Sixty years ago dentists were holding x-ray film with their fingers in patients’ mouths while the exposure was taken. Explaining to the patient why the x-ray was needed was a challenge. Fifty years ago dentists were using arsenic on vital pulpal exposures to mummify the contents of the pulp chamber in lieu of traditional root canal therapy. Explaining how important it was to keep the tooth instead of extraction was a challenge. Forty years ago amalgam was prepared by combining mostly silver particles and mercury. This was triturated. The mixture was placed in a cloth circle. Then the amalgam was squeezed between the fingers to express the excess mercury. Getting the patient to understand that a gold restoration was better was a challenge. Thirty years ago composites were replacing silicates. They percolated and rapidly discolored. Telling the patient that deep silicate restorations caused irreversible pulpal inflammation was difficult. Twenty years ago baking soda and peroxide was going to be the treatment to arrest periodontal disease. Getting the patient to accept periodontal surgery after the conservative therapy failed was not easy. Microscopic examination of periodontal pocket contents was the rage. Where is your microscope today? Ten years ago radiographs, translumination, detecting dyes, and visual examination were the only way to detect caries. Having the patient realize that caries was an infection that can spread in the mouth to other teeth was a challenge.
Today, digital radiographs minimize radiation and eliminate the use of environmentally hazardous processing chemicals, excess mercury has been greatly reduced in amalgam restorations, composites are placed more than amalgam, conservative periodontal therapy with intra-pocket antibiotics have reliable results if used with the correct protocol, and caries can be detected with density diagnostics with Diagnodent® and lasers.. The dental profession has greatly improved the health outlook for the patient.
However, some things never change. The ability to communicate and motivate the patient to accept the necessary treatment is a constant challenge. The dental team needs to utilize every available tool to get the patient to accept the necessary treatment. Fortunately, aids to communication have improved. There are video informational tapes, brochures, intra-oral cameras, digital photos, and the newest modality, digital radiographs.
Digital radiographs not only improve the ability of the dentist to diagnose disease, but also enable the patient to identify with their problem. Certain digital x-ray systems, such as Dexis® have more options than others. More dentists are purchasing digital x-ray systems than any other major dental equipment at the present time. Digital x-rays are more cost effective than regular film. Take an average office taking 2 full sets a day, 6 sets of bitewings and 5 periapicals. The film costs at the end of the month are around $525. A digital system’s monthly investment would be around $325. Perhaps the greatest benefit is for the patient. There is greater intra-oral comfort, lower radiation exposure, shorter appointments and great visual display that improves the patient’s understanding of their treatment.
Digital x-rays systems are more efficient which is a key factor in today’s dental practices. You are able to have an instant image, quick retakes, no processing equipment to clean, no lost x-rays, and easy duplication. Digital x-rays also benefit the practice as it facilitates rapid diagnosis, improves case acceptance, and streamlines the work flow.
X-rays today remain a fundamental diagnostic tool of every dentist in America. How you choose to take those images can greatly impact your practice. Our recent e-Management newsletter survey stated that more dentists were choosing to implement digital radiography than any other technology available to them.
In the next article I will discuss the different equipment available and the protocol on how to use it to maximize the interaction between the dental team and the patient. In addition, understanding the ways the image can be displayed and enhanced and the advantages that the digital system has to offer in improving diagnosis will help to improve your practice.
Interested in having Dr. Allan Monack speak to your dental society or study club? Click here.