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Radiograph Frequency — ORE Part 1 MCQ

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ModerateRadiology & ImagingRadiograph FrequencyORE Part 1

A new adult patient is dentate, has posterior contact areas and is assessed as being at high caries risk. No recent diagnostic radiographs are available. Which radiographic plan is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Take posterior bitewings now and repeat them at 6-month intervals until no new or active lesions are evident

Explanation lettering: C = shown as A · A = shown as B · E = shown as C · B = shown as D · D = shown as E

A is correct. SDCEP guidance for oral health assessment states that high-risk children and adults should have bitewing radiographs every 6 months until no new or active lesions are apparent. In a dentate patient with posterior contacts and no recent images, posterior bitewings are the appropriate baseline caries examination because they supplement visual assessment, particularly for approximal lesions. A panoramic radiograph is not a routine caries-screening investigation and has lower diagnostic utility for proximal caries. Twelve-month and 24-month bitewing intervals are too long for a patient classified as high risk; 12 months applies to moderate risk and 24 months to low-risk adults. A full-mouth periapical survey is not justified routinely for caries assessment, as radiographs must be selected and justified for the clinical question.

Reference: Scottish Dental Clinical Effectiveness Programme. Oral Health Assessment and Review: Full Guidance, Version 1.0, May 2012, section 4.4.1, pp 22–23. https://www.sdcep.org.uk/media/sy2ldxp2/sdcep-ohar-version-1-0.pdf