/30; 43.3%) children), followed by inhalation sedation (10/30; 33.3%) and local anaesthesia (6/30; 20.0%), with only one child (3.3%) in the 'no analgesia' modality.Conclusion BWs play an important role in treatment planning carious primary molars.