Aim. To determine the bilateral occurrence of caries lesions in 5–12-year-old children, and to assess whether one bitewing photograph can predict caries size and occurrence in the homologous tooth on the other side of the mouth.

Study design. The study was carried out on 222 medical files of children 5–12 years old who were first examined in the university dental clinic. The presence and size of the caries lesions in the first and second primary molars and first permanent molars were recorded.

Results. No correlation was found when comparing the caries lesion distribution of each tooth’s proximal surface. Seventy-one of the X-rays demonstrated a single caries lesion in a first or second primary molar or in a first permanent molar on one side of the mouth, of which 21.3% demonstrated a single caries lesion in the collateral side, 43.6% demonstrated 2 or more lesions, and 35.21% did not have any caries lesion on the collateral side of the mouth.

Conclusion. One bitewing cannot determine the presence and size of a caries lesion on the same site of the homologous tooth.

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