Smile:
Dental X-Rays Get Easier
Shift to Digital Systems Cuts
Discomfort and Wait Times;
Lead Apron Still Required
RHONDA L. RUNDLE / Wall Street
Journal 29nov2005
One of life's minor discomforts — having dental X-rays taken — is getting
more pleasant.
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Some advanced digital systems permit panoramic dental X-rays (shown here), though most make images similar to traditional X-rays.
Mindfully.org note:
Use of this technology moves us one step
further in the Big Brother world. Insurance companies, known world-wide
for lack of security, will then have further access to digital scans of
your body, allowing identity comparisons at lightening speed. Of course
it's good to avoid this technology. But it is even more important to avoid
x-rays in general. Dentists and doctors many times x-ray patients just because they
are avoiding litigation rather than suspecting some problem. They casually
"take a look," when it should be used only if absolutely
required. Dentists
will tell you that the dose is so low that it is safe when done
infrequently. But the truth is that any dose of this radiation is not
good. Again, avoid it unless the dentist absolutely requires it.
Consider that we are bombarded with all sorts of ionizing and nonionizing radiation on a
24/7-basis. It all adds up and causes problems.
You are exposed to the incidental releases from a nearby nuclear power
generators. You are also exposed to the radioactive pollution from
depleted uranium (DU) shells being used in the present war in Iraq because
it travels around the globe in a matter of days.
And how many of you have a cellphone crammed against your head for
several minutes or hours each day? Or perhaps you work near an automatic
door-opening sensor or there are wireless devices such as a computer
system. Maybe you have a wireless speakers on your entertainment center at
home. Do you live near a microwave tower? If your cellphone can pick
up a signal, then you are being bombarded all day. If your cellphone picks
up an extremely weak signal, then in order to connect to the cell tower,
your cellphone will transmit a very strong signal. The weaker the signal,
the stronger the cellphone will output microwaves.
All of these sources have negative synergistic effects that have not been
studied. But it isn't just radiation that one needs to be concerned with,
it's all the rest of the toxic products we're exposed to on a 24/7 basis
that combine in totally unknown ways with the radiation to make trouble
for our bodies. Plastics, pesticides, cleaners, cigarettes and so on, all
add up to one giant mess for your health.
It's not that we believe there is no place for x-rays in society, but
rather that it is all used quite frivolously and without regard for the
known and/or unknown effects. And the unknown effects most certainly far
outweigh the known effects. |
A growing number of dentists are installing digital X-ray equipment in their
offices, eliminating the need for patients to bite down on sharp swatches of
film (while fighting the impulse to gag) then wait while the shots are
developed. With the digital method, a technician glides a small sensor around
inside a patient's mouth and the images instantly pop up on a computer screen in
the exam room. The digital images, which look similar to traditional X-rays, can
then be enlarged and manipulated, which many dentists say gives them a better
feel for what's going on inside a patient's mouth.
Patients say they can more easily understand a treatment recommendation
because they get a good look at the problem blown up on the screen in front of
them, rather than having to squint at a postage-stamp-size shot held up to the
light. "It's very cool — in seconds the picture is there, right on the
screen," said Rocio Hodges, a 42-year-old accounting clerk, after getting
digital X-rays at a recent dental appointment in Chula Vista, Calif. In the
past, she said, it was hard to see anything on the dinky film. But this time,
she said, the problem was clear: a shadow under a filling that was evidence of
decay.
Insurance generally covers digital dental radiography, and the cost is
frequently the same as for traditional X-rays. Dentists say that despite their
upfront costs to buy the new systems, they save on the continuing costs of film
and photographic-development chemicals.
Some makers of digital radiography systems say the method produces
significantly less radiation than traditional X-ray equipment, though such
claims are in dispute among dentistry experts and the manufacturers themselves.
Patients still must wear a lead apron during the procedure.
Dentists first started using digital X-ray equipment more than a decade ago,
but early versions were costly and the technology often broke down. As recently
as five years ago, few dentists had acquired the equipment. In 2002, only about
16.5% of the nation's 150,000 dentists were using a digital X-ray unit,
according to the most recent data from the American Dental Association.
Manufacturers' own estimates range from 15% to 25% of dentists today.
As the available technology has improved and costs have come down, more
practices are starting to adopt it. Prices can vary considerably, depending on
what features are included with a system, but it typically costs a dentist
$10,000 to $20,000 to acquire the software and sensors needed to take digital
X-rays. The upfront costs are more than double that of traditional
film-processing systems, according to Eastman Kodak Co., which makes
digital-imaging systems, but the dentist saves on the film and chemicals.
Kodak says sales of its digital dental equipment are rising. And
dental-digital-system maker, Schick Technologies Inc. in Long Island City, N.Y.,
says sales of its digital imaging systems are up 40% over a year earlier.
Electronic Records
At a time when dentistry is booming thanks to an aging population and pricey
new cosmetic treatments, digital technology is a way for dentists to
differentiate their practices to patients. It's also part of a move in the
health-care industry to create electronic health records that can be stored on
computers and emailed to insurers and other practitioners. Dentists have long
used computers for scheduling, billing and filing insurance claims. And more
recently, some offices have added software to create electronic charts for their
patients. The new digital X-ray technologies can be combined with these systems,
allowing dentists to swiftly send X-rays to an oral surgeon or a dentist in
another city if a patient has an emergency while traveling — or to file an
electronic insurance claim for further treatment.
For insurance companies, the digital X-rays reduce claims-handling costs and
the problems of lost film and the hassle of mailing shots back to a dentist
after evaluation. Electronic clearinghouses have sprung up to help dentists and
insurers process the digital records and insurance claims. One, National
Electronic Attachment Inc. in Atlanta, says it has 135 insurance companies using
its service, including Aetna Inc., Cigna Corp. and Delta Dental of California.
Dentists pay $20 a month for the service.
Regardless of the type of equipment, prices for dental X-rays vary widely
depending on the region and the size of the practice. The average cost of a
complete set of X-rays, which should be taken every couple of years, ranged from
over $100 in the New England region to around $77 in parts of the South in 2003,
according to the most recent data from the American Dental Association.
Robert Matkovich, who spent $150,000 last year to put digital equipment into
all 11 treatment rooms at his Chula Vista, Calif., dental practice, says he
charges the same prices as when he used traditional film: $135 for full-mouth
digital X-rays and $21 for a shot of a single tooth. He can do this, he says,
because he is saving $20,000 a year on disposable costs for film and chemicals.
The experience, according to patient Ms. Rocio, is comfortable. The digital
sensor, which is a bit stiffer than traditional film, "doesn't really
bother you that much," she says. Proper placement by the technician is
important, says Dr. Matkovich, and "for most patients, the sensor isn't a
problem."
Some makers of digital X-ray systems tout reduced radiation exposure as one
of their biggest advantages — claiming that patients may get 50% to 90% less
radiation than with traditional film-based systems. However such claims haven't
been independently verified. Dental X-rays in general produce low doses of
radiation that aren't generally considered dangerous to patients if they are
protected by lead garments.
Radiation Exposure
Digital sensors include a material that essentially magnifies the X-rays,
which may allow for a lower dose to be used to produce an image. Some makers,
such as Kodak, say claims of large reductions in radiation may be exaggerated,
and can depend greatly on what film-based method is used for comparison.
And outside experts are also skeptical that much lower doses are achievable
in practice: According to an article in the October issue of the Journal of
the American Dental Association, dosage
depends on the settings used by the practitioner to achieve the desired image
quality. "It should be clear that dose reduction for digital radiography is
quite limited," the article said.
p.D1