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I N T E R P R E T A T I O N T I P S

Proper film mounting and viewing techniques are essential in the interpretation of dental

radiographs, especially in the evaluation of dental caries.

.

All films must be properly mounted in opaque film mounts prior to interpretation.

Mounted f ilms should be viewed in a room with subdued lighting that is free of

distractions.

An illuminator or viewbox is required to

accurately view radiographs and assist in

the interpretation of images.
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If the screen of the viewbox is not

completely covered by the mounted

radiographs, the harsh light around the

mounted films must be masked to reduce

glare and intensify the detail and contrast

of the radiographic images.

The use of a pocket-sized magnifying glass

is helpful in evaluating the radiographic

appearance of dental caries and can be

used to detec t slight changes in densityand contrast present in radiographic

images.

Dental radiographs should be viewed with the patient present.

F A C T O R S I N F L U E N C I N G C A R I E S I N T E R P R E T A T I O N

There are a number of factors that can influence the radiographic interpretation of

dental caries. Radiographs must be of diagnostic quality in order to evaluate dental


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caries.

.

Errors in technique may result in

non-diagnostic films. For

example, a bite-wing film that is

used to detect dental caries

must be free ofoverlappedcontacts. Improper horizontal

angulation causes overlapped

contact areas (see red arrows)

and makes it impossible to

interpret the interproximal

regions for dental caries.

Errors in exposure may also result in non-diagnostic films. For example, a dental

radiograph used to detect dental caries must exhibit proper contrast and density.

Incorrect exposure factors result in films that are too dark or too light and are

useless in the detection of caries.

C O N D I T I O N S R E S E M B L I N G C A R I E S

A number of radiolucencies that involve the crown and roots of teeth are seen on a

dental radiograph and may be confused with dental caries. Restorative materials,

abrasion, attrition and cervical burnout may all resemble dental caries on a

radiograph. The dental professional must remember that the final diagnosis of caries is

made only after the clinical andradiographic findings are corroborated. Both the clinical

examination and interpretation of radiographs are mutually contributory aids in making


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the diagnosis of dental caries.

RESTORATIVE MATERIALS

Restorative materials, such as composites,

silicates and acrylics, may appear radiolucent and

resemble dental caries on a radiograph. Theappearance of an anterior cavity preparation

restored with these materials differs from the

appearance of interproximal caries and can be

identified by the well-defined, smooth outline (see

red arows).

In addition, a careful clinical exam helps the dental

professional determine the difference between a

restorative material and dental caries.

ABRASION


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Abrasion refers to the wearing

away of tooth structure from the

friction of a foreign object. The

surface of the tooth affected

depends on the causative factor.

The most frequent type of

abrasion is caused by tooth

brushing and is seen at thecervical margin of the teeth.

Tooth brush abrasion affects the

root surface of a tooth and may

be confused with root surface

caries.

On a dental radiograph, tooth brush abrasion appears as a well-defined horizontal

radiolucency along the cervical region of a tooth (see red arrows). Clinically, the areas

affected by abrasion appear as hard, highly polished defects in dentin and should not

be confused with root caries that appears brown and leathery.

ATTRITION


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Attrition, or the mechanical wearing down of teeth,

may be mistaken for dental caries on a radiograph.

Attrition may be seen on the incisal or occlusal

surfaces of deciduous or permanent teeth. When the

incisal or occlusal enamel is worn away, the underlying

dentin wears away rapidly, and shallow concavities

may form (see red arrows). These concavities may

resemble occlusal or incisal caries on a dental

radiograph. Clinical examination enables the dental

professional to distinguish attrition from caries.

CERVICAL BURNOUT

Cervical burnout, a radiolucent

artifact seen on dental

radiographs, may also be confused

with dental caries. Cervical

burnout appears as a collar or

wedge-shaped radiolucency on the

mesial and distal root surfaces

near the CEJ of a tooth (see redarrows).

When seen as a radiolucent collar,

cervical burnout may be confused

with root caries. This radiolucent

artifact is seen because of the

difference in densities of adjacent


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tissues.

.

The t issue density at the cervical region of the tooth is less dense than the regions

above and below it; above the neck of the tooth, enamel covers the crown, and below

the neck of the tooth, bone covers the roots. Cervical burnout can also appear as an

ill-defined wedge-shaped radiolucency on the mesial or distal root surfaces near the

CEJ of posterior teeth. This wedge-shaped radiolucency is seen because of the

anatomic root concavities found in this area.

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