Value of bitewing radiographs in detection of occlusal caries

A system of diagnosing occlusal caries from bitewing radiographs was developed in an attempt to overcome the problems of clinical diagnosis found in other studies. Standardised bitewing radiographs for 1172 Berkshire schoolchildren aged 11-13 years who were participating in a toothpaste trial, were assessed for occlusal caries under uniform magnification and illumination. The radiographic scores were then compared with the clinical records for these subjects. The radiographic technique proved to be acceptably reproducible at 82.6%. However, only 33.2% of the lesions present were detected on the radiographs. It is concluded that bitewing radiographs for the detection of occlusal caries are of little value in epidemiological studies.