BITEWING BLUES

I had a request from a few students for help on placing BWX films.

1. Make sure you have the distal of the canine on the premolar shot. Usually the mandibular canine is more mesial (unless a class II occlusion) so make sure you use the most mesial canine as the judge.

2. Always make sure the patient bites down hard! There are too many sissy patients who think if their lips are closed that means their mouth is closed. Have the patient smile after they bite down. This will lift their cheeks and lips out of the way so you can see if the mesial edge of the film is where its supposed to be.

3. Sometimes having the patient rest their head on the headrest can be helpful as it will prevent their head from wobbling around. Make sure they are not raising their head up too much as the further back you bend your head the more likely you are to gag a little.

4. There is a line on the center of your bwx holder. If you match this line up to be parallel with an interproximal space, you will almost never get overlapping. This can be a little harder to watch for though.

5. Remember after placing the film and seeing the smile its time to line up that cone. Do your best to make the circle on the xray cone be as close to exactly matching the circle on the Rinn. If your film is placed correctly this is the last step to avoid overlap.

As with anything the more you do it the easier it will be. I'm sure after a hundred "retakes" form your instructor that you'll eventually get it right!

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Here is some help with BWX using tabs from Florece Noring, RDH.

I have taken BWX for 18 years - pet peve: I hate retakes. I probably do 10 a year and see some 40-50 people a week. I work 3 days a week. I rec. you use bitewing tabs and pull back the cheek to see where you have put the x-ray. See how the teeth come together and when in doubt angle more mesial. Also against all that is told to you in school angle the x-ray cone more down (-5). Also little tip for doing young children- count 1 to 3. Example: 1 - bite down, 2 - hold still, 2&1/2 - BEEP!(take the picture) 3 - Open. Do tell them not to open till you say three.

Also learn from how you take x-rays - be self correcting and what works for you to open the contacts 99% of the time -with out cone cutting. I think I cone cut maybe once a year maybe.

In all truth my father tought me to take the best X-rays. He is a dentist and had been practicing for some 20 years when he tought me. I asked him his secrets because I was so frustrated with retakes.

PS These red bite bitewing holders work good for some people and bitetabs work better for others -= bottom line Be Flexible and remember the goal is to just get the X-ray and get a good one.

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Here are some types from Loreena

I have been a hygienist for over 17 years and I have a trick that I do to take bwx. I use tabs and place the tab to what would be the mesial part of the film as it would be in the mouth.
I leave a little space from the end of the film about 2mm. I place the film on the first molar and ask the pt to close all the way together. This method assures that I will get all the molars including the 3rds if they are there. I line up the cone just mesial to the first molar. No more cone cutting or missing teeth on x rays. I do the same when it comes to taking the premolar shot. I place the film on the first premolar and line up the cone to the middle of the canine. This works every time for me.