Home Dental Radiology Patterns of radiograph use in a population of commerically insured children

Patterns of radiograph use in a population of commerically insured children

by adminjay



The objective of this study was to evaluate differences in number and type of radiographs used among 3 age groups (0-5, 6-12, 13-18 years) by general dentists, pediatric dentists, and other specialists, and to determine the association between number and type of radiographs and clinical need.


A retrospective analysis of insurance claims by age group and oral health care provider type included children aged 0 through 8 years in 2005 who had a minimum of 10 years of continuous eligibility. Indicator claim variables were calculated to identify high-risk, high-need patients.


A total of 6,712,155 records from 105,010 patients and 34,406 providers were analyzed. There was a significant effect (P < .001) of age on the number of radiographs obtained per visit. The estimated rates of radiographs per visit for ages 0 through 5, 6 through 12, and 13 through 18 were 0.373, 0.492, and 0.393, respectively. There was a significant interaction effect between age and provider type. For patients younger than 13 years, general dentists had lower rates of obtaining radiographs than did pediatric dentists, with no significant difference between providers for the 13- through 18-year age group. Treatments received, except for extractions and prosthodontics, were significantly associated with rate of radiographs per visit, with “number of restorations” as an indicator of increased risk, need, or both showing an inverse association with radiograph use.


Child age and provider type had an effect on number of radiographs obtained per visit. Lack of caries diagnostic codes and uncommon use of risk codes hindered interpretation of whether use, frequency, or both is associated with need.

Practical Implications

Radiograph use should follow existing guidelines or recommendations based on clinical need.

Radiographs can help in the evaluation and diagnosis of many oral diseases and conditions. These images, when of diagnostic quality, can provide information about the presence and progression of carious lesions, periodontal disease, intraosseous infections, and pathology, as well as evaluate trauma to maxillofacial structures.


American Academy of Pediatric Dentistry
Guideline on prescribing dental radiographs for infants, children, adolescents, and persons with special health care needs. 2017. Revised 2021.