Dental Radiograph Selection Tool Flashcards
Individualized radiographic exam consisting of…
selected periapical/occlusal views and posterior bitewings if proximal surfaces cannot be visualized or probed
T/F: Patients without evidence of disease and with open proximal contacts may not require a radiographic exam at this time.
True
What is the recommendation for a child (primary denition) with clinical caries or increased caries risk?
Posterior bitewing exam at 6-12 month intervals if proximal surfaces cannot be examined visually or with a probe.
What is the recommendation for a child (primary denition) with no caries and low caries risk?
Posterior bitewing exam at 12-24 month intervals if proximal surfaces cannot be examined visually or with a probe.
What is the recommendation for a child (primary denition) with periodontal disease?
- Use clinical judgment, regarding the need for and type of images for the evaluation of periodontal disease.
- Imaging may consist of, but is not limited to, selected BWX and/or PA images of areas where periodontal disease (other than non-specific gingivitis) is demonstrated clinically.
What is the recommendation for a child (primary denition) to assess dental/skeletal relationship?
Clinical judgement as to need for and type of radiographic images for evaluation and/or monitoring of dentofacial growth and development or assessment of dental and skeletal relationships.
What is the recommendation for a child (primary denition) thats a new patient?
Individualized radiographic exam consisting of posterior bitewings with panoramic exam OR posterior bitewings and selected periapical images
What is the recommendation for an adolescent that is a new patient?
Posterior BWXs with panoramic exam. Or, BWXs with selected PAXs.
An FMX exam is preferred when patient has clinical evidence of general dental disease or history of extensive dental treatment.
What is the recommendation for an adolescent with no clinical caries or low caries risk?
Posterior BWX exam at 18-36 month intervals.
What is the recommendation for an adolescent with clinical caries or increased caries risk?
Posterior BWX exam at 6-12 month intervals, if proximal surfaces cannot be examined visually.
What is the recommendation for an adolescent with periodontal disease?
- Use clinical judgment, regarding the need for and type of images for the evaluation of periodontal disease.
- Imaging may consist of, but is not limited to, selected BWX and/or PA images of areas where periodontal disease (other than non-specific gingivitis) is demonstrated clinically.
What is the recommendation for an adolescent for assessment of dental/skeletal relationship?
- Clinical judgement as to need for and type of radiographic images for evaluation and/or monitoring of dentofacial growth and development or assessment of dental and skeletal relationships.
- Panoramic or PA images as needed to assess developing 3rd molars
What is the recommendation for an adult that is a new patient?
Posterior BWXs with panoramic exam. Or, BWXs with selected PAXs. FMX exam is preferred when patient has clinical evidence of general dental disease or history of extensive dental treatment.
What is the recommendation for an adult with clinical caries or increased caries risk?
Posterior BWX exam at 6-18 month intervals, if proximal surfaces cannot be examined visually
What is the recommendation for an adult with no clinical caries or low caries risk?
Posterior BWX exam at 24 -36 month intervals.
What is the recommendation for an adult with periodontal disease?
- Use clinical judgment, regarding the need for and type of images for the evaluation of periodontal disease.
- Imaging may consist of, but is not limited to, selected BWX and/or PA images of areas where periodontal disease (other than non-specific gingivitis) is demonstrated clinically.
What is the recommendation for an adult for assessment of dental/skeletal relationship?
Usually not indicated for monitoring of growth and development. Clinical judgement as to the need for and type of radiographic image for evaluation of dental and skeletal relationships.
What is the recommendation for an adult (edentulous) that is a new patient?
Panoramic radiograph and selected periapicals based on clinical signs and symptoms.
What is the recommendation for an adult (edentulous) that is a recall patient?
Individualized radiographic exam based on clinical signs and symptoms.
What is the recommendation for an adult (edentulous) for assessment of dental/skeletal relationship?
Usually not indicated for monitoring of growth and development. Clinical judgement as to the need for and type of radiographic image for evaluation of dental and skeletal relationships
What are examples of positive historical findings?
- Previous periodontal treatment
- Previous endodontic treatment
- History of pain or trauma
- Familial history of dental anomalies
- Postoperative evaluation of healing
- Monitoring of caries remineralization
- Presence of implants, previous implant pathosis or evaluation for implant placement
- Dental and craniofacial pathosis
What are examples of positive clinical signs and symptoms?
- Clinical evidence of periodontal disease
- Evidence of foreign objects
- Positive neurologic findings in head and neck
- Pain and/or dysfunction of the temporomandibular joint
- Deep carious lesions
- Facial asymmetry
- Malposed or clinically impacted teeth
- Abutment teeth for fixed or removable partial prosthesis
- Swelling
- Unexplained bleeding
- Evidence of dental/facial trauma
- Unexplained sensitivity of teeth
- Mobility of teeth
- Unusual eruption, spacing or migration of teeth
- Sinus tract (fistula)
- Unusual tooth morphology, calcification or color
- Clinically suspected sinus pathosis * Unexplained absence of teeth
- Growth abnormalities
- Clinical tooth erosion
- Large or deep restorations
- Peri-implantitis
*Oral involvement in known or suspected systemic disease
What are examples of positive clinical signs and symptoms for adult edentulous patients?
- Swelling
- Positive neurologic findings in the head and neck
- Evidence of facial trauma
- Evidence of foreign object
- Sinus tract (fistula)
- Pain and/or dysfunction of the temporomandibular joint
- Clinically suspected sinus pathosis
- Facial asymmetry
- Growth abnormalities
- Unexplained bleeding
- Oral involvement in known or suspected systemic disease
What are the treatment planning considerations for adult edentulous patients?
- Teeth that may become abutments for fixed or removable partial prosthesis
- Large or deep restorations which may require full coverage crown
- Evaluation of edentulous areas as implant sites
- Other restorative or endodontic treatment need
What are factors that increase the risk for caries?
*High level of caries experience/demineralization
* Developmental or acquired enamel defects
*History of recurrent caries
* Developmental or acquired disability
*High titers of cariogenic bacteria
* Xerostomia (objective or subjective)
*Existing restorations of poor quality
* Genetic abnormality of teeth
*Poor oral hygiene
* Many multi-surface restorations
*Inadequate fluoride exposure
* Chemo or radiation therapy
*Prolonged nursing (bottle or breast)
* Eating disorders
*Frequent high sucrose content in diet
* Drug/alcohol abuse
*Poor family dental health
* Irregular dental care
What are factors that increase the risk for caries WITHOUT positive clinical findings?
- Acquired disability (e.g., stroke, injury)
- Taking new xerostomic medication
- New symptoms of or worsening of xerostomia (objective or subjective)
- Recent worsening of a medical condition
- Recent history of chemo or radiation therapy
- New or worsening eating disorder
- New or worsening drug/alcohol abuse
- Change in financial status that leads to a decrease in dental care
