Effect of Illumination on the Accuracy of Identifying Interproximal Carious Lesions on Bitewing Radiographs

Background: Dentists generally use a viewbox as the primary source of illumination when examining radiographs. Secondary sources of illumination (i.e., light other than that originating from the viewbox) can reduce radiographic contrast and may therefore affect diagnostic accuracy.Objective: To determine if the accuracy of identifying interproximal carious lesions on bitewing radiographs depends on the level of secondary illumination.Methods: Fourteen dentists examined bitewing radiographs of simulated interproximal lesions on dentition phantoms in conditions of maximal secondary illumination (the light condition) and minimal secondary illumination (the dark condition).Results: There was no significant difference (p = 0.07) in the accuracy of identifying simulated interproximal carious lesions on bitewing radiographs in the light mean accuracy (72% ± 12%) and dark (75% ± 12%) conditions.Clinical Significance: Examining bitewing radiographs on a viewbox located in the operatory is adequate for accurately identifying interproximal carious lesions.