Quality of intraoral radiographs from 9-11-year-old Norwegian children

The quality of intraoral radiographic series consisting of 10 periapical and two posterior bitewing radiographs from 200 children were examined by six dentists. The radiographs were evaluated both without and, subsequently, with specified criteria. In the absence of specified criteria, no general agreement between the examiners was found when they were asked to state the quality of a radiograph. Using specified criteria much better agreement was obtained. The radiographic images of the maxillary and mandibular incisors were generally found acceptable using the criteria set up for the present study while the images of the canines, premolars and especially molars frequently were found unacceptable. Only a small proportion of the approximal surfaces on the posterior bitewings were found to be unreadable for caries of dentin while approximately 20% of the approximal surfaces were unreadable for caries of enamel. Approximately half the bitewing films had been placed wrongly in the mouth. Considering the available knowledge about prevalence of disease and anomalies in children of this age, quality of the radiographs, examiner variability and a possible harmful effect of radiography, screening with full-mouth intraoral radiographs in the actual age group does not seem to be justified in the population studied.