Which radiographic technique is best for detecting interproximal caries and assessing crestal bone levels?

• A. Bitewing radiographs
• B. Periapical radiographs
• C. Panoramic radiographs
• D. Occlusal radiographs

Answer: (A)

Bitewing radiographs are the view that best shows both the spaces between adjacent teeth and the level of the supporting bone. They are positioned to capture the crowns of the posterior teeth and the interproximal regions, plus a portion of the roots and the crestal bone between them. This combination makes them the most sensitive for detecting early caries that develop in contact areas and for assessing crestal bone levels over several teeth in one image. The images clearly show where the enamel-dentin interface is and whether there is demineralization between teeth, which is essential for proximal caries detection, while also revealing the height of the alveolar crest relative to the cemento-enamel junction.

Periapical radiographs focus on a single tooth and its surrounding bone, which is great for pathology at the root tip or around a specific tooth but can miss or obscure proximal caries due to overlapping contacts. Panoramic radiographs cover the entire arch but at lower resolution with more distortion, making fine proximal caries and precise bone height measurements less reliable. Occlusal radiographs provide different perspectives of the arch or floor of the mouth and are not optimized for proximal caries or crestal bone assessment.