Name of the Procedure:

Common Name: Bitewings - Two Films
Medical Term: Dental Bitewing Radiography (HCPCS Code D0272)

Summary

Bitewing X-rays involve taking images of the upper and lower back teeth in a single view to detect cavities (caries), bone loss, and other dental issues. Two films typically means that images are captured from both the left and right sides of the mouth.

Purpose

Medical Conditions:

• Detection of cavities between teeth
• Assessment of bone loss from periodontal disease
• Examination of dental restorations like fillings or crowns

Goals:

• Provide a clear image of the interproximal (between the teeth) areas
• Aid in early diagnosis and treatment planning
• Prevent further dental issues by detecting problems early

Indications

Symptoms/Conditions:

• Visible cavities or dental decay
• Unexplained dental pain
• History of periodontal disease
• Routine dental check-ups

Patient Criteria:

• Adolescents and adults during routine dental exams
• Special cases in younger children upon orthodontist or dentist recommendation

Preparation

Pre-procedure Instructions:

• No specific preparation required for patients.
• Patients should inform the dentist if they are pregnant.

Diagnostic Tests:

• Review of patient dental history.
• Visual examination of the mouth prior to X-rays.

Procedure Description

1. Positioning: The patient sits in the dental chair, and the dentist places a lead apron over the patient to protect from radiation.
2. Film Placement: Small, wing-shaped holders with X-ray films are placed inside the patient's mouth between teeth.
3. Image Acquisition: The dentist or dental assistant takes two images, one from each side of the mouth.
4. Technology Used: Digital sensors or photographic films.
5. Anesthesia: None required.

Duration

Typically takes about 5-10 minutes.

Setting

Performed in a dental office or clinic.

Personnel

• Dentist
• Dental Hygienist
• Dental Assistant

Risks and Complications

Common Risks:

• Minimal exposure to radiation.

Rare Risks:

• Discomfort from film placement.

Management:

• Use of minimal necessary radiation and protective measures like lead aprons.
• Communication to adjust film placement for patient comfort.

Benefits

Expected Benefits:

• Early detection of dental issues.
• Informative diagnosis aiding in effective treatment plans.

Realization:

• Immediate image viewing if digital technology is used.
• Prompt diagnosis and management.

Recovery

Post-procedure Care:

• No special care required.

  Recovery Time:

• Immediate return to normal activities.

Follow-up:

• Routine dental visits every 6 months or as recommended.

Alternatives

Other Options:

• Panoramic X-rays: Takes broader images but less detailed for cavities.
• Periapical X-rays: Focuses on specific teeth but not as comprehensive for cavities between teeth.

Pros and Cons:

• Bitewings are preferred for detailed cavity detection.
• Alternative X-rays may be more comfortable but less detailed for specific areas.

Patient Experience

During the Procedure:

• Mild discomfort from film/sensor placement.
• Brief sensation as the X-ray is taken.

After the Procedure:

• No pain or discomfort is expected once the films/sensors are removed.
• Immediate resumption of routine activities.

Pain Management:

• No pain management necessary due to minimal discomfort involved.