Radiology · patient case question

What radiographs should you take?

Patient case: New patient with decay on #14 and #19

Scenario: A NEW patient presents with two decayed teeth (#14 and #19) and wants her teeth checked. NO radiographs were provided in the patient box.

  1. Full mouth series (FMX) with a panoramic
  2. Periapicals with a panoramic
  3. Bitewings with a panoramic
  4. Bitewings only
Show answer and explanation

Correct answer: A. Full mouth series (FMX) with a panoramic

  • A. Correct per the source key. A new adult patient with clinical caries and no previous radiographs falls under the ADA/FDA selection criteria for an INDIVIDUALISED FULL-MOUTH SURVEY — posterior bitewings plus selected periapicals covering all areas of clinical or historical evidence of disease.
  • B. Periapicals with a panoramic omit the bitewings, which are the single most accurate view for interproximal caries.
  • C. Bitewings alone or with a panoramic show interproximal caries and crestal bone but do not display apices, which is inadequate for a first comprehensive assessment with active disease.
  • D. Bitewings only is far short of the standard for a new comprehensive patient.

Note: Note the ADA/FDA wording: a panoramic is NOT a substitute for an FMX, and radiographs are always prescribed on an individualised basis after a clinical examination — never routinely.

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