Exploring the Impact of Digital Dental Radiology in Veterinary Care

Since the discovery of X-rays over a hundred years ago, radiography has proved an invaluable tool in both the human and veterinary medical fields.

But it wasn’t until the mid-1980s that the technology made such a huge leap forward, that it turned the whole discipline upside down.

This is when digital radiography came along. 

Up until this point, the process of obtaining radiographs was time-consuming, laborious, and at times, messy and potentially dangerous.

By using X-ray film and manually developing each image, practitioners were able to obtain an image, but if the alignment was wrong, or the settings were incorrect, they had no option but to repeat the whole process again.

With digital radiography, the image obtained can be instantly adjusted and manipulated to aid diagnosis and then stored digitally, allowing rapid recall of previous studies and saving vast amounts of physical space. 

Where digital radiography has really come into its own though, is in the field of dentistry. 

Veterinary dentistry has undergone a similar transformation in recent decades

Our understanding of the intricacies of how to provide a high-quality service has improved drastically, all aided by being able to look ‘under the surface’. When teaching dentistry, emphasis is placed on the areas below the gum line as often being the source of dental problems.

Therefore, it should be the required focus of treatment, much more so than the visible crown. We are now able to complement this knowledge with the ease and detail that digital dental radiology allows in order to provide a first-class, thorough treatment process for all our patients. 

Teeth are regularly likened to icebergs 

What you can see is only a small portion of the whole - and with teeth, it’s what is below the gum line that we need to focus on.

What we see on the crowns of the teeth, such as tartar or discoloration, and what we see on the gums, such as recession or gingivitis, are just markers for the damage we cannot see.

As with most things in veterinary medicine, it is always best to treat the source of a problem, rather than just manage the symptoms. 

Scaling the tartar off the visible surface will give a good cosmetic appearance, but the bacteria and plaque – the origin of the tartar – will be in the gingival sulcus. If this isn’t cleaned as well, the problem can spread down into the periodontal space and tooth root.

The only way to thoroughly evaluate this area is to use radiography. 

More complex pathologies really benefit from radiographic examination

Digital dental radiography can also bring huge advantages to the treatment of one of the most common, yet frustrating, aspects of feline dentistry – the feline resorptive lesion.

By utilizing dental radiographs, we can determine if the lesion is a type one or type two and therefore which of the two diametrically opposite treatment options – full extraction or crown amputation – is appropriate.

If radiography shows that only a crown amputation is needed, we have saved not only time and stress for the surgeon but also prevented unnecessary pain and trauma for the animal which would have occurred had the option chosen been to attempt full extraction.

Without the radiography, we only have half a diagnosis, and the treatment option chosen would be a ‘best guess’. 

Imagine working like this in any other aspect of veterinary medicine!

Other things that can only be detected by radiography include:

• bone loss

• supernumerary teeth (especially if non- or incompletely erupted)

• supernumerary roots

• abnormally shaped roots

• periapical disease

• pulp diameter

It’s clear to see how the use of radiography in veterinary dentistry can yield huge benefits. And using digital dental radiography maximizes these benefits and brings its own. 

With practice, a full-mouth series of digital radiographs can take a matter of minutes

This speed means that anesthetic time can be drastically reduced – a huge advantage, especially in fragile patients. 

From an operator's point of view, digital radiography can provide vastly superior image quality and the ability to enhance certain features and correct radiographic faults.

This will all lead to improved diagnostic ability and treatment of patients.

The images can also be easily shared between practitioners and even sent to imaging specialists without the need to transfer the patient.

A key benefit that is also often overlooked is that digital imaging requires up to 80% less radiation to produce an image than traditional film radiography.

The big advantage in today’s market is a digital system is very reasonable in price.

The integration of digital dental radiography can revolutionize a veterinary practice. 

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References:

1. Lommer MJ, Vertraete FJ. Prevalence of odontoclastic resorption lesions and periapical radiographic lucencies in cats: 265 cases (1995-1998). J Am Vet Med Assoc 2000;217(12):1866-1869.

2. Heney CM, Arzi B, Kass PH, Hatcher DC, Verstraete FJM. The Diagnostic Yield of Dental Radiography and Cone-Beam Computed Tomography for the Identification of Dentoalveolar Lesions in Cats. Front Vet Sci. 2019 Feb 21;6:42. doi: 10.3389/fvets.2019.00042. PMID: 30847347; PMCID: PMC6393352. 

3. Mupparapu M. Digital dental radiography - a review of the solid-state and semi-direct digital detector. Orofac J Sci2011;3(1):40