Digital X-Rays Give Dentists the Big Picture

For years, an X-ray at the dentist's office went pretty much the same way. The dentist or an assistant would put a wooden or cotton block in your mouth, tell you not to move and disappear.

You'd heard a quick clicking sound, and then you would wait for someone to return with tiny films that could be displayed on a lighted box or board.

Those days are fading. Digital technology has spread to the dentist's office. From 10 to 30 percent of dentists have forgone film, choosing instead digital X-rays that come with a number of advantages.

"There's no film, no chemicals, no darkroom—and the feedback is instant," says Jay Garlitz, D.M.D., a private-practice dentist . "It's quicker and it allows me more time to communicate with the patient, to show them a problem, to make them more of a participant in the process."

Variety of equipment

The equipment varies. Dr. Garlitz, for instance, shows patients their digital X-rays on a 42-inch plasma monitor. However, digital radiography offers the same advantages in a range of settings. Patients can view their X-rays faster, in a much larger format.

"I can use a cursor to point things out to a patient," says Dr. Garlitz. "The better view helps them understand better."

There's also less exposure to radiation, although the degree depends on the old equipment the dentist was using and the new equipment that replaced it. "In some cases, patients are exposed to as much as 80 percent less radiation," says Matthew J. Messina, D.D.S., a consumer adviser for the American Dental Association (ADA). He has been using digital radiography in his practice for 11 years. "I'm changing over now, again, to new, updated equipment."

Experts say radiation exposure from dental X-rays was never high, but less exposure is always better. "The exposure is negligible," Dr. Messina says.

Subtle differences

You probably won't notice anything different about the camera. Your first clue might be large TV-type monitors in the office. Instead of a wooden or cotton block being placed in your mouth, the new technology employs small electronic sensors that are covered with protective barriers and come in different sizes so they can fit comfortably in the mouth.

"We use two barriers—they're like sheaths—for each patient," says Dr. Garlitz.

Film records are at high risk for being destroyed or lost because only the original exists. With digital radiography, the images can be stored on a computer at your dentist's office and copies can be kept off site. "I back up my patient records every night and it takes less than 10 minutes," adds Dr. Garlitz.

Not only are your X-rays better protected and always available, they can be sent electronically to specialists—endodontists, oral surgeons, or periodontists, for example—who are embracing digital dental radiology even faster than general dentists.

James C. Pettigrew Jr., D.M.D., believes that within 10 to 15 years, the vast majority of dentists will be using digital radiography.

The next Next Generation

Dentists now have an even newer tool at their disposal. It's very expensive, but it really produces, and like most new technology, the cost will come down with time.

The new technology is called cone beam computed tomography.

A cone beam CT device shoots a beam at many different angles toward the patient's mouth or jaw, covering a large area in a single pass. Its high-resolution images allow dentists to see areas of interest more precisely.

"It provides 3-D cross-section imaging," explains Dr. Pettigrew. "Cone beam CT has been around in the last five to 10 years, but it's become a lot bigger in the last couple of years."

Cone beam CT will be used to help general dentists and specialists in a variety of ways. Here are some ways, Dr. Pettigrew says, in which the technology provides great advantages:

• Oral surgeons can visualize cysts and tumors and find nerves.

• Orthodontists can visualize nerves.

• Dentists who do implants can visualize nerves and get a cross-section view for placement.

• Dentists who remove wisdom teeth can visualize the space in which nerves run.

"We're able to find things we didn't suspect so they can be corrected before they become a bigger problem," says Dr. Pettigrew.