April 20, 2021
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Digital X-Rays

By: George Malkemus
March 5, 2021

One of the most important pieces of equipment in a dental office is the x-ray machine. X-rays are like Superman. X-rays detect problems in your mouth that can't be seen with the naked eye.

For years, conventional dental x-rays, using film, have been wonderful for detecting decay and dental problems.  Now, detection has improved with the advent of the digital computer age. 


Digital X-rays are like digital photos

Digital x-rays are replacing conventional film x-rays, much like digital cameras have replaced film cameras with many of the same advantages.  Digital images allow downloading on a computer for storage with much less energy use and waste.  Digital images are instantaneous, allowing immediate viewing of the image to determine if a retake is necessary.  This saves time and eliminates the use of toxic chemicals for developing film.


Advantages of digital x-rays compared to film x-rays

• Conventional film x-rays expose you to ten times more radiation than digital x-rays.

• Digital x-rays appear on the computer screen instantaneously. Film x-rays need extra time, both to take and then to develop the film.

• Computer storage for instant retrieval.  

•Digital x-rays can be enhanced to improve the image, avoiding the need for retakes.  Film x-rays can miss detail like decay due to over or under exposure of the film. 

•Film x-rays use developing chemicals, which are toxic and a hazard to the environment and so take special disposal systems.  Digital x-rays use a computer sensor, so are totally clean

 •Film x-rays add more waste to landfill and use more energy in production than digital x-rays.


 Digital x-ray procedure

With a digital x-ray, a small, flat plastic sensor is placed in your mouth and presto in a few seconds a picture of your teeth displays on a computer screen. It takes only seconds to re-take an x-ray—if necessary—and the radiation is 90 percent less than conventional x-rays. Digital technology produces sharp images, showing great detail.  The quality of the image can be instantly enhanced and the image can be magnified for more detailed viewing with just a click of the computer mouse. With increased resolution, cavities and other problems can be detected early on.


The digital pan  

The digital panographic x-ray, called a pan for short, is a machine that shows your entire mouth in just one image.  The name comes from the word panoramic, a full view.  With normal individual x-rays, many x-rays need to be taken to view the entire set of teeth. The pan shows all the teeth, both jaws and other important items like the sinuses in one full image. With the pan, the need for a traditional full mouth series of x-rays is eliminated.

My office has been using digital x-rays for over 15 years with great results.  About 12-years ago, I purchased a digital pan. It’s an amazing machine. It uses even less radiation and is more comfortable.  The machine rotates around the patient’s head without the need for film or sensor placement in the mouth. 


Major benefits of the digital pan

 •High-resolution technology provides crystal clear images.

 •Better patient education-patients gain better understanding of their mouth and needs with a full view of their mouth.

 •Patient comfort – patients love it.  No more gagging or discomfort from film rubbing on soft tissues.

 •Quicker – It’s fast! Only 5-10 secs.

 • Zoom and enhancement capabilities show detailed information.

 • Less radiation exposure.

 • Best image for planning dental implants, extractions and wisdom teeth removal.

 • Best image for finding cancer or abscess in the jaw.


Cone beam computed tomography [CBCT] 

CBCT is an amazing technology that allows a 3-dimensional computer image of the jawbones and teeth.  CBCT is an important tool in determining jawbone height, width and density, as well as, nerve location and position of other structures such as the sinuses.  This helps safely determine implant placement and need for additional bone placement during surgery.  CBCT is also helpful when treating cancer or extreme bone infections. CBCT is not needed for routine dental treatment, but definitely has a place for many surgical related treatments, especially implant placement.

No matter the type of x-ray, it is important to have regular dental visits to maintain an x-ray image history of the changes in your mouth. Early detection is the key to identifying potentially harmful changes. Digital x-rays are the latest development to improve early detection. I usually recommend yearly 4 digital x-rays to determine decay between the teeth and digital pan every five years to check changes in the jawbone and roots of the teeth.  For patients with rampant decay, I will up the frequency as needed.


Enjoy Life and Keep Smiling!


George Malkemus has a Family and Cosmetic Dental Practice in Rohnert Park at 2 Padre Parkway, Suite 200. Call 585-8595, or email info@  Visit Dr. Malkemus’ Web site at