Transitioning from Film-Based to Digital Radiography
Paul Feuerstein, DDS
Digital radiography has become one of the fastest-growing
technologies for the dental industry. Clinicians rely on radiographs for the
diagnosis of dental disease, from caries to growth abnormalities. Traditional
film radiography has been easy to use and forgiving with regard to technique. Although
this method may appear inexpensive, all of the peripheral factors should be
considered. Film, chemistry and disposal, mounts, processor maintenance, as
well as developing and mounting time, may total more than $8,000 per year. While
many practitioners may balk at the initial cost of transitioning to digital
radiography, in approximately three years, the average dental practice will
demonstrate a significant return on investment.
In addition to cost factors, the clinical advantages of
digital radiography are readily demonstrable. As many dental students witness during their university training, diagnosis of a condition on a 17-inch
screen is often easier for the clinician and most certainly for the patient to visualize.
Manipulation of brightness and contrast, along with software filters, offer
cleaner images to detect subtle oral changes. Sharing the images with colleagues,
specialists, and third parties may be rapidly facilitated by either printing or
sending electronically, eliminating the chore of duplication. A distinct
advantage of digital systems also exists in the significant reduction of radiation.
Diagnosis of oral conditions is enhanced by the use of
various programs and filters. Some systems, for example, assist in the
evaluation of digital radiographs and enable the detection of interproximal
caries and determination of the presence of decay. Other companies have
"sharpness" filters, fracture filters, relief filters, and even
pseudo 3-D software. The latter provides a three-dimensional image that
highlights bone levels, overhangs, large decayed areas, and other specific
regions to assist the dental professional in educating the patient about their
condition. The growing availability of tablet computers is similarly conducive, aided by digital images, to discussing intraoral conditions with patients.
The return on investment will also be recognized by the time
saved in taking and, if necessary, retaking images. In a typical emergency
visit, using a sensor allows a patient to be seated, radiographed, and
diagnosed in less than two minutes. These implications are obvious in a busy
practice, especially for patients who are “squeezed into the schedule.” There
may be time for palliative treatment rather than prescribing medication for the
patient and rescheduling for further treatment.
Since the images are stored electronically, stacks of
envelopes and old mounts are eliminated, as well as misplaced or misfiled. Some
practice management systems allow indexing of the images by tooth numbers; for
example, all films of tooth #4 on a particular patient can be displayed
chronologically for comparison purposes.
Prior to purchasing a digital radiography system, it is best
for the practice to attend a dental supply dealer's showroom, a dental meeting,
or schedule a demonstration at the office. The devices and sensors can be
tested by the clinician as well as all staff members who will be utilizing the
system. A significant part of the purchase decision should also be based on the
manufacturer, including warranties, service contracts and, most importantly,
interviews with other users of the system.
Digital radiography will be a valuable component in the
majority of dental practices over the next few years. Do the homework and experience
an easy transition from film radiography to digital.
*Private practice, North
Billerica, MA., Technology Editor for Dental Economics, ADA Council on Dental Practice Consultant.