What is a common radiographic error associated with bitewings?

• A. Underexposure causing faint images.
• B. Vertical angulation errors that distort the image.
• C. Contact point overlap or improper vertical angulation causing distortion.
• D. Poor film handling.

Answer: (C)

Bitewings are meant to show the crowns of the posterior teeth and their contact areas, so keeping the contacts open and the image undistorted is crucial. The most common issue you’ll see with bitewings is contact point overlap, which happens when the horizontal angulation is off and the teeth aren’t opened up for a clear view of the contacts. If the contacts are overlapped, you can’t accurately assess proximal surfaces or caries between teeth, which defeats the purpose of the bitewing.

Vertical angulation also matters; if it’s not correct, the image can be distorted, causing elongation or foreshortening and misrepresenting tooth height and bone levels. The combination of contact overlap from improper horizontal angulation and distortion from vertical angulation makes this option the best description of a common bitewing radiographic error.

While underexposure can make images faint and poor film handling can cause other problems, they aren’t the bitewing-specific errors that most impact diagnostic utility.