Extraoral Bitewings: When Are They Beneficial?

Patient comfort is an integral part of my practice; after all, what better way is there to retain the patients you currently have and attract others than through word of mouth? In light of this, it’s important to have a number of tools available to improve the patient experience.
In every practice, you have patients who simply hate or cannot tolerate standard intraoral bitewing X-rays. The most common issues I encounter include:

• sensitive gag reflex;
• claustrophobia (traditional bitewings make them feel like they’re being smothered);
• small mouths; or large mandibular tori that prohibits placing the sensor in the patient’s mouth.

Intraoral photo taken of Mandibular Tori

Extraoral bitewings taken with CS 8100 3D

The option of taking extraoral bitewings is an enormous benefit for these types of patients. They have typically endured painful, irritating intraoral X-rays in the past and are thrilled with the option of having comfortable diagnostic images taken that do not leave them uncomfortable for days. It is a win-win for the patient and the healthcare provider.

Of course, there are still a number of benefits to capturing intraoral bitewings. Many intraoral sensors deliver enhanced diagnostic capabilities thanks to higher image resolution; there are even some that are compatible with caries detection software. However, I have found that having extraoral bitewing capabilities within my panoramic imaging system to be beneficial in specific situations.

Do you use extraoral bitewings in your practice? If so, when?