Dental X-rays are a diagnostic tool that allows professionals to view structures inside the mouth not visible during a routine visual examination. These images use controlled bursts of radiation to create a picture of the teeth, bones, and surrounding tissues. The bitewing X-ray is one of the most common types of dental radiographs acquired during a standard preventive checkup. This image provides dentists with detailed information to monitor the integrity of your teeth and the health of your supporting bone structure.
Defining the Bitewing View
The term “bitewing” describes how the radiograph is taken, as the patient bites down on a small tab attached to the sensor or film holder. This positioning captures the crowns of both the upper and lower posterior teeth (premolars and molars) in a single view. The resulting image focuses specifically on the interproximal areas, which are the surfaces where adjacent teeth meet. This view differs from a periapical X-ray (which captures the entire tooth) or a panoramic X-ray (which gives a broad view of the entire jaw structure). By concentrating on the crowns and the crest of the alveolar bone, the bitewing X-ray provides the localized detail needed for routine surveillance.
Detecting Hidden Dental Issues
The primary purpose of bitewing X-rays is to detect dental decay in the difficult-to-see spaces between teeth. These interproximal areas are often impossible to evaluate accurately with a mirror alone because the outer enamel may appear intact while decay progresses underneath. Bitewing radiographs allow the dentist to visualize shadows representing demineralization, indicating a cavity.
The images can reveal decay in its earliest form, known as incipient decay, appearing as a small change in the enamel layer. Early detection allows for minimally invasive treatment or enhanced preventive measures to halt the lesion’s progression. More advanced decay shows up as a larger, darker shadow that has penetrated deeper into the dentin layer.
Bitewings are also instrumental in assessing the level of the alveolar bone supporting the teeth. Loss of bone height over time, visible on the radiograph, is an early sign used to monitor periodontal disease progression. These images also help determine the condition of existing restorations, checking for recurrent decay or poor fit.
The X-Ray Procedure Explained
The process for taking a bitewing X-ray is straightforward and takes only a few moments. You will be seated upright, and the professional will place a small, flat device (a film packet or digital sensor) into your mouth. This device is held in a positioning arm with a plastic tab, which you will be instructed to bite down on firmly. Biting down on the tab ensures the sensor is held steady and correctly angled to capture the overlapping surfaces of the teeth.
The X-ray tube head is positioned adjacent to your cheek, aimed at the sensor inside your mouth. The professional will step behind a protective barrier before activating the machine for a quick burst of radiation. Modern practices predominantly use digital sensors, which produce an image instantly on a computer screen. This eliminates waiting time for chemical processing and uses a lower dose of radiation than traditional film.
Patient Safety and Imaging Schedule
Concerns about radiation exposure are common, but modern bitewing X-rays use extremely low doses, making the procedure safe. A typical series of four bitewing images exposes a patient to less radiation than the average daily exposure received from natural environmental sources. To minimize exposure risk, a lead apron is routinely placed over the chest and abdomen, and a thyroid shield may be used to protect the neck.
The frequency of bitewing X-rays is not a fixed schedule but is determined individually based on risk factors for dental disease. Patients with a high risk of cavities, existing decay, or active periodontal disease may be advised to have bitewings taken more often, typically every six to eighteen months. Conversely, healthy adults with a low-risk profile may only require new images every two to three years. This risk-based approach ensures that the diagnostic benefits of early detection outweigh the minimal radiation exposure.