title: The additional information of bitewing radiographs in the detection of established or severe dentinal decay in 14-year olds: a cross-sectional study in low-caries population.
abstract: OBJECTIVE
  To reveal the additional value of radiographic bitewings (BW) in detection of caries and in comparing the occurrence of clinically undetected severe decay between 14-year olds with and without clinically observed dentinal caries in a low-caries prevalence population.
  
  
  METHODS
  The cross-sectional study used 363 pairs of radiographs read by one examiner without knowledge of the clinical findings. The yield was analyzed on a tooth surface level by cross tabulating the clinical and radiographic information and on an individual level by counting the number of yield surfaces for all subjects. Mann-Whitney U test was used.
  
  
  RESULTS
  On a tooth surface level, the contribution of BW was the greatest on the occlusal surfaces of the first molars, where established or severe dentinal decay was registered in BW in 11% of clinically sound surfaces and in 40% of established cavitated enamel lesions. On an individual level, 53% of subjects benefited from BW. The subjects clinically DMFS > 0 benefited more than the clinically DMFS = 0 subjects (P = .004), nearly 60% in relation to 47%, respectively.
  
  
  CONCLUSIONS
  In a low-caries prevalence population a remarkable portion of both clinically DMFS = 0 and DMFS > 0 14-year olds benefit from BW examination. Most of the benefit is obtained on the occlusal surfaces of the first and the second permanent molars.
authors.affiliation: Carea Joint Municipal Authority for Medical and Social Services in Kymenlaakso, Kuusankoski, 06100 Porvoo, Finland.
authors.forename: Aija-Maaria
authors.initials: AM
authors.lastname: Hietala-Lenkkeri
authors.affiliation: Department of Community Dentistry, Institute of Dentistry, University of Turku, 20520 Turku, Finland.
authors.forename: Mimmi
authors.identifier: 0000-0002-0889-8164
authors.initials: M
authors.lastname: Tolvanen
authors.affiliation: Department of Community Dentistry, Institute of Dentistry, University of Turku, 20520 Turku, Finland.
authors.forename: Pentti
authors.initials: P
authors.lastname: Alanen
authors.affiliation: Department of Community Dentistry, Institute of Dentistry, University of Turku, 20520 Turku, Finland.
authors.forename: Kaisu
authors.initials: K
authors.lastname: Pienihäkkinen
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D003731:Dental Caries / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D003804:Dentin / Q000000981:diagnostic imaging*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008963:Molar / Q000000981:diagnostic imaging*; D015995:Prevalence; D011859:Radiography