The look and feel of the modern dental practice has changed dramatically over the past 10 years. Systems that were once paper-based have now moved into the digital realm. In many dental advances over the past few years, there’s no doubt that the technology has been the driving force in this process. This is as true in other fields as it has been in dentistry. In the early 1990’s, intraoral cameras were all the rage. In the late 90’s, it was digital cameras. And, at present, no other topic seems to generate greater interest that digital radiography. While entire books can be written on the subject, the goal for this article is to focus on how digital radiography can improve the profitability of the practice, particularly by improving case acceptance.  

Having worked with hundreds of offices who have installed digital radiography, the biggest hurdle to adopting this technology is financial. Not only is the cost of the sensors and software very high, but there is the need to add operatory workstations, expand the capacity of the server, mount monitors, improve the data backup, and the ongoing costs of support and maintenance. While these initial costs are high, there is little doubt that using digital radiography can definitely help the bottom line of the practice by increasing patients’ willingness to come to the practice and accept treatment. There are a number of key areas where digital radiography makes sense:
 

1. There is no doubt that in order to increase case acceptance, we have to improve our ability to diagnose disease, and the vast majority of dental practices find digital radiography to be superior to film. In a recent survey in DentalTown magazine, over 73% of the respondents claimed that they found digital radiography to be more diagnostic than film. There are a few reasons for this. First, there’s a big difference between seeing a life size image which is around 1” vs. an image magnified to fill up a typical 17” or 19” screen. A good monitor with a high contrast ratio (greater than 500:1) will bring out all the subtle shades of grey that are important when trying to diagnose caries. Secondly, and just as importantly, all digital radiography software gives us incredible tools to improve diagnostics. The most popular of these is the capability to alter the brightness and contrast of the image. Other tools that many offices will use include sharpening, smoothing, equalization, inverting, gamma, and noise removal. All software also has magnification tools, permitting you to zoom in on key areas of the image. There are a few programs that really simply this process. For example, XDR, a smaller company from the Los Angeles area, offers a “caries” icon and a “perio” icon. One click of the icons will apply numerous filters and enhancements to bring out the diagnostic features of the image with minimal muss and fuss.
2. A practice that is efficient and saves time will be very attractive to your patient base, many who are busy and would prefer to minimize the time spent in the office. The time savings with digital radiography are quite significant. However, it’s important to understand that the time savings are limited to the hard sensors. Phosphor plates systems, while an excellent option for many offices, does not provide any time savings over traditional film. Offices also need to know that the process of digitizing film through use of a film scanner will also slow down the process. When using sensors, most offices will see the image on the screen within 5-6 seconds. Another big time saving is that once the full series is complete, there is no more work to be done. The images don’t need to be processed in the developer, there is no mounting of the film, and no clean up or mess of the chemicals. Many offices can start and finish a full mouth series of radiographs in well under 10 minutes, allowing patients to get in and out of the office quicker.
3. Another key feature of digital radiography is the fact that you can reduce the exposure time of the radiographs. This can be a big selling point for current and future patients. One thing to be cautious of is that many vendors still claim unrealistic amounts of exposure reduction. When digital radiography was first introduced, film was much slower and their claims of 80-90% reduction in exposure were accurate. However, over the past 15 years, the speed of film has greatly increased, and many offices are now using E speed film. While offices using digital radiography should still expect a reduction, it’s closer to 30-50% over film. In any event, this can be a big marketing advantage for the practice. Even though many of us know that the exposure even with film is minimal, patients want to know that they are being exposed to the least amount of radiation possible.
4. Speaking of marketing, another reason for offices to consider digital radiography is how having these technologies improves the image of the practice. For many years, dentists who purchased digital radiography systems were considered to be very progressive. Many offices saw a large influx in new patients that were referred by existing patients who were impressed that the office was so technologically advanced. While that is still true today, many offices are now considering digital radiography not to stay ahead of the curve, but to catch up. Recent surveys in various journals have shown that the market penetration of digital radiography is around 20-30%, far more than was originally thought. Just as importantly, at least 15-20% of offices plan on adding digital radiography in the next 12-18 months. So, it’s no longer a matter of being on the bleeding edge but rather, to keep up with your competitors.
5. Probably the biggest selling point of digital radiography for case acceptance is the concept of co-diagnosis. In the past, patients had to rely on their trust of the practice and the dentist to proceed with dental treatment. In many cases, their conditions were not apparent to them, did not have any associated pain, and patients often were unaware of their dental problems. While we often tried to show patients the x-rays on a viewbox, this is really not ideal for most patients as they have trouble seeing the problems. Digital radiography changes all of that. Now, dental problems that show up in a radiograph can be viewed on a 17” or 19” screen, and the patients, for the first time, can see exactly what we as dental professionals can see. Once they see and understand their condition, they will be far more accepting of our treatment plans, as there will be no doubt in their mind about the status of their condition. This is the core of thinking behind co-diagnosis. In that same DentalTown survey that was previously mentioned, a whopping 94% of practices found that digital radiography had improved their profitability, and increased case acceptance is a big part of that.  

For offices that have been sitting on the fence, now is the time to consider digital radiography. The technology is mature, the systems are stable, and the ability to involve your patients in the process will greatly increase your case acceptance.