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Transitioning from Film-Based to Digital Radiography

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.

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