Optimising radiographic bitewing examination to adult and juvenile patients through the use of anthropomorphic phantoms.

Four anthropomorphic phantoms (an adult male, an adult female, a 10-y-old child and a 5-y-old child) were exposed to bitewing radiographs at film and digital settings using both rectangular and round collimation. Optically stimulated dosemeters were used. For children, average organ doses were <40 microGy and the organs with the highest doses were the salivary glands, parotid, oral mucosa, skin and extrathoracic airway. For adults, average organ doses were <200 microGy. Highest adult doses were to the salivary glands, oral mucosa and skin. Effective doses ranged from 1.5 to 1.8 microSv for children and from 2.6 to 3.6 microSv for adults when optimised technique factors were employed, including digital receptors, rectangular collimation, size-appropriate exposure times and proper clinical judgment. Optimised doses were a fraction of the natural daily background exposure. Therefore, predictions of hypothetical cancer incidence or detriment in patient populations exposed to such low doses are highly speculative and should be discouraged.