Digital dental X-rays are increasingly being embraced by dental professionals as they move away from traditional X-rays. Digital dental radiography may seem expensive and difficult to adapt to, but it is possible to offset the initial costs over time. Digital X-rays can save money on the cost of developing film, while providing faster and more effective imaging.

Traditional X-rays were discovered in 1895, and it was only in 1987 that the first digital dental X-ray was made available. By 2024, the UK market was worth an estimated $583.63 and is expected to reach £837.49m by 2029.

In this guide, we will explore the types of digital X-ray machines, how they work and some of the leading manufacturers.

What is a digital dental X-ray?

Like traditional X-rays, digital dental X-rays use electromagnetic waves, which pass through human tissue and are detected by a receptor behind it.

But rather than using photographic film to record the image, digital X-rays use digital sensors that feed the image into a computer. The image is then immediately available for review, without need for developing.

What are the benefits of digital dental radiography?

There are numerous reasons for moving towards digital dental X-rays for you and your patients.

• Higher quality images: image resolution is typically higher for digital dental X-rays, thanks to the sensors they use. This allows images to be enlarged and otherwise manipulated to a far greater extent
• Fewer waste products: chemicals used in traditional X-ray process can cause environmental damage, as can discarded film. Digital X-ray technology uses neither, making it far more sustainable
• Less radiation: digital dental X-rays can use just 10% of the radiation of traditional X-rays. This makes them far less harmful for patients and practitioners
• Image manipulation: dental digital radiography allows dentists to alter images’ brightness, contrast and other variables. This can make it easier to see elements of the image
• Storage: traditional dental X-rays demand a large amount of space. Physical X-ray images need to be kept somewhere. However, digital radiography images can be saved to a hard drive, network or on the cloud. They can also be reproduced and transmitted to other medical professionals with ease
• Costs: digital dental X-ray machines can cost tens of thousands of pounds. It might therefore seem counterintuitive to suggest that they are cheaper than traditional X-rays. However, there are long-term savings to be made, such as the costs involved with developing film. The speed and efficiency of modern digital X-ray machines also mean faster treatments, allowing you to see more patients.

What types of digital dental X-rays are there?

Digital dental X-rays fall into two main categories, intraoral and extraoral:

Intraoral X-rays

Intraoral X-rays (IOX) are taken inside the mouth. There are three main types.

• Bitewing X-rays: bitewing dental X-rays are used to see the upper and lower teeth in an area of the mouth. Bitewing X-rays can be used to see decay between teeth, determine bone density and fit dental crowns and restorations. They can also discover mouth cancers, orthodontic problems and infections. For these, the patient bites down on a sensor, holding it in place while the X-ray is taken. The image shows teeth from the crown to the base. They do not usually show the root
• Periapical X-rays: periapical X-rays are used to see a tooth’s root structure and surrounding bone structure. They can determine bone loss, decay and gum disease. Abnormalities to teeth and their surrounding bone can also be observed. This also involves the patient biting down on a sensor while the X-ray is taken
• Occlusal X-rays: occlusal X-rays are used to image the floor of the mouth or the roof/palate. These provide images of tooth and bone structure for the entire mouth. Patients are required to hold the sensor or film between upper and lower teeth for the X-ray to be taken.

Extraoral X-rays

Extraoral X-rays are taken from outside the mouth. They include:

• Panoramic/OPG X-rays: panoramic X-rays, also known as panorex or orthopantomogram (OPG) X-rays, show the whole mouth in a single image. This includes all teeth in the upper and lower jaws and surrounding bone and tissue. Uses of panoramic X-rays include the diagnosis of jaw problems, impacts and impacted wisdom teeth. They are also used to detect cysts, jaw tumours and oral cancer. The image is taken using a rotating arm that moves around a patient’s head in a semi-circle
• Lateral cephalometric projections: lateral cephalometric projections take images of the entire head. They are mainly used for orthodontic diagnosis and to plan treatments
• Cone beam computerised tomography: cone beam computerised tomography (CBCT) is used to image the internal structures of the head in three dimensions. It can be used to identify problems in facial bones, fractures and tumours. It can also define the exact structure of the jawbone during the dental implant process. During CBCT imagining, the patient sits or stands while the scanner rotates around the head.

What to look for in a digital dental X-ray machine

It is important to choose the right digital X-ray machine for you. Here are some factors to consider:

Machine quality

A high-quality X-ray machine means fewer breakdowns and less downtime. This means it will last longer, avoiding the cost of a replacement. Quality is also important in terms of ensuring your machine is operating safely.

Image quality

There remains a significant difference in image quality between 3D and even 2D X-ray images.

It is essential to determine whether the superior image quality is a result of advanced software tools or the inherent quality of the images themselves. The voxel size plays a crucial role in producing high-resolution 3D images. It directly affects the detail and accuracy of the output.

When investing in X-ray technology, prioritise systems that offer low-dose X-rays without compromising on image quality. Achieving this balance is vital for accurate diagnostics and enhanced patient care.

In particular, voxel size is a game-changer in endodontic treatment.

High-resolution 3D images, enabled by optimal voxel size, allow for precise visualisation of root canal anatomy. This clarity is crucial for effective diagnosis and treatment planning, ultimately enhancing the success rate of procedures.

Costs

The costs associated with buying a new digital X-ray machine are more than just its price tag. For a start, you will need to install it, which may also involve changes to your surgery’s design. X-ray rooms will need to be made compliant with UK Health Security Agency and Radiation Protection Adviser guidelines. You may also need to pay for maintenance, repairs and parts in the future.

Investing in digital X-ray machines differs significantly from other types of equipment, especially when it comes to patient billing.

This investment is often viewed through the lens of ‘return on investment’ (ROI). Unlike traditional machines, digital X-ray systems allow for enhanced efficiency and quicker diagnosis. This ultimately leads to improved patient care.

Moreover, the ability to charge patients directly for these services can enhance revenue streams. Thus, understanding the ROI associated with digital X-ray machines is crucial for making informed purchasing decisions.

This strategic investment not only benefits the practice financially but also elevates the quality of service provided to patients.

Warranty

The warranty on X-ray machines is important, as it directly impacts costs.

Without a comprehensive warranty, you could end up spending thousands of pounds on repairs.

Therefore, it’s essential to clarify the type of warranty offered – whether it is a full parts warranty or limited to main components. Understanding these details will help you make a more informed decision and protect your investment in the long run. A robust warranty safeguards against unforeseen costs.

Customer support

Reliable customer support is invaluable for promptly addressing any issues that may arise. Prioritising ease of use of both the machine and software will ultimately improve your practice’s efficiency and patient care.

Software usability and training

It is crucial to ensure that both the machine and the imaging software are user-friendly.

While capturing an X-ray may seem straightforward, you might encounter challenges with software that is not intuitive. This can lead to frustration and inefficiencies in your workflow.

Therefore, seek out a provider that offers comprehensive user training and robust local customer support. Having access to excellent training resources can significantly enhance your team’s proficiency and confidence in using the equipment.

Safety

Different models of digital dental X-ray machine emit different levels of radiation. The level of radiation required to capture a quality image will vary between machines. Keeping radiation exposure to a minimum is vital to the health and safety of your patients and staff. Modern digital X-ray machines often require lower doses of radiation.

Given that all X-rays involve radiation, choosing low-dose X-ray technology is important, especially when treating children.

Children are more sensitive to radiation exposure, so utilising low-dose options can significantly reduce potential risks. This approach not only ensures their safety but also provides peace of mind for parents and caregivers. When selecting X-ray equipment, consider the technology’s ability to minimise radiation while still delivering high-quality imaging.

Digital dental X-rays buying guide

Vatech

Vatech’s extraoral X-rays

CBCT

Vatech Green X and Smart X offer the best image quality on the market with the smallest voxel size. They offer advanced imaging capabilities for a wide range of dental procedures.

Green X

The Green X has five distinct innovative features:

1: The Green X Endo mode, with the world’s smallest voxel size of 49.5 microns, allows clinicians to obtain more detailed information. This increases their chances of solving clinical problems.

2: Its Ez3D-I Endo software supports the whole process of surgery. Itsc has specialised functions for diagnosis, implant planning, simulation and consultation, especially endodontic plan with root canal tracing.

3: Vatech’s green technology reduces the radiation level of the Green X without reducing image quality with Green Scan Time.

4: Advanced metal artefact reduction technology enhances image clarity. It improves diagnostic accuracy by minimising the distortions, or artefacts, caused by metal objects. These include dental implants, crowns, braces and surgical hardware.

5: Magic pan technology produces superior panoramic images by eliminating distortions and blurring caused by improper patient positioning.

Smart X

Smart X is the latest addition to Vatech’s premium X series. It is thoughtfully designed to incorporate the innovative features of the Green X while offering enhanced cost efficiency.

The world’s smallest voxel size

Smart X also has Endo mode, with the world’s smallest 49.5 μm voxel size. This enables clinicians to access more comprehensive information, enhancing their ability to address clinical challenges effectively.

Smart focus mode

Smart focus mode allows for ultra-high-definition images at a 4x4cm size within a 12x9cm FOV using endo mode. It is powered by Vatech’s world-leading X-ray generator and sensor technology and combined with AI-based software.

Sleek and modern design

Smart X stands out for its sleek, ergonomic and modern design. Minimalist and sophisticated, it seamlessly integrates into clinical environments while maximising space efficiency.

Smart Plus

Smart Plus has a three-in-one digital X-ray imaging system that incorporates pano, ceph (optional) and CBCT (with auto pano). The Smart Plus provides high-quality images with lower radiation.

One scan, two images

One scan with the Smart Plus gives you a CT image and an auto pano image. This means, patients who require both images do not need to undergo two X-ray scans.

Anatomical FOV 12X9

The innovative FOV of the Smart Plus provides an arch-shaped volume. This shows a wider view of dentition compared to other devices of the same FOV.

Compressed sensing technology

Vatech dramatically improves its image quality with much less artefact and noise via its compressed sensing technology (CST). This iterates its reconstruction process 10 times more than the normal amount to depict the object’s true representation.

OPG

Pax-I Plus

The Pax-I Plus provides the most precise and high-quality panoramic images by combining image processing.

Vatech’s intraoral X-rays

Currently, the X-rays drawing the most attention from dentists are handheld and wall mounted. This is because they allow for immediate imaging in the surgery room and are priced more affordably compared to CBCT.

The most trusted handheld X-ray available on the market today is Vatech’s Ezray Air Portable.

Ezray Air Portable

The Ezray Air Portable is the world’s first X-ray device utilising carbon nano technology (CNT).

To learn more about CNT, please check out this video.

Lightweight

At 1.8kg, the Ezray Air Portable is a lightweight portable X-ray device designed for easy handling and stable positioning. It delivers optimal image quality for your intraoral X-ray images. The ease of device positioning produces clear images without any motion artefact.

No warmup, faster cooling

Unlike conventional X-rays, Ezray Air Portable has no start-up delay as the source warms up. Its carbon nano technology allows for quicker exposure after you turn on the device.

Ezray Air Portable has an almost 75% reduction in cooldown time between shots when compared to leading competitor devices.

Double shield: internal shielding and external backscatter shielding

The internal radiation shielding is perfectly designed to protect the operator from radiation leakage. Exposure to radiation results from the beam interacting with the surface of the patient. This causes radiation to bounce off as radiation scatters in different directions. The backscatter shield significantly reduces the amount of radiation being reflected.

Ezray Air has been approved by the European Commission (EC), the International Organisation for Standardisation (ISO) and the Food and Drug Administration (FDA), ensuring its safety and reliability.

Ezray Air Wall

Lightweight

The Ezray Air Wall, a wall-mounted unit featuring carbon nano technology, is designed to be lightweight. Its compact tube head offers a stable and user-friendly X-ray source that enhances image clarity and streamlines workflow.

This intraoral X-ray is fully equipped for rigorous daily use. It is crafted to be simple for dentists to operate and easy to position accurately while requiring minimal space.

Ergonomic design for safety and efficiency

• Round shape design: the Ezray Air adds a modern and chic touch to your clinic
• Strong and stable arm: the strong and stable X-ray unit arm allows accurate positioning of a 2.4kg lightweight tube head, aiding distortion-free images
• Ergonomic one-handed grip: a hand grip provides an easy method of positioning the Ezray Air quickly and accurately.

Safety and reliability

Ezray Air Wall has been approved by the EC, ISO and FDA, ensuring its safety and reliability.

Intraoral sensors

IOX should be used in conjunction with either an intraoral sensor or a phosphor plate.

The Ezsensor Classic and Ezsensor HD are Vatech’s flagship intraoral sensors. They are available in sizes suitable for children (1.0 size), adults and a 1.5 size that can be used by both adults and children. Its rounded design ensures comfortable use for patients.

Photostimulable phosphors

VSP

Vatech VSP is one of the smallest and lightest photostimulable phosphors (PSP) scanners. It weighs only 3.3kg and has dimensions of 233x141x191.5mm.

VSP output image quality is always in super resolution (20lp/mm) or high resolution (10lp/mm).

The world’s first PSP scanner was created using multi-pixel photon counters (MPPC). What sets MPPC apart from the existing photo multiplier tube (PMT) is immunity to magnetic fields and high resistance to mechanical shock.

Also, the MPPC is lower than 10 times voltage operation. And more than that, 10 times high gain can be obtained when compared to PMT. And it is a small size. MPPCs can be driven at a low voltage, are small in size and are inexpensive.

Store up to 500 high-resolution images

The Vatech VSP has a built-in memory, so you can store up to 500 scan images without a PC connection. It is possible to verify that imaging is done normally through the LCD preview screen even when scanning without PC.

Four sizes

Flexible imaging plates come in four sizes. Cableless, thin and soft imaging plates optimally stick to various oral shapes to provide high quality images while maintaining maximum comfort for the patient.

Image plates are highly durable and reduce the risk of damage. Ultra-thin imaging plates can be reused repeatedly while maintaining great image quality.

Acteon

Intraoral X-rays

Cephalometry

Panoramics/OPG

CBCT

Belmont

Intraoral

Carestream

Extraoral

CBCT

Cephalometric

Panoramic

Intraoral sensors

Intraoral generators for dental X-rays

Dentsply Sirona

Extraoral

Intraoral

Kavo

Extraoral

Ceph imaging

Intraoral

Conclusion

Digital X-rays offer a host of benefits when compared to traditional X-rays. Quality, detail, sustainability and the ability to manipulate and share images can hugely improve your offering.

This guide has shown the range of functions available in modern digital dental X-rays and some of the devices on the market.

Think about your needs, budget, available space and other factors when making your choice. The right decision could transform your practice.