Howard Speaks by Howard Farran, DDS, MBA, MAGD
Publisher, DentalTown Magazine

If you have not yet purchased a Diagnodent, I can’t tell you how much fun you’re missing. In fact, I believe the Diagnodent is one of the best pieces of dental equipment I have purchased in the last five years. I always see dark pits and fissures in teeth and know patients hate it when I go poking around with a sharp explorer. Sometimes, it’s hard to make a quick decision. Should I take a ‘wait and see’ approach for the next six months on this pit and fissure or should I take action and recommend immediate treatment? If I decide to recommend immediate treatment, why didn’t I recommend it six months ago? What exactly has changed? Why don’t I watch it, again for another six months? If I decide to recommend treatment today, how do I explain this to the patient? Should I get out the intraoral camera? Can the patient see this cavity with a mirror?

Now say hello to my little friend…the Diagnodent. At my Today’s Dental practice, we have one Diagnodent for our three hygienists to share in treatment rooms #1, #2 & #3 and another one for our two dentists to share in treatment rooms #4 through #8. The dentists use the Diagnodent for new patient exams and the hygienists use this diagnostic masterpiece on recare exams. We show patients a photo on the wall showing the two kinds of cavities—a flossing cavity and a pit and fissure cavity. Then we explain to our patients that cavities can’t grow in air because the ‘bugs’ that eat their teeth and gums are anaerobes and can’t live in oxygen. We go on to explain that the ‘bugs’ thrive in between their teeth give them a flossing cavity and the ones that live down in the pits and fissures eventually turn into a pit and fissure cavities.

Next we take the flossing x-rays to check for cavities in between the patient’s teeth. Some dentists call these bitewings but I believe calling them flossing x-rays is much more descriptive for the patient. We can show our patients their x-rays immediately on a flat screen computer monitor or print them out on a Hewlett Packard DeskJet 932C color printer. It’s so convenient because our Today’s Dental office is now completely paperless. (We use Trophy for our digital x-rays and SoftDent for our practice management software.)

While showing the patient how many existing flossing fillings (MO’s, DO’s, & MOD’s) they already have, in addition to how many new cavities they’ve developed, it’s fun and helpful to circle the cavities with a red felt pen on their printed digital x-rays. How many dentists or doctors offices do you know that always give their patients a printed out copy of their x-rays? Visual communication makes treatment acceptance much easier.

To check the pit and fissures, we have the patient hold the Diagnodent machine while we run the tip across the grooves checking for deep decay. The patient gets to watch the readings tooth by tooth. As the readings go deeper the machine makes a deeper noise. There is not a single device in dentistry that can convince a patient of the need for an occlusal filling better than the Diagnodent.

I can not tell you how many times this machine has amazed me over the last year or so. One situation I recall vividly was a 14-year-old kid with great homecare and a diet controlled mostly by his mom. I observed perfectly white pit and fissures, couldn’t get a stick anywhere and the bitewings looked great. And yet, the Diagnodent read a 74! Because the Diagnodent has always shown itself to be so extremely accurate, I anesthetized the tooth with Septocaine and set my timer for six minutes. When I started to prepare the tooth, I immediately fell into an inverse mushroom cloud of mush. For operative dentistry the Diagnodent is as reliable and as indispensable as my RootZX is for endo.

Just in case you’re wondering, I paid for my Diagnodent just like you did, or should do soon. I paid $2705 for mine. In my practice, the fee for a 2385 occlusal composite is $135. In terms of cost effectiveness, this means the Diagnodent would have to find and sell 20 occlusal composites to pay for itself. The Diagnodent not only paid for itself the very first month, but drastically improved my diagnostic ability to diagnosis hard-to-find and hard-to-see decay. This isn’t a sales pitch, it’s a plea to those poor dentists who get up and practice everyday without this technology.

If one dentist’s opinion doesn’t convince you, log on to www.DentalTown.com and see if 12,000 registered dentists can convince you. Go to “Message Boards” click “Search” and then type in the key word “Diagnodent.” There must be over 200 messages posted on this topic and they’re all good. There is even a new case in our case presentations module showing the remarkable diagnostic capabilities of the Diagnodent.

Go check it out…..