Image-management software

Over the past few columns, we have evaluated various systems for adding a digital radiography component to the modern dental practice.

Lorne Lavine, DMD

Over the past few columns, we have evaluated various systems for adding a digital radiography component to the modern dental practice. We have looked at the differences between the sensor-based and phosphor-plate systems, focusing on the raw data and suitability of both for different practice settings. Now that dentists have the tools to choose the best system, it's time to throw out everything we have learned so far! As most practices have discovered after plunging into digital X-rays, the software has as much — and often more — to do with the user experience with these systems as anything else.

Aren't they all the same?

Almost all digital-radiography systems come with their own software that allows capture and basic manipulation of the images. While this software is adequate for some offices, it often is "underfeatured" in its ability to perform more advanced tasks, such as applying filters to sharpen or improve contrast, emailing images directly from the program without the need to cut and paste, and incorporating images directly into Word documents with a single click. Also, most of these programs are free-standing and do not directly bridge to practice- management software. This is important because most dentists want to link the images to their patient data without having to retype the patient information when taking images. Enter image-management software.

Image-management software is designed to serve a number of functions. It allows an easy method of taking, organizing, and manipulating images. By bridging to the patient record, it permits data to be exchanged without retyping. It also will act as a central database for all images, including digital X-rays, intraoral camera images, digital cameras, and scanned photos, slides, and documents.

To bundle or not

Probably the most difficult decision dentists face is whether to purchase image-management software sold by the practice-management software company they are currently using or to invest in a third-party product. Both have their pros and cons.

Most of the major PMS companies have incorporated imaging suites into their offerings. On the plus side, these programs are tightly integrated with the PMS software; you will feel like you are still in the same program, even though the databases usually are separate. This is actually preferred. With the constant consolidation occurring in dental technology, it makes sense to have images stored in a separate database in case the dentist chooses to switch to another program at some point in the future. With the complexity of these various packages, it's comforting to have the same company responsible for all aspects of the software. In a few cases, it is possible to have the patient chart and thumbnail-sized images on the same screen; this is not possible when using a third-party program. Also, since three major companies currently dominate the market, dentists can be relatively secure that the company they choose will not go out of business or stop supporting their software.

However, staying with your current practice-management software company may not always be the best option. In most cases, the image software is significantly more costly than the third-party programs. Many of the image programs sold by the PMS programs are modular. The dentist would have to purchase separate modules to obtain images from digital radiography, intraoral cameras, digital cameras, and scanners. Also, the cost of the fully-loaded image suite from the PMS company may be more than the PMS program itself! Another concern is that some programs will only capture images in a proprietary format, requiring time-consuming conversion utilities if a standardized format — such as jpeg — is needed. Finally, the compatibility of the software with digital radiography systems is more limited with the PMS systems. Most are compatible with 8 to 10 different sensors, while the average for third-party programs is 23 to 25. Finally, some of the image suites from major vendors use a word processor that is unique to that software, rather than working with Microsoft Word.

As we move towards the chartless practice, many systems must be evaluated to find the best choice. While most practitioners will spend the majority of their time evaluating hardware choices, the software is often the most important component. Dentists should not overlook this factor when choosing their imaging systems.

Lorne Lavine, DMD, practiced periodontics and implant dentistry for more than 10 years. He is an A+ certified computer repair technician, as well as Network+ certified. He is the president of Dental Technology Consultants, a company that assists dentists in all phases of technology integration in the dental practice. He can be contacted by email at or by phone at (866) 204-3398. Visit his Web site at

More in Practice