Proximal Caries Detection — ORE Part 1 MCQ
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Correct answer: E — Bitewing radiography
Bitewing radiography is the most accurate method for detecting proximal caries in UK dental practice. SDCEP guidance endorses bitewing radiographs as standard-of-care, recommended at intervals of 6–12 months for high-risk patients. Intraoral bitewing radiography demonstrates superior sensitivity and specificity compared to alternative methods. Visual examination alone is inadequate due to contact point visibility. DIAGNOdent (laser fluorescence) has limited sensitivity for early enamel caries (39%) and detects only advanced lesions with bacterial accumulation. Transillumination is emerging technology without established UK clinical protocols. Explorer/probe carries risk of harm. Bitewing radiography uniquely combines accurate lesion detection, depth assessment for treatment planning, accessibility, and cost-effectiveness.
Reference: Scottish Dental Clinical Effectiveness Programme (SDCEP). Prevention and Management of Dental Caries in Children. Radiographic Assessment. 2018 (updated 2024–2025). https://www.childcaries.sdcep.org.uk/guidance/assessment/clinical-assessment/assessing-carious-lesions/radiographic-assessment/