Costs5 – the initial costs associated with digital equipment is one major disadvantage with dental practices. To purchase the computer hardware and software, and the digital imaging sensors can be costly. And just like dental equipment there is maintenance, repairs, software updates, and equipment replacement that must be considered when changing from radiographic film to digital imaging. Just as it is with radiographic film, digital imaging will require clinicians to think about asepsis or infection control when they’re taking images. The practice will need to purchase disposable barriers to be placed over phosphor plates and hard sensors, as the sensors cannot be sterilized. Phosphor plates can be reused a number of times before they need to be replaced. However, damage will require phosphor plates be replaced more often. Damaged phosphor plates can obscure the image not allowing the clinician to make a thorough diagnoses.
Patient Comfort5 – direct sensors are hard and not flexible like film. They can be rather thick, depending on the manufacturer. However, some of the hard sensors on the market have excellent contrast and density, allowing for enhanced diagnoses of incipient lesions. In fact, just in the last few years the diagnostic value has increased considerably due to increased technology of hard sensors. However, patient comfort and limited positioning of the sensor intraorally due to patient anatomy, is one disadvantage that prohibits some dental practices from considering purchasing hard sensors. With all types of digital sensors, training will be needed to show dental providers how to place sensors to allow for the most coverage of anatomy.
Medico-legal5 – concerns regarding manipulating images has been addressed by manufacturers. Dental software has warning features if the enhanced image does not match the original image. It is recommended copies of the original images be stored on the computer or network server. Researchers in the area of fraudulent digital dental records recommend digital content have attached metadata. In forensic dentistry metadata and watermarking be added to discourage tampering documents.3,5