Transitioning to Digital Imaging

Overview of Dental X-ray

Since its discovery in early 1900’s, the dental industry has been providing dental radiographs, referred to as x-rays. X-rays are used to capture images of the mouth to diagnose, treat and identify oral problems. X-ray images can help identify cavities, cancerous or benign masses, hidden dental structures (such as wisdom teeth), and bone loss that just cannot be seen with the naked eye during a routine oral examination. The film based units use a photographic film that has been exposed to radiation which in turn has to be developed.    

Dentist conducting an x-ray on a female dental patient at the Rochester Dental Dispensary in the early 1900's.

The main drawbacks to the “traditional” x-ray:

  • Requires developing
    • Film requires exposure to a series of chemicals in a dark room
      • Ongoing chemical expenses
      • Handling, storage and disposal of chemicals
  • Time and effort required to clean and maintain film processors
  • Film storage, degradation of images and lost films
  • Film is sensitive to normal light and will expose the film
  • Time consuming process
  • Incorrect exposures or mistakes result in the need to retake
    • Further exposing the patient to additional radiation
  • Inconsistency and poor reliability
Because of the obvious drawbacks of x-ray film, digital x-ray has addressed some of these issues and is becoming widely used in dentistry as the technology evolves.

Benefits of Digital Radiography

Digital radiography is a form of x-ray imaging, where the use of digital x-ray sensors is used instead of traditional photographic film. Instead of x-ray film, a digital image capturing device is used to record the x-ray image and make it available as a digital file. It can then be viewed immediately and saved as part of the patient’s medical record.

The advantages of digital over film include:

  • Speed – depending on the type of system used the images can appear on the computer screen instantly resulting in:
    • Endodontic treatment
    • Post placement in endodontically treated teeth
    • Implant placement
    • Evaluation of the margins of crown and bridge restorations.
  • Image Manipulation – use of computer diagnostics in images
  • Quality – digital imaging produces more consistent quality and is far more reliable.
  • Reduced radiation – an exposure that is often 70 – 80% lower resulting in a safer environment for patients.
  • Diagnose easier and faster
  • Centralized storage and retrieval – all images are stored on a computer and can be accessed almost instantly.
  • Saves Money – lower cost to produce image.
  • Make more money – Doctors can charge more for digital X-ray.
  • Faster payments – Doctors can process the insurance claims electronically.
When we are talking about digital devices there are several types of digital x-ray image equipment that can be used in the dental office: *price range is based on refurbished to new.

Transitional Paths to Digital Imaging

  A panoramic film, able to show a greater field of view, including the heads and necks of the mandibular condyles, the coronoid processes of the mandible, as well as the nasal cavity and the maxillary sinuses. 

The first step in going digital in an existing office is the use of a digital scanner which goes hand in hand with Phosphorus Plates. These plates come in different sizes ranging from intraoral, extraoral, panoramic and cephalometric. The individual plates are taken like film with an x-ray and then placed in a special scanner where the image is retrieved point by point and digitized, using laser light scanning. The image can be seen on the computer screen from between 90 seconds to 4 minutes later. This method is halfway between old film-based technology and current direct digital imaging technology. It is very similar to the film based process but differs because the chemical development process is replaced by the scanning process. For the dentist on a budget this option offers a relatively inexpensive method of incorporating digital x-rays into the dental practice because they can use their existing film based pan alongside the digital scanner. With a single scanner, a dental office can use and reuse the plates to scan images into the computer. From there, the images can be viewed for diagnoses and then stored in the patients file.

Other methods of changing an office to direct digital can include the addition of Digital Intraoral Sensors, Digital Panoramic/Cephalometric and the 3D Cone Beam Computed Tomography.

Technology is not getting less expensive, and with the ever-changing economy, dentists have been seeking other avenues for updating their practice. Digital technology helps dentists by increasing clarity in x-rays, reducing radiation exposure and dramatically reducing patient visit times. This positively impacts the patient experience and increases efficiency and profitability.