Clinical Caries and Evidence of High-risk Factors for Caries

Children with Primary and Transitional Dentition

The recall child patient with either a primary or transitional dentition who presents with evidence of clinical caries, may have proximal caries. Identification of additional risk factors suggest proximal caries may be present as well. If the proximal contacts are closed, bitewing radiographic imaging is the only means of detecting the carious lesions. In such circumstances, a posterior bitewing examination is recommended at 6-to-12-month intervals. Usually two posterior bitewings are adequate to examine the proximal surfaces of the teeth, one on each side.

Adolescents

Similarly, the recall adolescent patient with a permanent dentition who presents with evidence of clinical caries and/or risks factors for caries, may have proximal caries present. A posterior bitewing examination is recommended at 6-to-12-month intervals when proximal contacts are closed. Usually two to four posterior bitewings are adequate to examine the proximal surfaces of the teeth, one or two on each side.

Adult Dentate, Partially Edentulous, Edentulous Patient

Adult recall patients either dentate or partially edentulous who present with clinical caries or increased risk factors for such, should be examined radiographically for new or recurrent carious lesions. The time interval should be determined based on caries risk assessment. A posterior bitewing radiographic examination is recommended at 6-to-18-month intervals. The patient’s caries risk may change so the recall interval may need to be adjusted over time. For the adult edentulous recall patient, no radiographic examination is indicated without evidence of disease.