The answer to the $10,000 question?

Sept. 1, 2003
Thank you so much to those of you who responded to the $10,000 question published in my May/June Dental Equipment & Materials column.
Send us your referral lists!

By Jeff Carter, DDS

Thank you so much to those of you who responded to the $10,000 question published in my May/June Dental Equipment & Materials column. Obviously, this column is not statistically representative of the dental profession and — for all of us who took statistics — can never be. With that disclaimer out of the way, here is a synopsis of the responses I received. Later in the article, we will explore what I would like to happen next with this issue.

  • No respondent fit my criteria of recommending the exclusive use of CCD or CMOS sensors for full-mouth and panoramic images on adults and children. The closest is a practice that obtained three Schick sensors for $9,000 total and a digital panoramic retrofit kit for $12,000. At an investment of $21,000, this doctor was satisfied with his Schick package. I agree that at the investment level of $21,000 — which is similar to the total cost for phosphor plate scanning systems — it was a great deal. Today, this sensor package would cost $50,000 to $55,000. The same doctor declined a recent offer to switch to the Schick wireless sensors for periapicals and bitewings due to the $34,000 investment cost for three new sensors.
  • Several respondents were satisfied with hard-wired sensors in more unique situations and not meeting the criteria mentioned above. For example, two Dexis users would recommend the use of Dexis sensors to other practitioners. One office invested $10,000 and uses one sensor for all radiographs. Another office purchased two sensors for $8,000 each and utilizes two sensors to take all radiographs in a one-doctor, two-hygienist facility.
  • All respondents of phosphor plate scanning systems would recommend their use to other practitioners. That is not to say there are not issues with these systems. I was unaware of the fragility of phosphor plates and the possibility that scratching the plate can necessitate its replacement. Fortunately, the phosphor plate replacement cost is not high. Others reported image contrast fluctuation problems similar to what has occurred with CCD or CMOS sensors. This fluctuation can be from a number of sources, including the phosphor plate, and would require a thorough testing of all related components to diagnose the cause. I failed to mention the Digora system by Soredex, which was highly recommended by one practitioner. The same practitioner also added that Soredex should do a better job of marketing its phosphor plate scanning system.
  • Several respondents related their experiences of researching the available digital radiography products and making the decision to stay with film for now. One practitioner added that the radiation exposure with the newer high-speed film and digital radiography is essentially the same and not an issue anymore.

Here is an e-mail response that stands alone and is worth everyone's consideration — including vendors:

Hello Jeff!

I enjoyed your article in DE&M. In our case, the $10,000 question is a minimum of $20,000 (or more) question. I am part of a general practice/specialty group of five. As the director, over the past 10 years I have taken a serious look at the available hard-sensor systems on three separate occasions. We are fully networked with a computer in every operatory. It seems logical that we should go to digital X-rays. However, on every occasion, I have issued the following request to each and every one of the manufacturer's reps that I dealt with — give me a minimum of five to six references of general practices that use your hard-wired digital radiography system to take all bitewings and periapicals on all patients (including children and adults).

We currently use film for all patients. From my point of view, having to use two systems rather than just one is a financial and systematic boondoggle. My only requirements are that the reference office has been on the system for a minimum of one year and that a significant number of children are seen in the practice. I have never received five to six references from anyone. On some occasions I get a few, but, when I call those references, I have always heard that they can't use the sensors routinely on all adults and certainly not on many of the pediatric patients. So, as part of the "survey" you proposed in your recent article, I would love to send my quest for information/digital X-ray challenge to you, to any manufacturer you are in touch with, and certainly to any offices that reply to you. I would love to get the five to six references that can fit the bill. I agree with you that the Den-Optix and Scan-X systems may fit the bill. Out of the hundreds and hundreds (perhaps thousands) of offices that have gone with hard sensors, I would like to find six that make the grade.

Thanks for your time,

Marty R. Lipsey, DDS, MS

Thank you, Marty. I can't summarize the issue any better than you just did, so, with Marty's help, we issue this request:

  • To any and all vendors of CCD or CMOS sensors — please send us a referral list of six practices that utilize your sensors to take all bitewings and periapical radiographs on adults and children. Please note if any of the listed practices are also utilizing digital CCD or CMOS panoramic sensors.
  • To any practitioners who meet the criteria of utilizing CCD or CMOS sensors to take all bite-wings and periapical radiographs on adults and children and would like to be a resource for other dentists — please send us your contact information. Please note if you are also utilizing digital CCD or CMOS panoramic sensors.

Vendors or practitioners can either e-mail me at pdgjeff@ or forward your information to Kevin Henry, the editor of Dental Equipment & Materials, at kevinh@pennwell. com. In the next issue of Dental Equipment & Materials, we will publish all lists that we receive in the body of the article and at no cost to the respondents.

I will again reinforce with all of you my sincere desire to have every dental office utilize digital radiography for all radiographs. This is not some anti-corporate hit piece. I love the tech world and gadgets as much as anyone. If there is any company out there that can manufacture and sell high-quality CCD or CMOS sensors for $3,000 (panoramic sensors for $10,000) and make them as user-friendly and compatible as off-the-shelf digital cameras, please call me immediately. I want to acquire as much of your stock as possible.

Dr. Jeff Carter is co-owner of the Practice Design Group, based in Austin, Texas. PDG specializes in providing architectural, interior design and equipment, and technology integration services to dentists nationwide. Dr. Carter may be reached at (512) 295-2224 or by e-mail at [email protected].