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Dental Radiograph Systems
In many dental advances over the past few years, there’s no doubt that the technology has been the driving force in this process. This is as true in other fields as it has been in dentistry. In the early 1990’s, intraoral cameras were all the rage. In the late 90’s, it was digital cameras. And, at present, no other topic seems to generate greater interest that digital radiography. While entire books can be written on the subject, the goal for this article is to briefly review the three different systems of obtaining digitized radiographs and the advantages and disadvantages of each system.
Scanners
Although it is certainly not a “digital radiography” system in the purest sense of the term, many offices use scanners to digitize their existing x-rays. This is especially true for “paperless” or chartless practices where the patient may bring in film radiographs that ideally should be part of the patient’s digital record. Scanners are also an excellent option for the office which desires some of the advantages of digital, but finds the costs to be prohibitive.
In this scenario, films are developed in their usual fashion and are then scanned into software. Many scanners come with their own software, although I would recommend using dental image management software. The key feature when choosing a scanner is the Transparency Unit Adapter (TPU), which is a light source that is in the lid of the scanner rather than the base. Many mid-priced scanners only have a 4” X 5” TPU, and while it’s fine for bitewings or a few PAs, would not be adequate for a pano or full mouth series in its mount. In these cases, a full sized TPU is needed, and there are only a few scanners that meet this requirement. The Epson 1680 Professional is the industry-standard, and the newer Microtek i800, which is only 1/3 the cost of the Epson, is also a good option.
Phosphor Plates
While some people consider phosphor plates (PSP) to be positioned between scanners and direct sensors, these systems are actually very highly developed and produce diagnostic quality images. The plates are “scanned” in a special machine which is basically a laser which reads the phosphor plates. The system must be attached to a computer which is running software image management software. The main advantages of phosphor plates are their similarity to film. They are as thin, and often thinner, than film packets. The staff can take images with the same RINN kits and methods that they use for film, they take the plates to a centralized “processor” to “develop” them, and they mount the images afterwards. The one difference is that the mounting occurs in software templates, not cardboard or plastic mounts. Also, unlike direct sensors, the plates are relatively inexpensive, which is wise since they typically must be replaced after 200-300 uses.
On the downside, the plates are easy to scratch and while they theoretically can last through those 500 uses, damage will normally require that they be replaced more frequently. Phosphor plates have less resolution, in line pairs/mm, then sensors. While this would not make a difference when viewing images on a typical 15” or 17” monitor, it can make a difference if you are magnifying the image to a great degree or printing out images that are larger than 8” X 10”. Also, because of the steps needed to get an image, the time needed to take phosphor plate images is very close to the time needed for film. Major PSP systems include the Soredex Optime, Air Techniques Scan-X, and Gendex Denoptix.
Direct Sensors
Direct sensors are silicon-based receptors, often encased in protective coating, that mimic the size and shape of PA film. These sensors, which are either CMOS or CCD, are connected to a thin cable which runs from the sensor to some device that would then connect to the computer. The sensors range in size from about 3 to 8 mm. The main advantages of sensors are speed and image quality. Images taken with a sensor appear almost immediately on the screen, making them the ideal choice for offices that do a lot of endo or implant procedures. They are comfortable, sturdy, and have excellent resolution; many can produce a highly diagnostic image when used with the proper software.
On the downside, they are thicker than film and have cables running off the sensors, which some patients don’t tolerate well. Also, they are not inexpensive, as a #2 sensor can range in price from about $5000 to $14000 USD.
Every system has pros and cons, so dental offices should evaluate the different systems to find the best option for them
Lorne Lavine, DMD is the Founder and President of Dental Technology Consultants. Dr. Lavine holds two prestigious certifications, the A+ Certified Technician designation and the Network+ Certified Professional. These designations demonstrate proficiency in computer repair, operating systems, network design and installation. Dental Technology Consultants provide dentists a full range of services relating to the implementation of technology.
Dr. Lavine can be reached directly at 1.866.204.3398.
Interested in speaking to Dr. Lavine about your technology concerns? Email him at Drlavine@thedentistsnetwork.net
Interested in having Dr. Lavine speak to your dental society or study club? Click Here.
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Health Savings Accounts
Health Insurance That Won’t Break The Bank
With the cost of health insurance premiums an increasingly significant concern for small business owners, including dentists, more and more practices are offering or considering Health Savings Accounts (HSAs) for employees. HSAs in combination with high deductible health insurance plans are a less expensive alternative to traditional healthcare plans, and they are designed to give consumers more flexibility in how their healthcare dollars are spent.
Cora Telaz, CEO of Sterling HSA describes them as medical Individual Retirement Accounts (IRAs). “Health savings accounts allow individuals to pay for qualified health expenses and save for future qualified medical and retiree health expenses on a tax-free basis. Contributions remain in a savings account and can be used to pay for medical care, dental care, vision, long-term care services, as well as insurance premiums. An HSA is similar to an IRA in that an HSA is established for the benefit of an individual, is owned by that individual, and is ‘portable.’ If the individual is an employee who changes employers or leaves employment, the HSA stays with the individual,” explains Ms. Telaz.
To qualify for an HSA you must be enrolled in a high deductible health insurance plan. In addition, you cannot be enrolled in Medicare nor can you be claimed as a dependent on someone else’s tax return. You are also ineligible for an HSA if you are already covered by another major medical plan, such as through a spouse.
The deductible for HSAs is set by the federal government and is subject to change each year. According to the US Treasury Department, for 2006, the minimum deductible for an individual is $1,050 and a maximum of $2,700. For a family the minimum is $2,100 and the maximum is $5,450. In 2006, annual out-of-pocket expenses cannot exceed $5,250 for individuals or $10,500 for families. Out-of-pocket expenses include deductibles, co-payments, and other amounts the participant must pay for covered benefits, but do not include premiums.
Employers and employees can contribute up to a specified amount each year to health savings accounts. Money saved in purchasing a high deductible health insurance plan, which is more affordable, can be funneled into the HSA account to pay for future healthcare needs. And unlike premiums, unused HSA dollars remain in the HSA. Employer contributions are made on a pre-tax basis while employee and individual contributions can be deducted from the federal tax return. Interest accrued is non-taxable and withdrawals for qualified medical expenses are also tax free.
For further information on health savings accounts contact Sterling HSA toll free at 800-617-4729 or visit the website at www.sterlinghsa.com.
Sally McKenzie is CEO of The McKenzie Company, Inc. a nationwide dental management, practice development and educational consulting firm. Working “on-site” with dentists since 1980, McKenzie Management provides knowledge, guidance and personalized systems that have propelled thousands of general and specialty practices to realize their potential. Sally can be reached directly at 1.877.777.6151
Interested in speaking to Sally McKenzie about your management concerns? Email her at Sally@thedentistsnetwork.net
Interested in having Sally speak to your dental society or study club? Click Here.
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