Ask Dr. Christensen
Q+A
In this monthly feature, Dr. Gordon Christensen addresses the most frequently asked questions from Dental Economics readers. If you would like to submit a question to Dr. Christensen, please send an e-mail to info@pccdental.com.
Q:
I am a mature practitioner, having practiced for 30 years. Early in my career, bitewing and periapical radiographs provided relatively good observation and identification of initial dental caries, and I did not miss many lesions. However, now I find that I often miss initial caries, and I am embarrassed on subsequent recall appointments to find significant, large lesions that I overlooked on earlier appointments. It seems to me that the current expensive digital sensors should offer better diagnostic capabilities than I am seeing. I am convinced that the analog radiographs that I used early in my career were much more diagnostic. What has happened to dental radiographs? What can I do to better identify initial caries?
A:
Your observations are shared by the majority of mature practitioners. Many younger practitioners have not noticed the inadequacy of periapical and bitewing radiographs because they do not have a historical perspective relative to the problem you described. I recently received a typical example from an excellent general practitioner in the eastern part of the US (figures 1 and 2).
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