Don't Let "Perfect" Get in the Way of "Better"

Sidekick: Dr. Dalin, you've been an advocate for digital radiography since 1999. What would you tell our readers who are considering making the switch from film to digital?

Dalin: Do it now. Don't wait any longer! So often we as dentists don't want to make a wrong decision and we end up doing nothing. This is a technology that we do not need to fear.

Sidekick: You say that with a lot of conviction. Is this the right solution for everyone?

Dalin: I believe it is. Don’t you think all practices and all patients deserve to enjoy the benefits digital radiography offers? Just think about reduced radiation, increased patient comfort, more productive chair time, and finally getting rid of the darkroom thanks to a chemical-free and environmentally friendly imaging technology.

Sidekick: Can you go into a little more detail about the benefits for patients?

Dalin: Sure. We were using D-speed film in my practice prior to going digital, and we were able to reduce radiation across the board for my patients. I know it doesn't seem like a big deal to those of us in the dental profession, but my patients are very appreciative of the fact they are getting less radiation in my office.

Sidekick: The benefits are substantial, but what about the initial investment? Many doctors think it's prohibitive.

Dalin: In fact, just the opposite is true. Most practices actually experience positive cash flow very soon after they switch from film to digital radiography. The first thing I became aware of was how much money I was spending each month on film and supplies and chemicals, not to mention wasted staff time spent developing film. When I was no longer paying those expenses, digital radiography actually cost less than film.

Sidekick: But don't you need to computerize and network your entire office in order to take full advantage of digital radiography?

Dalin: There are some people who say that, but I disagree with them. There is no need for any dental practice to hold off installing digital radiography while they wait to computerize their office. Although the fully networked approach is advisable for some offices, it is often overkill for a majority of others. The way I put it is, “Don't let 'perfect' get in the way of 'better.'”

Sidekick: What do you mean?

Dalin: Well, I hear some advocating doing nothing until you can install the perfect, paperless practice with everything from a computer in each operatory to computer screens with televisions to cosmetic imaging to charting, intraoral cameras, lasers, and the like. I personally like all of these technologies, and I use most of them. However, some of my colleagues might be retired before they would ever see the first X ray popping upon a computer screen if you are waiting to do all these things at once.

If you are looking at digital X ray as a film-replacement technology, it should happen today! This should be the FIRST step towards a digital dental practice and not the last. We are taking X rays daily—this is a logical transition.

Sidekick: How has your team taken to digital radiography?

Dalin: I can say without hesitation that if I asked any of my team members to go back to film I would have a mutiny on my hands. I know they don't miss the processor and the changing of chemicals. More importantly they can do a full mouth set of X rays in five minutes, and they like being able to spend the time they save with our patients giving the best exam possible. For me I know when I walk in the operatory I will see a perfect set of X rays each time, because any retakes can be done instantly, with no wasting another six or seven minutes in the darkroom.

Sidekick: What are some of the other issues that have prevented dentists from making the switch from film to digital?

Dalin: One of the critical issues that seem to be preventing dentists from making the switch to digital radiography is the perceived cost. With regard to cost, you can start small with digital radiography and build gradually. What most dentists find is that they're actually realizing positive cash flow each month after they convert to digital. The monthly costs for consumable supplies and wasted staff time spent in the darkroom developing film is greater than the cost to lease a digital radiography system.

Sidekick: Is the laptop solution an option for all practices?

Dalin: It's an especially good option for small to midsized practices. It enables the dentist to provide his or her patients with the most up-to-date X-ray technology at a cost less than that of continuing to use film radiography. If you decide you want to network your office later, you can simply add computers. Your initial investment is protected and you'll be getting increased patient comfort and treatment plan acceptance in the bargain, you can’t beat that.

Sidekick: You mention patient comfort and acceptance. Is it really significant?

Dalin: Yes, one complaint I heard often from my patients while using film was that the sharp corners of the film hurt their mouths. I no longer have this with digital. With the system that I use, there's a single sensor, and it has rounded corners so there are no sharp edges to dig into patients' gums. I can take every X ray necessary, including vertical bitewings with the same sensor. With some systems you need to keep your film operation running because they can’t take certain images, so it's important make sure that the system you do purchase allows you to take every X ray in the mouth.

Sidekick: How do patients react to this new technology?

Dalin: I treat this as a case acceptance issue. I remember the very first patient I took digital X rays on actually said "Wow!" when she saw the image appear instantaneously on the computer screen. And she commented on how much she appreciated being able to actually see an X-ray image and be involved in determining the course of treatment.

Digital radiography makes it much easier to involve the patient, and it makes patient acceptance much more likely. I mean, just look at the differences in the way you present X rays to patients between film and digital. With film, you often have your back turned to the patient while you bend over to examine a tiny image on a light box. Talk about excluding the patient! With digital, you're side by side with the patient, and both of you are viewing an X-ray image together. That alone speaks volumes about why patients appreciate digital X rays so much.

Sidekick: What are some of the other issues that might confront dentists as they're deciding whether or not to switch to digital radiography?

Dalin: There's a lot of misinformation out there about compatibility and integration of digital-imaging systems with practice-management software.

Sidekick: Can you elaborate on that?

Dalin: Well, some companies present that you need to purchase image acquisition hardware and practice- management software from the same vendor to ensure full compatibility—but I see this more as a marketing strategy. Nowadays compatibility is no longer an issue. The major manufacturers of digital radiography systems all provide links to the leading practice-management systems. The level of integration differs so it is worth taking a closer look, but you do have the freedom of choice.

Sidekick: So what is your advice?

Dalin: You chose your practice-management software because it best fit your needs. You want to make your decision on a digital radiography system the same way. Period. The most important thing is to purchase the best quality available, as that is the best for your practice and your patients. You should look at image quality, sensor comfort, and ease of use as your main criteria.

Sidekick: What about integrating a digital radiography system with existing computers for those who already have them in their practices?

Dalin: It is very easy to do. My experience is with DEXIS, and all I had to do was adding a PC-card reader to plug in the sensor. I am sure the other companies are similar.

Sidekick: Are these card readers expensive?

Dalin: No. They are actually very reasonably priced and robust. I think I paid around $175 per computer.

Sidekick: What are some of the other reasons dentists should make the switch to digital radiography?

Dalin: The real, and arguably most important, benefits come in the improved diagnostic capabilities of digital, in improved patient satisfaction and buy-in, and in significant time saving. There is simply no comparison between seeing an X-ray image on a large computer screen and being able to enhance it to make a truly informed diagnosis on the one hand, and trying to make a sound diagnosis from a tiny piece of film on the other. I have found digital to be less expensive and better as a diagnostic tool than film.

Sidekick: Finally, Dr. Dalin, we'd like to hear about this year's “Give Kids a Smile” Day, a program you initiated locally in St. Louis, which has grown into a terrific national event.

Dalin: This year's Give Kids a Smile Day date was February 3. The program originated as an effort to provide complimentary dental checkups and treatment to low-income children. Over the years it has grown to the point where more than a million kids will receive checkups from more than 25,000 dentists, dental assistants, and hygienists nationally.

Sidekick: Thank you, Dr. Dalin, for spending time with us.

Dalin: Thank you.

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