D1g1tal dent1stry

Digital imageNew technology invades dental care despite high cost of equipment

If you think the business world’s constantly changing landscape is limited to brick and mortar, you haven’t been to the dentist lately. If that’s the case, you’re missing out on the opportunity to check out your pearly whites – the ones with an “uh oh” or two – on a flat-screen monitor.

“I can bring that [X-ray] image in front of [a patient], talk with them, show them and explain with visual aids what’s going on in their mouth,” said Dr. Kristian Rapisarda, a Vancouver dentist.

Thanks to digital X-ray technology, getting a fast “up close and personal” snapshot of a patient’s teeth is not only convenient, it’s less harmful – digital X-rays use about half the radiation of their predecessors. In addition, they can be shared with other dental practices with the click of a mouse, can be manipulated for clinical diagnostics and are more environmentally friendly with the elimination of an office darkroom.

Five years ago, the American Dental Association (ADA) reported that 36.5 percent of all dental practices used digital X-rays in their practice. These days, more dentists are following the digital siren call and ramping up their practices to include all things digital, including X-rays, lasers and sensors (to replace casting molds).

“If you don’t have digital, you’re behind the times,” Rapisarda said.

For dental labs, which, with dentist’s specifications, craft patient crowns, bridges, dentures and such, the advances have been a mixed blessing.

On one hand, digital images have reduced lab turn-around time from an average of ten working days to three, according to Verne May, a partner in May Brothers Dental in Vancouver. On the other hand, the equipment needed to craft high-tech dental implants is pricey – $55,000 for a scanner and $250,000 for a milling machine. This technology is designed to work within an always-upgrading digital world, though much of it uses proprietary software that doesn’t always communicate with other systems.

Kent Firestone of Dental Arts, a Vancouver dental laboratory, takes a wait-and-see approach to capital equipment upgrades.

“We don’t jump on it too soon because it’s so expensive,” Firestone said.

Instead, those dental orders that require the quarter-of-a-million-dollar milling machine get outsourced to bigger labs, then return to his lab for the rest of the work before delivery to Vancouver-area dental offices. Once a price tipping point is reached – when too many orders are being partially outsourced – Firestone said he knows the time is right for investment in a new piece of laboratory equipment.

Even with the expense (outsourcing included), May figures he’s more productive and profitable with his digital presence. His four-person staff turns more units per day with digital-based equipment than they ever could with handcrafting.

“I think it’s made our product more uniform, more consistent,” May said.

Back at the dental office, Rapisarda figures the digital technology is good for his patients and for his growing practice. Before digital X-rays, he showed his patients traditional film scans. Rapisarda said his patients would strain, knit their brows and sometimes simply nod in agreement without understanding what he was trying to show them. With digital images, besides the cool and wow factor, Rapisarda said he’s able to educate and show a patient what’s going on in their mouths and explain problems more fully.

For a patient who can’t make out a spec on a piece of film and is thinking about a how a dental bill is going to pinch his wallet, the educational tool has become invaluable to demonstrate need and treatment acceptance. Moreover, when a patient is referred to a specialist, his or her records, X-rays and history can be shared within moments. No more taking chances with lost charts.

Beyond the clinical side of things, dental offices, much like medical offices, have begun digitizing records and billing. That’s resulted in some heavy-lifting work to transfer 30-year-old records from paper to digital at Rapisarda’s practice, which he purchased in 2008.

“In a paper chart, you can lose a sheet,” Rapisarda said. “One thing that is nice about having computer charts or a digitally run front office, is that you don’t lose information.”

Gone are the days of the office secretary spending time thumbing through a binder’s worth of information after a patient arrives for an appointment.

“Eventually we will get to the point where no one will have a paper chart anymore, Rapisarda said.

While the digital conversions going on inside our local medical and dental offices are destined to streamline practices, improve patient care and save money and overhead costs, Rapisarda said he hasn’t see the cost payoff – yet.

“It’s an expensive start up,” he said.