Bitewing radiographs and dentists' treatment decisions.

A study involving twenty-one general dentists in private practice in Rochester, New York, was performed to assess the relationship between radiographic evidence of caries and restorative intervention in permanent teeth. Seven thousand three hundred thirty-eight bitewing radiographs taken of 387 patients over the most recent 10-year period were obtained and independently examined by six Eastman Dental Center faculty members as to presence of restorations and caries status of nonrestored proximal surfaces. Patients 20 years of age and younger had significantly lower mean maximum caries penetration scores before restorative treatment when compared to older patients. For all age groups, the mean maximum caries penetration scores indicated that, on the average, restorative treatment was initiated before there were radiographic changes in dentin. There were no differences among the dentists in the study regarding the mean elapsed time between radiographic caries diagnosis and restorative treatment. The random distribution and low number of apparent caries reversals, and the subsequent restoration of 25% of these teeth, suggested that the dentists in this study did not employ systematic remineralization strategies for their patients.