TEACH Lesson Plan
19 Bite-Wing Technique
CHAPTER LESSON PLAN & OBJECTIVES
Lesson 19.1: Bite-Wing Technique
1. Define the key terms associated with the bite-wing technique.
2. Describe the purpose and use of the bite-wing image.
3. Describe the appearance of opened and overlapped contact areas on a bite-wing image.
4. State the basic principles of the bite-wing technique.
5. List the two ways a receptor can be stabilized in the bite–wing technique and identify which one is
recommended for bite-wing exposures.
6. List the three receptor sizes that can be used in the bite–wing technique and identify which size is
CHAPTER TEACHING FOCUS
• Students will have the opportunity to learn about the basic concepts and describe patient preparation,
Chapter 19: Bite-Wing Technique 2
TEACH Lesson Plan
CHAPTER PRETEST
Have the students answer these questions prior to covering this chapter to understand where they stand
in relation to the content.
1) The identification dot in bite-wing placement:
a) has no significance.
b) should be oriented “dot distal.” c) should be oriented “dot down.”
d) should be oriented “dot up.”
2) How many sizes of bite-wing receptors are available?
a) Six
b) Four c) Three
d) Two
3) What modification in technique is recommended when the patient has an edentulous space causing
a problem with the bite-wing receptor placement?
a) Skip the bite-wing image.
b) Place a cotton roll in the area of the
missing tooth or teeth.
c) Have the patient hold the receptor in
position with a hemostat.
d) Take a periapical exposure with a bite-
block instead.
4) Vertical bite-wings are often used for patients with:
a) sealants.
b) mixed dentition. c) bone loss.
d) extensive decay.
7) Which size receptor may be placed in a horizontal or vertical position?
a) Size 0
b) Size 1 c) Size 2
d) Size 3
8) Which size of bite-wing receptor is used to examine the posterior teeth of children with mixed
dentition?
a) Size 0
b) Size 1 c) Size 2
d) Size 3
9) For the molar bite-wing exposure, the front edge of the receptor should be aligned with the midline
of the __________ premolar.
a) maxillary first
b) maxillary second c) mandibular first
d) mandibular second
10) For the premolar bite-wing exposure, the front edge of the receptor should be aligned with the midline
of the:
a) maxillary canine.
b) maxillary first premolar. c) mandibular canine.
d) mandibular first premolar.
Chapter 19: Bite-Wing Technique 3
TEACH Lesson Plan
IANNUCCI AND HOWERTON: Dental Radiography: Principles and Techniques, 5th Edition
CHAPTER PRETEST ANSWERS
1) a
If using film, the identification dot has no significance in the bite–wing placement.
p. 204
5) d
In the adult patient, a size 2 receptor is recommended for bite–wing exposures.
p. 200
Chapter 19: Bite-Wing Technique 4
TEACH Lesson Plan
IANNUCCI AND HOWERTON: Dental Radiography: Principles and Techniques, 5th Edition
Classroom Preparation
Lesson 19.1: Bite-Wing Technique
INSTRUCTOR PREPARATION
Textbook Objectives Covered
1. Define the key terms associated with the bite-wing technique.
2. Describe the purpose and use of the bite-wing image.
3. Describe the appearance of opened and overlapped contact areas on a bite-wing image.
4. State the basic principles of the bite-wing technique.
5. List the two ways a receptor can be stabilized in the bite–wing technique and identify which one is
recommended for bite-wing exposures.
6. List the three receptor sizes that can be used in the bite–wing technique and identify which size is
National Standards Covered
ABHES DAI (Dental Assisting I – Basic)
• Section A: Curriculum, Competencies, Externship and/or Internal Clinical Experience:
ABHES DAII (Dental Assisting II – Advanced)
• Section A: Curriculum, Competencies, Externship and/or Internal Clinical Experience:
• Clinical equipment function and maintenance: Operate dental equipment according to
manufacturer’s guidelines and institutional policy. (6.b)
Chapter 19: Bite-Wing Technique 5
TEACH Lesson Plan
IANNUCCI AND HOWERTON: Dental Radiography: Principles and Techniques, 5th Edition
National Standards Covered (Continued)
CODA Standards for Dental Assisting Programs
• Standard 2: Educational Program:
• The curriculum must include content at the in-depth level in dental radiology. Students must
exposing dental images on manikins. (2-16.e)
CODA Standards for Dental Hygiene Programs
• Standard 2: Educational Program:
Lesson Preparation Checklist
• Prepare lecture from TEACH lecture slides available on Evolve.
Materials and Supplies
• bite-wing film holder and bite-wing tabs
Instructor Note
• The estimated time for student preparation marked with an asterisk (*) will increase depending on how
many activities you decide to assign as homework versus performing in the laboratory.
Chapter 19: Bite-Wing Technique 6
TEACH Lesson Plan
IANNUCCI AND HOWERTON: Dental Radiography: Principles and Techniques, 5th Edition
Classroom Preparation
Lesson 19.1: Bite-Wing Technique
STUDENT PREPARATION (8* hrs)
1
READ – Textbook (pp. 197-210)
ANSWER – Textbook
• Quiz Questions: Short Answer, question 1 (p. 212)
3
READ – Textbook (p. 198)
4
ANSWER – Textbook
READ – Textbook (pp. 198-199)
ANSWER – Textbook
• Quiz Questions: Essay, question 16 (p. 213)
ANSWER – Workbook Module 4: Technique Basics
8
ANSWER – Textbook
READ – Textbook (p. 201)
ANSWER – Textbook
• Quiz Questions:
• Short Answer, question 7 (p. 212)
Chapter 19: Bite-Wing Technique 7
TEACH Lesson Plan
IANNUCCI AND HOWERTON: Dental Radiography: Principles and Techniques, 5th Edition
STUDENT PREPARATION (8* hrs) (Continued)
11
• Short Answer, question 4 (p. 212)
ANSWER – Workbook Module 4: Technique Basics
• Drawing: Horizontal Angulation, questions 1, 2 (p. 126)
READ – Textbook (pp. 202-203)
• Procedure 19-1: Patient Preparation for Bite-Wing Images (p. 203)
• Procedure 19-2: Equipment Preparation for Bite-Wing Images (p. 203)
ANSWER – Textbook
12
• Multiple Choice and Short Answer: Bite-Wing Exposure Sequence, questions 1, 2 (p. 128)
READ – Textbook (pp. 203-204)
ANSWER – Textbook
• Quiz Questions:
• Multiple Choice, question 15 (p. 212)
• Essay, question 20 (p. 213)
• Ordering, questions 24-28 (p. 213)
ANSWER – Workbook Module 4: Technique Basics
• Bite-Wing Technique Assessment Exercise 5 (p. 137)
APPLY – Workbook Module 4: Technique Basics
ANSWER – Workbook Module 4: Technique Basics
• Drawing: Receptor Placement, questions 1-4 (p. 127)
• Identification and Short Answer: Bite-Wing Errors, questions 1-8 (pp. 129-130)
REVIEW – Workbook Module 4: Technique Basics
• Bite-Wing Technique Assessment Exercise 1 (p. 133)
• Bite-Wing Technique Assessment Exercise 2 (p. 134)
• Critical Thinking Questions 1, 2 (p. 166)
14
READ – Textbook (p. 210)
15
REVIEW – Workbook Module 4: Technique Basics
• Review Materials (pp. 169-175)
READ – Textbook (p. 210)
Chapter 19: Bite-Wing Technique 8
TEACH Lesson Plan
IANNUCCI AND HOWERTON: Dental Radiography: Principles and Techniques, 5th Edition
STUDENT PREPARATION (8* hrs) (Continued)
All
PRACTICE – Laboratory Manual*
• Module 6: Bite-Wing Technique with Tabs: Exposures, Mounting, and Critique (pp. 403–412)
ANSWER – Laboratory Manual*
• Module 6: Bite-Wing Technique with Tabs: Exposures, Mounting, and Critique (p. 413)
Chapter 19: Bite-Wing Technique 9
TEACH Lesson Plan
IANNUCCI AND HOWERTON: Dental Radiography: Principles and Techniques, 5th Edition
50-Minute Lesson Plan
Lesson 19.1: Bite-Wing Technique
LECTURE OUTLINE (25 min)
3
OPENED AND OVERLAPPED CONTACT AREAS: SLIDE 10 (p. 198)
4
TECHNIQUE PRINCIPLES: SLIDE 11 (pp. 198-199)
• Discuss the basic principles of the bite-wing technique.
1
&
KEY TERMS AND BITE-WING USE: SLIDES 6-9 (pp. 197-210)
• Discuss the key terms associated with the bite-wing technique.
• Describe the purpose and use of the bite-wing image.
7
HORIZONTAL ANGULATION: SLIDE 15 (p. 201)
• Describe correct and incorrect horizontal angulation.
8
VERTICAL ANGULATION: SLIDE 16 (p. 201)
• Describe the difference between positive and negative vertical angulation.
9
RECOMMENDED VERTICAL ANGULATION: SLIDE 17 (p. 201)
• Discuss the recommended vertical angulation for all bite-wing exposures using a bite-wing tab.
10
• Describe the basic rules for the bite-wing technique.
13
MOLAR AND PREMOLAR RECEPTOR PLACEMENTS: SLIDES 24–26 (pp. 204-210)
• Describe the correct premolar and molar bite-wing receptor placements.
14
VERTICAL BITE-WING IMAGES: SLIDE 27 (p. 210)
BASIC RULES: SLIDE 18 (pp. 201-202)
LEARNING ACTIVITIES (choose one or more to equal 25 min)
1
&
2
REVIEW (15 min; 20 min)
• Using the key terms flash cards that the students prepared as a homework assignment, have
the students quiz one another with the flash cards. Correct their pronunciation as needed.
Chapter 19: Bite-Wing Technique 10
TEACH Lesson Plan
IANNUCCI AND HOWERTON: Dental Radiography: Principles and Techniques, 5th Edition
LEARNING ACTIVITIES (choose one or more to equal 25 min) (Continued)
3
POST & COMMENT (10 min)
• Post Critical Thinking Question 1 for this lesson on the Evolve discussion board. Students
should post their answers and conduct an online discussion in comments. Each student should
offer critical feedback to at least two other students.
• Appropriate Setting: Online
DISCUSS (20 min)
• Divide the class into small groups. Provide each group examples of dental radiographs with
opened and overlapped contact areas. Have each group discuss how this error occurs and
4
DEMONSTRATE
• See the Simulations activities at the end of this Lesson Plan.
5
PRACTICE (15 min)
• Divide the class into small groups. Provide each group with a bite-wing film holder and bite-
wing tabs. Have each group practice placing a bite-wing film holder and bite-wing tab. Provide
feedback as necessary.
• Appropriate Settings: Traditional classroom, flipped classroom
6
DISCUSS (20 min)
• Divide the class into small groups. Distribute the four different sizes of dental film to each
group. Have the groups discuss the different films sizes and what they are used for. Have the
groups share their findings with the class for discussion.
• Appropriate Settings: Traditional classroom, flipped classroom
• Appropriate Settings: Traditional classroom, flipped classroom
8
CREATE (15 min)
• Divide the class into small groups, and have each group create a chart indicating the correct
vertical angulation to be used on intraoral radiographs. Have each group share its chart with
the class for further discussion.
• Appropriate Settings: Traditional classroom, flipped classroom
9
vertical angulation to be used on bite-wing radiographs. Have each group share its chart with
the class for further discussion.
• Appropriate Settings: Traditional classroom, flipped classroom
• Appropriate Settings: Traditional classroom, flipped classroom
REVIEW (20 min)
• Divide the class into two groups, and assign one group anterior teeth and the other group
posterior teeth. Have each group create a list of the procedural steps needed to produce a full
radiographic survey of the anterior teeth and posterior teeth, using the paralleling technique.
• Appropriate Settings: Traditional classroom, flipped classroom
CREATE (15 min)
• Divide the class into small groups, and have each group create a chart indicating the correct
Chapter 19: Bite-Wing Technique 11
TEACH Lesson Plan
IANNUCCI AND HOWERTON: Dental Radiography: Principles and Techniques, 5th Edition
LEARNING ACTIVITIES (choose one or more to equal 25 min) (Continued)
13
REVIEW (15 min)
• Divide the class into two groups, and assign one group premolars and the other group molars.
Have each group create a list of the procedural steps needed to produce a four-film
radiographic survey of the premolar and molar teeth, using the bite-wing technique.
• Appropriate Settings: Traditional classroom, flipped classroom
CRITICAL THINKING QUESTIONS
1. After exposing and processing images, the dental radiographer notices that all four of the bite–
wing images have overlapped contact areas and cone–cuts. Why did these errors happen, and
what can the dental radiographer do to correct them?
Discussion Guidelines: Bite-wing images are used to detect interproximal decay, so it is very important
2. After exposing and processing images, the dental radiographer notices that both molar bite–
wing exposures do not show the necessary teeth for a diagnostic image. Why did this error
happen, and what can the dental radiographer do to correct it?
Chapter 19: Bite-Wing Technique 12
TEACH Lesson Plan
Assessments
Chapter 19: Bite-Wing Technique
ASSESSMENTS BY OBJECTIVE
2
Workbook Module 4: Technique Basics
• Completion: Basic Concepts, question 1 (p. 125)
3
4
Workbook Module 4: Technique Basics
5
Evolve Instructor Resources
• Test Bank: Multiple Choice, question 1
8
Evolve Instructor Resources
• Test Bank: Multiple Choice, question 10
9
Evolve Instructor Resources
Evolve Instructor Resources
10
• Multiple Choice and Short Answer: Vertical Angulation, questions 1-5 (p. 128)
Workbook Module 4: Technique Basics
Workbook Module 4: Technique Basics
Evolve Instructor Resources
• Test Bank: Multiple Choice, question 20
Workbook Module 4: Technique Basics
13
Evolve Instructor Resources
• Test Bank: Multiple Choice, questions 12, 14
Evolve Instructor Resources
• Test Bank: Multiple Choice, question 13
Evolve Instructor Resources
• Test Bank: Multiple Choice, questions 8, 15-17
Workbook Module 4: Technique Basics
• Drawing: Receptor Placement, questions 1-4 (p. 127)
• Identification and Short Answer: Bite-Wing Errors, questions 1-8 (pp. 129-130)
• Bite-Wing Technique Assessment Exercise 1 (p. 133)
• Bite-Wing Technique Assessment Exercise 2 (p. 134)
Chapter 19: Bite-Wing Technique 13
TEACH Lesson Plan
IANNUCCI AND HOWERTON: Dental Radiography: Principles and Techniques, 5th Edition
ASSESSMENTS BY OBJECTIVE (Continued)
All
Laboratory Manual
• Module 6: Bite-Wing Technique with Tabs: Exposures, Mounting, and Critique (pp. 403–413)
Chapter 19: Bite-Wing Technique 14
TEACH Lesson Plan
Simulations
Chapter 19: Bite-Wing Technique
SIMULATIONS BY OBJECTIVE
Bite-Wing Technique (15 min)
4
Equipment Needed
• bite-wing tabs
Patient and Equipment Preparation for Bite-Wing Images (30 min)
11
split into pairs and role play being the patient and the dental radiographer, in order to practice
Equipment Needed
• beam alignment device
• bite-wing tab
PRACTICE – Textbook
• Procedure 19-1: Patient Preparation for Bite-Wing Images (p. 203): Demonstrate to the class
how to prepare the patient for bite-wing images. After the demonstration, have the students
the students practice the procedural steps.
Premolar and Molar Bite-Wing Exposure with Bite Tab (30 min)
13
demonstration, have each of the students practice the procedural steps.
Equipment Needed
• beam alignment device
• bite-wing tab
PRACTICE – Textbook
• Procedure 19-3: Premolar Bite-Wing Exposure with Bite Tab (pp. 204-206): Demonstrate to the
class the prescribed steps to follow for premolar bite-wing exposures with bite tabs. After the
Chapter 19: Bite-Wing Technique 15
TEACH Lesson Plan
IANNUCCI AND HOWERTON: Dental Radiography: Principles and Techniques, 5th Edition
SIMULATIONS BY OBJECTIVE (Continued)
Bite-Wing Placement (15 min)
14
Equipment Needed
• bite-wing films
• bite-wing tabs
PRACTICE