Film vs. digital

For years, practitioners have documented their cases with slides. 35 mm film is still the standard due to resolution and color accuracy, but the world of instant gratification has caught up with us.

Paul Feuerstein, DMD

For years, practitioners have documented their cases with slides. 35 mm film is still the standard due to resolution and color accuracy, but the world of instant gratification has caught up with us.

Recent advances in computer chip density have made the digital camera the choice of many. No matter what the new digital experts show and tell, there is still a noticeable difference when compared to slides. However, the intended use of the photos will dictate the camera of choice. Although high-resolution digital photos are submitted to publications such as this one, and can be nicely projected from a computer, such organizations as the American Academy of Cosmetic Dentistry (AACD) will accept only 35 mm slides for reasons mentioned later.

Looking at the current state of digital cameras, there seem to be some "darlings" on the retail side and a few dental-oriented packages. Kodak, SciCan, DICOM, Digital Dentist, Polaroid, and Lester Dine have put together complete camera, software, and accessory kits that can be used out of the box with very little technological background. These are among the "point-and-shoot variety," with high-enough resolution to give professional results and not break the bank.

The purists want high-resolution cameras with some bells and whistles and their own selection of accessories. Cameras can be purchased in retail stores, photo shops, online, and other sources, but PhotoMed and other dental-oriented camera companies strongly focus on the dentist's needs.

Two cameras that seem to come up in all discussions are the Olympus 3030 ($1,000) and the Nikon Coolpix 990 ($950). Note: These prices are as of the beginning of the year and include only the camera - no flash, rechargeable batteries, or other accessories. There is always a discussion of "megapixels" along with which is "best." The higher the number, the more dots per inch, thus the denser the picture and better the enlargements. The cameras mentioned above are 3.4 megapixels. Sony Mavica FD95, also widely used, is currently 2.1 megapixels, but stores the images on a floppy disk, while Sony's new unique CD1000 (also 2.1) actually has a miniature CD writer in it. This eliminates downloads and transfers with special devices that cause anguish for some users.

It is notable that pictures taken with the higher resolutions can be very large - 1 MB for .jpg and more than 9 MB for .tif. Canon offers a 1 GB microdrive and can store more than 500 photos at the highest resolution with no problem. That said, the 2-megapixel cameras are quite good and certainly adequate for most office needs.

As with computer processors, pick a point in time and jump in - you will never have the latest, but, as the numbers get higher, the older ones drop in price and more used models appear. Keep in mind that, as the resolution increases, you can make bigger enlargements and the lens quality becomes more important.

Just to confuse this issue, several SLR companies have just introduced a series of 4-megapixel cameras with a more traditional feel and look, true through-the-lens focusing and interchangeable lenses. Notable are Canon EOS D30 and Olympus E-10. I have not had a chance to see these at press time but have been informed that the Canon will accept a ring flash.

Once you have these wonderful picture files, you can enter the world of imaging and, with some amazing software, can do before-and-after photos for your patients. This is where a problem comes in with some organizations.

I spoke with Marty Zase, a member of the Board of Governors of the AACD, who said for now and the foreseeable future, the only acceptable method of photography for use in the AACD's Accreditation process is 35 mm slides. Besides their obvious excellent accuracy and detail, slides do not easily lend themselves to falsification. In a proposal being considered in the upcoming protocol, an undeveloped roll of film is submitted with the case for the clinical segment of the exam. Although this is seen as removing temptation in a very competitive arena, it also points out the superiority of film. It is particularly noticeable when doing enlargements. Incidentally, if you are in the market for a 35 mm camera, look at the Yashica Dental Eye III.

Most of the items discussed here are easily found at many dental meetings, either directly from the manufacturers or through special dental-camera dealers. Try them for ease of use, the feel of the camera, and, of course, the quality of the images. As with any high-tech device, the information here is subject to immediate change.


Dr. Paul Feuerstein installed one of dentistry's first computers when he placed a system in his office in 1978, and he has been fascinated by the technology ever since. For more than 20 years, he has taught courses on technology throughout the country. He is a mainstay at technology sessions in New England, including annual appearances at the Yankee Dental Congress, and has been a part of the ADA's Technology Day since its inception. A general practitioner in North Billerica, Mass., since 1973, Dr. Feuerstein maintains a Web site (www. computersindentistry.com) and can be reached by e-mail at drpaul@computersindentistry.com.

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