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Medical Forum / General / Dentistry / August 2005Are digital x-rays betterthan film?
I would like to change dentists (a matter of location). I am considering two new dentists, one uses the old-fashioned film-rays, the other one uses the new digital x-rays. I am impressed with the clarity and detail of the digitals. You can even magnify particular areas of interest. The images are much larger than the tiny film x-rays. They are also instantaneous and subject patients to less radiation. Why is not every dentist using the new, digital x-rays? Is this a matter of cost? Are film x-rays obsolete? I wonder about the percentage of dentists that use the digitals. Does anyone know?  SignatureJames > I would like to change dentists (a matter of location). I am considering two > new dentists, one uses the old-fashioned film-rays, the other one uses the [quoted text clipped - 11 lines] > -- > James Both methods of radiological examination will give a competent dentist similar useful diagnostic information. It would be more productive to choose a dentist based upon factors of proven skill and reputation in the community. Your dental health will be much more dependent on the skill of the dentist who delivers your healthcare than upon the brand or subtype of eqipment used. - dentaldoc >From a patient perspective it does not matter. There are some advantages to using digital in certain offices. Also as far as comfort film is more accomodating than the digital sensors. ...................... > >From a patient perspective it does not matter. There are some > advantages to using digital in certain offices. Also as far as comfort > film is more accomodating than the digital sensors. Phosphor plates are even softer than film >> I would like to change dentists (a matter of location). I am considering >> two [quoted text clipped - 23 lines] > be much more dependent on the skill of the dentist who delivers your > healthcare than upon the brand or subtype of eqipment used. I agree with the last paragraph fully. However, the dentist can certainly see more on an image which is two foot wide compared to one that is one inch wide. > > Both methods of radiological examination will give a competent dentist > > similar useful diagnostic information. [quoted text clipped - 7 lines] > see more on an image which is two foot wide compared to one that is one inch > wide. The camera that I use to put up my photos and x-rays for all to see here on the SMD is a Fuji 6900S with three different close-up lenses, which screw on. You have all seen that the photos taken this way off the x-ray view box and posting them can be detailed enough to discuss cases with. Before going down South, I took an x-ray of a symptomatic lower PM and took a digital photo of that x-ray and then plugged the camera directly into the TV/VHS arrangement that my little I/O camera is connected to. I SAW the lesion on the (126$CDN) screen; whereas on the x-ray with my loops, I saw _what might haved been_ a periapical lucency. Bite-Wings would also benefit from this magnification as well, I'm sure. It is worth taking the time to do this, if only to show the patient what you're looking at and why s/he needs this procedure you're proposing done. Some day, I'll have digital x-rays, if only to help me see what all you eagle-eyed pointy-heads see on the little number 2 Kodak UltraSpeed film. For now, this double procedure will have to suffice. Cheers <the Pipe falls off the chair> SP SignatureFinally: take out the TRASHH You can certainly digitize film and having good quality for diagnosis. The problem I've had although minor is the time it takes to digitize an fmx and then archive it. Then you have old endo x-rays that have not been fully fixed and deteriote over time. and you are always dependent of the quality of your chemicals as the day progresses. I am sure your system works for you eventually you will find yourself with the situation I was in either buy digital x-rays or give the $$$ to uncle sam. They have some nifty software out there that organizes all the images for fast retrieval without having to wonder which x-ray belonged to which patient after being trapped in the film processor. There are other nice features which allow you to accurately calibrate the exposure so that you can see both sides of a penny. On film you will have a very hard time to tune your beam to this accuracy, I am not saying that it is useful to see a penny from both sides but its a way to calibrate your settings so you can see more detail. I have to tell you patients hate the sensors and at times it is difficult. I have been holding the sensor many times as my assistant zaps the x-rays. It's been a learning curve here. Also the RINN kit is more picky than the one for film since you now have to worry about the position of the wire relative ti the rinn holder. We started to experiment with different types until we figure out what works best. Given all of this and factoring patient comfort it makes you wonder what the original poster know thinks or meant by the subject line. Or what is the relevancy of it? I am not saying I am not happy about my decision I had good reason to go this route and I am glad I did because from the diagnosis aspect I am getting better quality images from my assistant. Sure you exchange one set of problems for another but I can live better with the digital. > > > Both methods of radiological examination will give a competent dentist > > > similar useful diagnostic information. [quoted text clipped - 32 lines] > > SP > Given all of this and factoring patient comfort it makes you wonder > what the original poster know thinks or meant by the subject line. Or [quoted text clipped - 3 lines] > am getting better quality images from my assistant. Sure you exchange > one set of problems for another but I can live better with the digital. Have you considered those phosphor plate arrangements like DrS uses?. I have seen the sensors get smaller and smaller with time, but I think the phosphor plate has advantages, one being that the hygienist can use the same system as well, at almost the same time. I dunno... The local Endo Guy has the same setup as well, and he doesn't regret it. Thanks SP SignatureFinally: take out the TRASHH I have considered the phosphor plate for a panorex solution. I realize they are smaller but you still have to arrainge them like film in the software. And if you need to retake you will not know until you scan the plates. With the sensor you can retake without removing the sensor from patient's mouth. In time they will probably come up with a flexible sensor which will eliminate these problems. Also they deteriorate after time. The sensor provides the same quality until the cord breaks at which point you can not get any image until it is repaired. All digital systems have pros and cons for my needs I can live with the cons for sensors. Maybe it is best to have both types for that odd patient and maybe as the cost goes down it may be worth getting. > All digital systems have pros and cons for my needs I can live with the > cons for sensors. > Maybe it is best to have both types for that odd patient and maybe as > the cost goes down it may be worth getting. I am watching these RF SYSTEMS people ( the ones who make the little inexpensive I/O camera I was so excited about ). They have been coming up with some really nifty technologies for dentists. If anybody develops the type of system you have in mind, I would bet on it being them. Now if they could only come up with an O3 based sterilizer for Laser handpieces and such.... Cheers SP SignatureFinally: take out the TRASHH Since we use Precision film holders for FMX images, it is VERY rare to ever have a re-take. It is all in the training and the equipment used. As far as re-arranging images on a template, it is drag and drop. Takes seconds to do the whole survey. Phosphor plates eventually get scratched and need to re retired. I get 2-4 years to a plate. Replacement cost is now less than $25. The only time I have to wait for an image is validating length during endo procedures. I suggest offices go phosphor plate with one sensor for endos. JMHO. Signature~+--~+--~+--~+--~+-- Stephen [What's a Temporary?], D.D.S. Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... >I have considered the phosphor plate for a panorex solution. > I realize they are smaller but you still have to arrainge them like [quoted text clipped - 10 lines] > Maybe it is best to have both types for that odd patient and maybe as > the cost goes down it may be worth getting. > The only time I have to wait for an image is validating length during endo > procedures. I suggest offices go phosphor plate with one sensor for endos. > JMHO. Do you have any brand names to recommend? Have these things been around long enough for there to be a second-hand market? Thanks SP SignatureFinally: take out the TRASHH I have not seen any being sold second-hand. First figure the cost of a networked PC in each treatment room. Add in the cost for a PC where you are going to scan the plates. After this, the system is usually about $16K USD. IF you check how much money you spend using film in a year (include cost for film, chemistry, chemical disposal, processor parts, labor to change the water every day, labor to change chemistry every few weeks, labor to duplicate images, labor to mount images, cost of film mounts, labor spent trying to find film images that fall out of charts, etc.). I think you will find that a digital x-ray system has a ROI of 2-4 years and is free after that. Your recurring cost will be the vinyl wrappers and replacing 2-4 plates a year if they get scratched. Wrappers are 13 cents each and plates are less than $25 each. I use Gendex. I know people who are happy with ScanX. Both have advantages and disadvantages. Cost is very close. Footprint and scanner height are slightly different. One will load and scan a single images faster, While the other is quicker to load a FMx or PanX/CephX Signature~+--~+--~+--~+--~+-- Stephen [What's a Temporary?], D.D.S. Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >> The only time I have to wait for an image is validating length during [quoted text clipped - 8 lines] > Thanks > SP > I use Gendex. I know people who are happy with ScanX. Both have advantages > and disadvantages. Cost is very close. Footprint and scanner height are > slightly different. One will load and scan a single images faster, While > the other is quicker to load a FMx or PanX/CephX labor spent trying to find film images that fall out of charts, etc. labor spent trying to find film images that fall out of charts, etc. labor spent trying to find film images that fall out of charts, etc. labor spent trying to find film images that fall out of charts, etc. labor spent trying to find film images that fall out of charts, etc. Yes! ... 'specially in Endo. 'K. Thanks for the info SP SignatureFinally: take out the TRASHH > I have not seen any being sold second-hand. First figure the cost of a > networked PC in each treatment room. Add in the cost for a PC where you are > going to scan the plates. After this, the system is usually about $16K USD. I figured that I would not nework, as I am not sure it is warranted with the low numbers of regular patients I have . I would have two laptops ( one for me and one for the hygiene room ) and we'd dance around each other with them. Then, I'd back up both to a removable harddisk or a tape system like you have. -- or -- What about having two scanners; one on each laptop? That could work, I think. If not, the computer running the scanner could be brodcasting it to the other two computers, which would no longer have to be laptops. How does that sound? Thanks SP SignatureFinally: take out the TRASHH You are far better off using PC's. Forget the laptop in a clinical situation. Too hard to disinfect, easy to steal, easy to drop, wireless networks are too slow for dental images, and there is an issue with privacy regulations, since you can take the lap-top home, anyone at your house could look at the data. Figure about $2K USD for each clinical PC,,, less for a front desk machine. You could share duties with the front desk machine as a workstation/server, or get a separate server. Network hub and wiring gets you in business (some time spent configuring the network and assigning rights to each PC.) Right now, there are not many scanners sold with transparency adaptors built into the lid that are large enough to scan a FMx or a PanX. These are $2-3K USD right now. Umax used to make one in the $500 USD range, but they stopped making it. You might be able to find a used one on eBay, but these required SCSI cards which are not supported by Windows XP. You would have to run Windows 2000 on the machine hooked up to the scanner. I estimate that in 2-3 years, you will not have any software vendors supporting windows 2000 anymore. They are already dropping out of supporting Windows 98. Signature~+--~+--~+--~+--~+-- Stephen [What's a Temporary?], D.D.S. Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >> I have not seen any being sold second-hand. First figure the cost of a [quoted text clipped - 19 lines] > Thanks > SP >Figure about $2K USD for each clinical PC,,, less for a front desk machine. Outrageous ! You can now get a new Dell with monitor for ~$400 I could build one for less. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com I am talking installed by an IT technician with full on-site warranty and guaranteed to function with your chosen software. Can you get a PC cheaper, yes. Will anyone guarantee that it will work with your chosen software, no. Signature~+--~+--~+--~+--~+-- Stephen [What's a Temporary?], D.D.S. Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >>Figure about $2K USD for each clinical PC,,, less for a front desk [quoted text clipped - 10 lines] > Take out the G'RBAGE > wubbabubbazG@RBAGEyahoo.com >I am talking installed by an IT technician with full on-site warranty and >guaranteed to function with your chosen software. > >Can you get a PC cheaper, yes. Will anyone guarantee that it will work with >your chosen software, no. I can get it to work. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com Perhaps so, but the average dental office has to rely on outside help. Signature~+--~+--~+--~+--~+-- Stephen [What's a Temporary?], D.D.S. Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >>I am talking installed by an IT technician with full on-site warranty and [quoted text clipped - 10 lines] > Take out the G'RBAGE > wubbabubbazG@RBAGEyahoo.com $329 including monitor in today's Metro! I am thinking I got to buy a new computer (at these prices), but I have a whole bunch of fairly new ones already! I just got the wireless Ethernet router to plug into our network at the office for doing some periodontal chartings and stuff. I wil let you know how it works out. The router was $19.95 after rebate at Office Max. Joel Joel W_B Wrote: > >Figure about $2K USD for each clinical PC,,, less for a front des > machine. [quoted text clipped - 9 lines] > Take out the G'RBAGE > wubbabubbazG@RBAGEyahoo.co -- Joel34 > I am impressed with the clarity and detail of the digitals. You can even > magnify particular areas of interest. The images are much larger than the > tiny film x-rays. They are also instantaneous and subject patients to less > radiation. very true > Why is not every dentist using the new, digital x-rays? Is this a matter > of cost? Are film x-rays obsolete? I wonder about the percentage of > dentists that use the digitals. Does anyone know? Dentists are not always the best businessmen. They forget to do the proper analysis to figure out cost to benefit ratio of these devices. The equipment is costly, but it actually costs more to use film and wet processing. Dental x-ray film is being phased out slowly by manufacturers. It will take a while to convert everyone. > Dental x-ray film is being phased out slowly by manufacturers. >It will take a while to convert everyone. I hear they are phasing out paper for the WC so that you may truly have a 'paperless' office. <G> -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com It is called a bidet. Signature~+--~+--~+--~+--~+-- Stephen [What's a Temporary?], D.D.S. Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >> Dental x-ray film is being phased out slowly by manufacturers. [quoted text clipped - 9 lines] > Take out the G'RBAGE > wubbabubbazG@RBAGEyahoo.com I was traveling to Argentina for a wedding with a couple of friends of mine we stayed at this one hotel that had a bidet. My friend decided to use it. He was sitting on it for 2 hours. When he came out he had a smile on his face. > It is called a bidet. > [quoted text clipped - 23 lines] > > Take out the G'RBAGE > > wubbabubbazG@RBAGEyahoo.com >It is called a bidet. Good one ! -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com |
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