If you're like me, you or your team has trouble getting the contacts on bitewings open at times. I would like to share a simple tip to help you get those difficult contacts open on your bitewings. While you might be expecting something high-tech it's actually about as low-tech as you can get – it's a cotton tip applicator.

Next time you are presented with a contact that's not open on your bitewing try this:

  1. Take a cotton tip applicator and place it in the occlusal embrasure of the contact you want to open. I find it easiest to place the applicator in a maxillary embrasure.
  2. Holding the applicator in place, line the tube head up so it's parallel with the stick you are holding in the embrasure. It is not necessary to have the sensor or film in place at this point, in fact, doing so would just make things way more complicated and less predictable. It's also not necessary to have the tube head in its final position, just in the ballpark and parallel.
  3. Next, without the patient turning their head or swiveling the tube, place your film or sensor and move the tube head into it's final position remembering you can move the head however you need as long as you don't swivel it left or right and lose your parallelism to the contact you are trying to open
  4. Expose your image; you should now have the contact you are aiming to open. Next time you need to open a contact on one of your radiographs I hope you will find this tip helpful.

John R. Carson, DDS, PC, Spear Visiting Faculty. [ www.johnrcarsondds.com ]


Commenter's Profile Image Michael Melkers
June 10th, 2013
That is awesome!
Commenter's Profile Image Joyce Hottenstein
June 10th, 2013
That is a great suggestion. But what do you suggest for those of use using nomads? I'd love to help my team get perfect every time!
Commenter's Profile Image John Carson
June 10th, 2013
@ Mike-Thanks! @ Joyce- unfortunately this tip would not easily lend itself to those working with Nomads. The only things I can think of would be to 1. place the cotton tip applicator and observe the angle to need to shoot at then try to burn that angle in your mind and then line your Nomad up or 2. have 2 team members taking images and have one act the the arm of the tube head keeping the Nomad at the needed angle. While I am not overly confident either of these modification would be perfect they may help, sorry I don't have any better ideas. Let me know if either of these work for you.
Commenter's Profile Image Charles Vogel
June 13th, 2013
Just lieve the tip there.
Commenter's Profile Image John Carson
June 13th, 2013
Charles, the hard part about leaving it there is you need to keep it firmly in the occlusal embrasure while you line the head up. For me trying to get a film or sensor in place while holding this in the embrasure and lining up the head is too difficult. I'm not saying it can't be done, just does not work for me.
Commenter's Profile Image Matt Standridge
June 19th, 2013
Thanks for the (Q) tip!!!
Commenter's Profile Image Charles LoGiudice
June 21st, 2013
Thanks for the tip. I will teach it to my staff. I seldom have trouble with bxw angulation but they do.