Ontario dentists: 2. Bitewing utilization and restorative treatment decisions

Guidelines for the selection of patients requiring radiological examination have recently been published in Canada and the United States. The purpose of this paper, the second in a three-part series on the results of a questionnaire to Ontario general practitioners, is to compare bitewing use in Ontario against the U.S. guidelines. This questionnaire determined the frequency of recall bitewing examination for low and high caries risk patients, as well as the factors that influence the diagnostic and treatment decisions of the responding dentists. For example, 49 to 78 per cent of dentists order recall bitewings--in accordance with U.S. guidelines--for their patients in individual low caries risk categories. Similarly, 49 to 88 per cent of dentists order recall bitewings for individual patients in high caries risk categories, which is also consistent with the U.S. guidelines. However, across all low and high caries risk groups of patients, the percentages of dentists who followed the recommended guidelines were 34 and 15 per cent, respectively. The responding dentists' estimates of the length of time required for caries to progress through enamel are indirectly associated with the interval prescribed for recall bitewing examination.