The revolution will be digitized
Digital technology is a groundbreaking force in dental imaging.
Medical radiology traces its origins back to 1895, and it only took two more weeks before Dr. Otto Walkhoff, a dentist from Braunschweig, Germany, applied it to dentistry. Dr. Walkhoff made a dental radiograph using a glass photographic plate wrapped in black rubber and requiring an exposure of 25 minutes. Thus was the first intraoral radiograph.
We’ve come a long way since then, and digital imaging gives us views—of both two- and three-dimensional varieties—that Dr. Walkhoff likely never dreamed of.
The merits of digital imaging
Diagnostically speaking, digital images give faster, clearer, more comprehensive views than their analog predecessors.
“Our diagnostic capability is greatly improved,” Dr. David Rice, DDS, a general dentist in Amherst, N.Y., and founder of IgniteDDS.com, says. “The clarity of today’s sensors is so much better than what we had in the past. Diagnostically, I’m a much better dentist. I can have real-time conversations with specialists, because I can take an image, pull it off my software, email it and in the moment—with the patient in the chair, or vice versa if one of my patients is in their chair—we can be talking back-and-forth about exactly what’s happening as it’s happening.”
Digital imaging includes more than just X-rays. For example, DEXIS’s CariVu system uses radiation-free imaging to discover caries in its early stages.
“2D imaging has gone way beyond the X-ray,” Marshall Martin, senior product manager for DEXIS, says. “The X-ray is just one component. There are capabilities for different modalities that are available to actually diagnose people. We’re looking much more comprehensively now. The old idea that you, as a patient, come in, get your X-rays and that’s only what your dentist uses to diagnose is out of date. It’s just waiting until disease progresses to a point that can actually be picked up in an X-ray. In this case, the dentist waits too long and disease progresses, when it could have been found sooner with another modality. One of the things dentists recognize is that if they can detect disease early, the patient may have a better outcome.”
“We’re able to catch decay so much earlier to be more preventive and conservative than ever before,” Dr. Jason Watts, DMD, a general dentist in Cape Coral, Fla., adds. “Everything we do is now enhanced by digital imaging: The root canal that we do and complete; the fillings that we do; the ability to detect decay before it becomes an abscess or infection.”
Doctors are always up against the clock, but when it comes to digital imaging, time is less of an issue.
“With standard analog film, you’ve got to wait for an image to be processed,” Dr. Ed Shellard, D.M.D, vice president of sales and marketing of Carestream Dental, says. “And then you have to determine, ‘Is that a good image or not?’ You may be a few minutes in after you’ve taken the image and then you may realize, ‘Hey, I didn’t get the images that I wanted. I didn’t get the full length of the tooth. I didn’t get the apex,’ and then have to go back and retake the image. But with digital, the image comes up immediately on the screen, and so you can tell right away if you captured the proper area, which is important from a treatment perspective and a time perspective. Within the office, that’s a big help.”
It isn’t just the doctor who can see more, thanks to digital imaging. Dr. Rice relies on digital imaging as an important tool for patient education.
“What I can do with digital that I can’t do with plain film is I can change the size of an image so it’s easier for them to read,” Dr. Rice says. “I can modify the image, so I can colorize it, I can do what’s called ‘inverting’ an image, which means we can change how the radiolucency and radiopacity appears on an X-ray, and that just really helps me get a patient on board and understand what I see.”
The ability to communicate that information to the patient aids in treatment plan acceptance.
Martin references a study showing a 25 percent increase in patient acceptance of treatment when digital imaging shows their condition.
“We know that patients are visual learners,” Martin says. “We know when the dentist shares his photographs, images and information in a way that is reasonable for a patient to understand, there’s a significantly higher response for patients. It’s the old adage: If you tell me, I’m going to forget it and I’m not going to care about it; if you show me, I might remember what you’re talking about; but digital allows the dentist to involve the patient, and when people are involved in their own treatment needs, there are better outcomes for the patient and the office.”
The portability of digital images is another benefit, allowing doctors to view patient scans virtually anywhere.
“One of my favorite features of digital imaging is our ability to access images from anywhere,” Dr. Leah Capozzi, DDS, a general dentist in Buffalo, N.Y., says. “I can remote into the system, if I need access to images, to discuss a case with a specialist or refresh my memory about a case. I also like to review the images from my office while the assistant or hygienist is working on the patient. It makes it so much easier to start treatment planning and get my thoughts organized prior to sitting down with the patient.”
“We’re seeing more and more offices and practitioners combining offices and going into group practices, or even medical facilities,” Jan Myskowski, clinical program manager, 2D and Small Equipment at Kavo Kerr Imaging, adds. “The doctors travel from office to office, and they’re needing the use of the application devices, so if they have a smartphone or if they have a tablet, they want an application where they can view these images and diagnose remotely.”
Up next: Benefits of 3D imaging ...