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What is a Bitewing?

Mary McMahon
Mary McMahon
Mary McMahon
Mary McMahon

A bitewing is a type of x-ray image which is taken by a dentist to assess oral health or to look at a particular area of the mouth. Also known as a bite wing, the bitewing x-ray is the most common type of dental x-ray. Most people who have received x-rays at the dentist's office have gotten a bitewing x-ray, and they have probably been shown the film by a dentist in the process of having a procedure or situation explained.

In this type of x-ray, the film includes a small tab which is held between the closed teeth. With the patient holding very still, the film is exposed with the use of an external x-ray machine, and then removed and developed. Once developed, the film will show several lower and upper teeth, along with their roots.

A dental X-ray machine.
A dental X-ray machine.

Sometimes, dentists will order a complete set of x-rays, in which the entire mouth is x-rayed with a series of progressive overlapping images. This is usually done when a patient first visits a dental practice, or when someone has not visited the dentist in some time. Doctors can also order bitewings of various areas of the mouth, including closeups of teeth which have been repaired so that the dentist can confirm that the repair was done properly and that it is healing well. X-rays are usually ordered after any extraction or filling procedure for this reason.

With a bitewing x-ray, a small tab is held between closed teeth while the x-ray is taken.
With a bitewing x-ray, a small tab is held between closed teeth while the x-ray is taken.

It can be uncomfortable for a patient to receive a bitewing x-ray, especially if he or she has a small mouth, because the film can be hard, and it has to be large, to ensure that the x-ray captures everything. Most dentist's offices are well aware of the comfort issue and the staff may have tips to help people cope with the unpleasant sensation. It is also not that uncommon to gag when the film is placed in the mouth.

Bitewing X-rays are made by placing small strips of film in the patient's mouth.
Bitewing X-rays are made by placing small strips of film in the patient's mouth.

Getting x-rays is important, because they can reveal signs of dental problems which are not visible on a basic physical examination. Dentists usually do not recommend x-rays unless they believe that the images are necessary and appropriate, as they want to limit exposure to radiation. These x-rays can reveal information about how teeth are developing, whether or not teeth are moving and becoming crowded, and if signs of decay are present in the mouth. By catching these problems early, a dentist can save a patient a great deal of money and pain.

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a WiseGEEK researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Learn more...
Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a WiseGEEK researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Learn more...

Discussion Comments

anon990552

Meningioma, the most common primary brain tumor in the United States, accounts for about 33 percent of all primary brain tumors. The most consistently identified environmental risk factor for meningioma is exposure to ionizing radiation.

In the largest study of its kind, researchers from Brigham and Women's Hospital (BWH), Yale University School of Medicine, Duke University, UCSF and Baylor College of Medicine have found a correlation between past frequent dental x-rays, which are the most common source of exposure to ionizing radiation in the U.S, and an increased risk of developing meningioma. These findings are published in the April 10, 2012 issue of Cancer.

anon945387

I went to a dentist lately, and had to use one of those for three separate x-rays. (Really four because I stuffed one up when I took the bitewing out of my mouth to swallow just as they did the x-ray).

It was pretty uncomfortable, and I was slightly anxious I was going to throw up or gag because I tend to retch really easily if something's towards the back of my throat, but my parents who were there just thought I was being silly and the dentist told me to cooperate.

I probably was being a bit silly, but it is uncomfortable and to prove it, I even have scratch marks along the flesh under my tongue where the thing scratched me. I wish they could make it smaller, or take that into consideration.

anon260588

I don't miss those awful things. I've had braces, headgear, all four wisdom teeth removed, and two root canals (in addition to s few fillings here and there) and one of the most uncomfortable/unpleasant things was the bitewing.

I'm not being a baby about it; I actually have a good reason. I have a large torus in the roof of my mouth. It's not a problem for me, nothing sticking out of the skin or anything. It just makes it very painful to fit the bitewing piece into the back of my mouth. If not for that, I think I'd be fine. I just wish my dentists would be a bit more understanding about something that apparently causes people with normal mouths discomfort when I tell them it is very painful for me.

shell4life

My dentist does bitewing x-rays once a year. He always places a lead apron on me to protect me from radiation. The lead apron is extremely dense. It can prevent a patient’s body from absorbing harmful rays.

However, he did tell me that dentists use a high speed film that minimizes the patient’s exposure to radiation. Also, the radiation I encounter during the x-rays is only equal to what I would naturally get from background radiation over a period of three weeks.

My friend goes to the same dentist, and she is pregnant. She told me that he actually has something called a maternity apron that shields her unborn baby from radiation.

wavy58

@orangey03 - I am curious as well. I live in the South, and my dentist gives me x-rays once a year. I go to him every 6 months, and every other visit I get the x-rays.

Now I’m wondering if that extra radiation exposure is really necessary. Every dentist I’ve ever been to has done x-rays at least once every two years, if not every year.

Maybe it’s a new discovery. My dentist operates in a small office, and he is the only dentist there. He sees one patient at a time. Perhaps he is used to doing things the old way, if this is a new thing.

orangey03

Apparently, dentists vary greatly in their opinion of how often bitewing radiographs should be carried out. I read an article which recommended that dentists only carry out the radiographs every three years for individuals who run a high risk of developing cavities. The article also stated that dentists should only carry out a radiograph every four years for those patients who have a low risk of getting cavities.

I am curious to see if different areas of the country maintain different norms for how often their dentists require bitewing radiographs. Anyone interested in telling me the region in which you live and how often you get bitewing x-rays?

lighth0se33

@Perdido - I, too, was puzzled by the dentist's request to remove my jewelry. I asked him what would happen if I left it in, and he showed me some bitewing xrays of a patient with long hair that hid her earrings who had forgotten she was wearing any that day.

Since the ears are in line with the jaw and the x-ray passes through the whole area, the earrings are in a position to block the rays from doing their job. Right at the spot where the earrings were was a black blob that blotted out that area of the teeth.

Perdido

Does anyone know why dentists ask you to remove your jewelry before getting an x-ray? I can't understand how my earrings could interfere with an image of my mouth.

I always comply with their requests, but I just find it strange. I have three holes in each ear, and sometimes I forget to remove all the earrings before going to the dentist. I would remove them prior to going, but I try to leave them in as much as possible to prevent the holes from growing up.

My friend has a lip ring that he never takes out, but he has to remove it at the dentist's office. I wonder if this is because the x-ray might heat up the metal and burn his lip, or because it somehow messes with the image?

manykitties2

If you are going into to have braces put in you will become quite familiar with the bitewing x-ray. When I had my braces on I had to get bitewing x-rays pretty frequently to make sure that my teeth were aligning properly and that everything was looking healthy.

I found that after awhile you can actually get used to having the tab in your mouth, but it really requires you to be calm and relax. I found have of my discomfort went away when I stopped being so tense and just let my orthodontist do his thing.

letshearit

The last time I went to my dentist for a checkup that made me have a bitewing x-ray to check for any abnormalities in my teeth. I actually find the bitewing x-ray to be really uncomfortable because of the tab that you are forced to bite onto while doing the x-ray. My dentist always tries to make me feel comfortable, but I find that the tab tends to jab me and always feels to big.

Does anyone have any ideas on how to make getting a bitewing x-ray less uncomfortable?

I only have to have them once a year but I still dread going in to have the x-ray done.

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    • A dental X-ray machine.
      By: Konstantin Shevtsov
      A dental X-ray machine.
    • With a bitewing x-ray, a small tab is held between closed teeth while the x-ray is taken.
      By: Pavel Losevsky
      With a bitewing x-ray, a small tab is held between closed teeth while the x-ray is taken.
    • Bitewing X-rays are made by placing small strips of film in the patient's mouth.
      By: Robert Kneschke
      Bitewing X-rays are made by placing small strips of film in the patient's mouth.
    • Sometimes, dentists will order a complete set of X-rays to gain images of the entire mouth.
      By: Andrey Armyagov
      Sometimes, dentists will order a complete set of X-rays to gain images of the entire mouth.
    • X-rays can reveal signs of dental problems.
      By: RED-ON
      X-rays can reveal signs of dental problems.
    • X-rays show hidden dental problems, especially in the roots.
      By: chalabala
      X-rays show hidden dental problems, especially in the roots.