Expert: Zev Kaufman, D.D.S. - 12/19/2009

Question
Dr. Kaufman, in your opinion do you think that digital x-rays are more accurate or the traditional film strips are more accurate?

My second question is, when checking for cavities, when a dentist uses an "explorer" to check for cavities, if nothing is sticking to the tooth or the filling, is that a sure way of telling there's no cavities present? Does cavity always develop from the outside where the explorer will stick? The reason I ask is because one set of explorers (digital) did find some cavities but could not be confirmed with the film strips so my dentist used an explorer and said if there were any cavities, the explorer will stick to the tooth, but nothing did. What's the deal here, doc?  Thank you!  

Answer
Dear Jeremiah:
The digital revolution came to dentistry at the same time it did to the photography world.  Dental X-rays are pictures activated by X-ray radiation instead of light (as in pictures).
At the beginning, the resolution of digital photography was not very good (like the resolution of your cell phone camera).  However, if you take the pictures with a high-end digital camera with a 8 Mega Pixel resolution, or higher, the pictures rival and surpass the traditional film.  this is why Kodak no longer makes Kodachrome film.
Digital dental systems have gone the same way.  Todays systems are fantastic.  The clarity and resolution are even higher than conventional film with much less radiation and with instantaneous results, using no-chemicals.
However, the software we use can be "too accurate" by modifying the images through filters, we can "see" thing that might not be there.
This is why any good diagnosis is dependent on three factors:
History of the condition, X-ray findings, and clinical examination.
In determining a diagnosis of caries (cavity/decay), one has to listen to the history (if pain or sensitivity is involved), check to see if anything can be seen X-ray (digital or conventional), and confirm the diagnosis with a proper clinical examination (the decay will feel like wet wood when stuck with the dental explorer).
When all three factors are positive, then a diagnosis can be made and a treatment plan can be devised.
No amount of technology can make up for knowledge, expertise, and experience.
The only advise that I can give you is to ask your dentist to show you the findings on the X-rays and in the mouth and show you have he/she arrived at the diagnosis.  You can always go to an expert (a Prosthodontist) for a second opinion.  www.prosthodontics.org will have a link to locating a Prosthodontist near you.
By the way, I am sorry for the delay.  I was just now foun your question in my very full spam folder.  It happens from time to time.  I get a tremendous amount of spam, and questions sometimes end up as spam.
Best of luck to you,
Dr. Zev Kaufman