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Radiographic assessment of high caries risk adult — ORE Part 1 MCQ

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ModerateDental RadiologyRadiographic assessment of high caries risk adultORE Part 1

A 34-year-old with high caries risk has multiple restored posterior teeth and visible plaque stagnation. The last bitewings were taken three years ago. Clinical examination shows early proximal shadowing but no pain. What is the most appropriate investigation?

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

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Correct answer: DPosterior bitewing radiographs tailored to caries risk status

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

Posterior bitewing radiographs are the evidence-based imaging modality for caries risk assessment in high-caries-risk adults. FGDP UK Selection Criteria recommend 6-monthly bitewings for patients in this category until risk reduces. The patient presents with multiple established risk indicators: high caries risk status, multiple restorations, visible plaque stagnation, clinical proximal shadowing, and 3-year imaging interval. Clinical examination alone detects only 30–40% of approximal dentine caries; bitewings are essential for diagnosis. Option A (panoramic radiography) has higher radiation dose and lower sensitivity for proximal lesions and lacks clear clinical indication. Options B and C are inappropriate imaging modalities entirely. Option E contradicts evidence-based risk-stratified guidance: age alone does not determine radiographic need; risk assessment does.

Reference: Faculty of General Dental Practice (FGDP) UK Selection Criteria for Dental Radiography (cited in NHS England Dentistry Care Pathways Guidance, 2024–2025); SDCEP Prevention and Management of Dental Caries in Children: Radiographic Assessment (2014); GOV.UK Delivering Better Oral Health Chapter 4: Dental Caries (2025). https://www.england.nhs.uk/long-read/nhs-dentistry-care-pathways-guidance/