Talking to X-Ray Resistant Patients

By Dr. Marty Jablow

You Tell the Patient They Need X-rays and They Tell You “NO!”

What should you do when talking to x-ray resistant patients? Most patients do not argue about having radiographs taken but many do. The reasons can be varied but ultimately they all lead to the same endpoint — x-rays necessary to provide the best care don’t get taken. Not to mention the frustrating high stakes negotiation had over and over with the same patients. Some may threaten to leave the practice over the frequency of radiographs even with a new dentist where a recent set of radiographs are absolutely essential. What you need to do is figure out what the issue is and find a way to motivate the patient in a positive manner to accept the minimum necessary radiographs that will allow you to do a thorough examination.

What’s Required of You as a Dentist: The ADA and FDA Positions

The ADA, in collaboration with the U.S. Food and Drug Administration (FDA), has developed recommendations for dental radiographic examinations to serve as an adjunct to the dentist’s professional judgment of how to best use diagnostic imaging. Radiographs can help the dentist evaluate and definitively diagnose many oral diseases and conditions. However, the dentist must weigh the benefits of taking dental radiographs against the risk of exposing a patient to X-rays, the effects of which accumulate from multiple sources over time. The dentist, knowing the patient’s health history and vulnerability to oral disease, is in the best position to make this judgment. For this reason, the ADA’s recommendations are intended to serve as a resource for the practitioner not as standards of care, mandates, or regulations. Developing a needs-based approach to radiographs (versus frequency based) will minimize additional radiation exposure.

What Do You Say to the Patient That Refuses X-rays?

What to say depends on the real reason behind the request. If you don’t flush out the reason there is little chance that you can get them to change that initial “NO” to “YES!”. To deal with x-ray resistant patients you must uncover why they feel the way they do about allowing radiographs. The two most common patient concerns are cost or radiation exposure. So when a patient objects to radiographs, resist the natural urge to explain why they are necessary and instead start with asking “Why are you hesitant to have x-rays taken?”.

Whether the issue is cost, safety, or something else, logic alone may not work as often these concerns are emotionally based and overblown. The tried and true “Feel, Felt, Found” approach to conflict resolution can be a great way to break down the walls between you and your patient. It provides you and your staff with an easy method to respond to patients in an effective and empathetic manner.

When Cost of X-Rays is the Primary Concern

If the patient has no dental insurance coverage they may be truly concerned about the cost of the radiographs versus the amount of radiation. The logical argument in this situation is that without early detection, something small, now, can turn into something larger, and far more costly, later. You could use the example of a small cavity that ultimately requires a root canal, explaining the cost difference of filling a cavity versus restoring a tooth after endodontic therapy.

And here’s how that might sound using Feel, Felt, Found language:

Dentist:    “Mrs. Smith, I understand how you feel. Initially other patients in similar situations have felt the same way. What they’ve found, is that once they understand the cost of missing something small, now, versus fixing something large, later, they want to move forward with x-rays. May I give you an example?”

Patient:    “Okay sure.”

Dentist:    “For example, taking care of a cavity while it’s small is easy and inexpensive.  Left untreated it can become a much more difficult procedure like a root canal and restoration which costs thousands of dollars.”

Pause and listen to the response offering additional clarification of questions or uncovering other concerns.

If the patient seems more open to the idea, you’re now in a good place to ask if it’s okay to take the radiographs. Often they will consent because you gave them a good logical reason why you need the x-rays (for early detection which is ultimately better from a health and financial perspective), in a way that addresses the emotional elements as well. Listening to and acknowledging how they feel has built empathy and rapport. Sharing that others have felt the same way creates trust and moves them to a more objective position. Showing them that others in the same initial position have changed their minds with a positive outcome often persuades them to change their mind as well.

What to Say to a Patient Who Refuses X-rays Over Safety Concerns?

If the patient has dental insurance that pays for x-rays at 100% then it is usually safe to assume that the reason for resistance is radiation exposure concerns. For many of these patients the fear is understandable. They may tell you that they have had lots of past radiation exposure from medical imaging such as CAT scans and MRI’s. We have to always remember that most patients have no idea just how low the radiation dose from dental x-rays really is.

The facts that will appeal to a patient’s logic are that the amount of radiation from an annual set of four bitewing radiographs utilizing digital sensors, about 0.005 mSv (micro-Sieverts), is less than the average daily dose of radiation we receive from going about our daily routines. A relatable comparison is that we get more radiation from a trip on an airplane or a day at the beach than we do from dental x-rays. In offices that use handheld X-ray units, older patients may be comforted by the fact that the staff no longer has to leave the room to take radiographs. Finally, you may be able to reassure them by offering to double drape the apron as added protection.

So here’s the Feel, Felt, Found dialogue for this situation:The guiding principle of radiation safety is “ALARA”. ALARA stands for “as low as reasonably achievable”. This principle means that even if it is a small dose, if receiving that dose has no direct benefit, you should try to avoid it. To do this, you can use three basic protective measures in radiation safety: timedistance, and shielding.

Dentist:   “Mr. Green, I understand how you feel. Initially other patients with concerns about x-rays have felt the same way. What they’ve found, is that when given a complete understanding of the health benefits of having x-rays versus how little exposure modern x-rays really involve, they want to have x-rays taken. May I explain how little?”

Patient:    “Yes.”

Dentist:    “Great. A set of modern x-rays provides less radiation than we get on a single plane flight or a day at the beach. But they allow me to find things like small cavities or decay well before I can see them with my eyes, or they start to cause you pain. It gives us the best chance of avoiding more invasive and expensive procedures down the road.”  

Their Health May Depend on Your Persuasive Skills

Taking radiographs is an important part of the dental examination, early diagnosis, and intervention. Failure to adequately diagnose due to lack of radiographs may place the dentist in a position of supervised neglect which has its own medical legal complications. Your responsibility aside, resisting routine radiographs can cause patients undue dental health complications which could have been avoided. The patients may be fully to blame but you are in a position to change their outcomes. So consider polishing your team’s persuasive skills and rehearsing scripts for everyone’s benefit.


How Much Does a Dental Digital Intraoral Sensor Really Cost?

By David Gane, DDS

What is the true cost of digital sensor ownership?  

This is always one of the first questions I hear from my colleagues researching digital intraoral sensors. Digital imaging technologies, including intraoral sensors, are mission critical to patient care and efficient operations and one of the most significant investments that a dental practice will make.  As a dentist, I clearly appreciate the need to understand true cost in order to get this decision right.

The challenge in answering this question succinctly is that there are literally dozens of digital intraoral sensors on the market today covering a wide range of price points. There are also a variety of practice specific factors that contribute to the overall cost of these technologies. So, a simple question on sensor cost often requires a bigger analysis on the technology needs of your individual dental practice, your desired budget, and what other imaging technologies you currently own.

Challenges aside, I’ll do my best to outline the factors that impact total costs and provide ranges as to what you’re likely to spend for intraoral sensors.

How Much Does a Sensor Cost?

Most digital intraoral sensors are priced in the $3,000-10,000 range, which includes the sensor itself, basic positioning accessories and an initial period of warranty coverage. This price can increase dramatically if additional items, including imaging software, technical support fees and extended warranty coverage are added.

Keep in mind, this is the cost for a single sensor. If you are a practice with multiple operatories and need several sensors, the cost will be scaled accordingly.

Imaging Software

Depending on your practice type, and if you are already utilizing digital technologies, you may or may not need to invest in digital imaging software along with an intraoral sensor. If your practice is transitioning to digital radiography from film, you will definitely need imaging software to capture and display digital radiographs. This software costs, on average, between $2,000 – $4,000 for a single location practice. Again, there can be considerable variation depending on the size of your practice and number of workstations that will need to have imaging software installed.

If your practice is already using digital imaging technologies and you are simply adding an additional sensor or replacing a broken one, you may not need to buy additional software. In this case, make sure that your existing imaging software will integrate with the sensor you are considering, as compatibility issues are common.

Support Fees

When purchasing digital sensors, you’ll need to consider whether there are additional fees for technical support for your sensor when things aren’t working.  While support is often included for the first year, there can be additional fees to get technical assistance following the expiration of the manufacturer’s warranty depending on the company you purchase the sensor from. We find that these support fees range from no charge to $800 per sensor per year.

Warranty Coverage

Warranty coverage also varies widely depending on the manufacturer, with out of the box warranty coverage lasting between 1-5 years. Having a good out of the box warranty can be a critical factor in the cost of ownership especially if you might be faced with replacing a high-end sensor costing $10,000 per unit. If you are interested in purchasing an extended warranty, these can often cost up to $2,000 annually per sensor.

The value of longer warranties (whether included in the original sensor price or purchased as an extended warranty) is a function of the replacement cost, the potential cost of dental sensor repair (if repairable) and the likelihood that the sensors are damaged or malfunction after the warranty has expired. A $2,000 annual extended warranty may make sense on a higher priced sensor but makes less sense if the cost of buying a new sensor is on the lower end of the range.

If an out of warranty sensor has only incurred minor damage and is relatively new, repair may be a viable route. However, with sensors that have been in service for 3 to 5 years, the economic trade-off between a repair or replace decision becomes a much tougher call. After 4-5 years, the investment in a newer technology is more likely to be a better long-term investment than a repair.

What’s obvious is that all other things equal, a more comprehensive and longer initial warranty period included in the purchase price is most beneficial.

New Leasing Options

A relatively new option in shopping for digital intraoral sensors is leasing the technology from the manufacturer for a lower upfront cost and a monthly subscription fee. Per sensor, the upfront investment is usually around $2,000 and requires a monthly subscription fee of between $125-$150 per month. This option may be good for practices looking for a lower cost point of entry but usually results in a higher cost-of-ownership over the life of the sensor.

So How Much Should You Expect to Pay for a Digital Intraoral Sensor?

The answer to how much digital intraoral sensors will cost really depends on your practice type and what your needs are.

If you are already using digital sensors and simply adding on a sensor to your existing system, there are very good options starting for as little as $3,000. At the high end, an individual sensor can cost up to $10,000 depending on the manufacturer, brand and feature set.

If your moving from film to digital, the cost will vary with the size of your practice and how many operatories you will need to equip. Let’s consider a practice with 2 operatories going digital – please note this does not include the costs of computer hardware or networking services, which could also be required if you do not already have these systems in place.

Upfront Costs:

  • 2 sensors – $6,000-$20,000
  • Imaging software – $2,000-$4,000

Total Upfront Costs – $8,000-$24,000

Be sure to research and compare warranty and support terms and associated fees to better understand add-on annual or monthly costs once the initial coverage periods expire.

Recurring Costs:

  • Technical Support – No Charge up to $800 per year per sensor
  • Initial Warranty – 1 to 5 Years with purchase
  • Extended Warranty – up to $2,000 annually per sensor

While these are general numbers, I hope they provide a good idea where to start as you begin shopping for sensors. I also hope this article arms you with some key questions to ask manufacturers as you move forward with the purchasing process.

If you need a quote for a sensor, we’re here and happy to help. Our team is available via the link below or at 877.278.3799.


Universal Direct-USB Compatibility: Tuxedo Digital Intraoral Sensor

While the quality of a digital intraoral sensor’s HD images is often its biggest selling point, its reliability and versatility should not be undervalued; dental professionals need to be 100% confident in a sensor’s ability to perform day in and day out with minimal headaches and as few complications as possible. A simple workflow provides more time and energy to focus on what matters most: the accuracy of a diagnosis and the patient’s complete satisfaction. The Tuxedo Digital Intraoral Sensor by LED Apteryx offers all this and more – its universal direct-USB compatibility with no inline boxes, hubs or controls means the sensor is ready at all times with no activation required and its universal capabilities ensure a simple, streamlined workflow from start to finish. In addition, the removal of inline boxes or hubs results in fewer points for possible failure; the simplicity and versatility the Tuxedo Digital Intraoral Sensor not only ensures an enhanced workflow but also provides peace of mind in knowing that it just works.

Universal Direct-USB Compatibility for a Streamlined Practice Workflow.

Call us toll free at 1-877-APTERYX for a customized quotation or complete the form below and we’ll contact you.  We can schedule a demonstration of the Tuxedo sensor as well as our XrayVision software and filters, or review our unique, no obligation 30-day trial program.  Your satisfaction is guaranteed.


Tuxedo Digital Sensor Warranty: 3-Years, No Deductibles

LED Apteryx offers great warranty protection for its wide selection of digital imaging devices and our Tuxedo Digital Sensor warranty is no exception. We warrant the Tuxedo intraoral digital sensor and equipment to the original purchaser against defects in material and workmanship for three (3) years from the date of purchase with no replacement deductible.

Should your device or equipment require repair or replacement, please contact Customer Support at 877-278-3799. Service or replacement must be performed by LED Apteryx.

For more information, please contact Customer Support at 877.278.3799.  Original proof of purchase is required.

Learn More About the Tuxedo Digital Intraoral Sensor and the Tuxedo Digital Sensor Warranty

Call us toll free at 1-877-APTERYX for a customized quotation or complete the form below and we’ll contact you.  We can schedule a demonstration of the Tuxedo sensor as well as our XrayVision software and filters, or review our unique, no obligation 30-day trial program.  Your satisfaction is guaranteed.


Patient Comfort and the Tuxedo Intraoral Sensor

Patient comfort should be a top priority for any dental practice – everybody wants to feel comfortable and at ease in the dentist chair. Unfortunately, many dental devices are inherently invasive in nature. People appreciate any efforts made to prioritize their comfort; the more comfortable your patient is the more satisfied they will feel with your service. This means more return visits and, ultimately, more business for your practice.

Physical design features of intraoral sensors can significantly impact patient comfort; most patients worry about experiencing pain and irritation during routine procedures and may be reluctant to have an intraoral sensor placed in their mouth. It is becoming increasingly important to take into consideration various aspects of the sensor’s construction to ensure the best possible imaging outcomes while also considering a patient’s comfort level.

The Tuxedo Digital Intraoral Sensor has a thin, ergonomic design featuring rounded corners, beveled edges and a rear-exiting cable connection; it is intended to fit into your patient’s mouth more comfortably than competing models. These simple design considerations ensure a more relaxed experience for your patient while you are gathering and processing image data. In addition, the Tuxedo Digital Intraoral Sensor is available with two sensor profiles that maximize the x-ray activation zone while accommodating variances in mouth size: use size #2 for typical adult mouths and #1 for smaller mouths or for children. Simply select the sensor size which enables placement of the sensor without excessive pinching or pressure on soft tissues to ensure the largest, most accurate images as well as a comfortable patient experience.

An Ergonomic Design for Patient Comfort and Satisfaction.

Call us toll free at 1-877-APTERYX for a customized quotation or complete the form below and we’ll contact you.  We can schedule a demonstration of the Tuxedo sensor as well as our XrayVision software and filters, or review our unique, no obligation 30-day trial program.  Your satisfaction is guaranteed.


Tuxedo Sensor Support: Customer Retention Through Satisfaction

A dental practice relies on its team of friendly and engaging reception staff, personable and caring hygienists and knowledgeable and experienced dental practitioners. We know just how much importance you place on patient satisfaction and how valuable patient retention is for your practice. We believe our primary role is to contribute in assisting with product knowledge, product selection and implementation and, ultimately, to ensuring your patient satisfaction each and every day.  Our commitment to you is that we will be available to provide you with product information, training and Tuxedo Sensor support so that you are consistently confident that your imaging technology choices are delivering the very best experience to your patients.

Think of us as an extension of your practice.  Each member of our US-based team of customer care representatives is an expert in digital imaging and can competently guide you through any image technology and software assistance you may need including anything relating to Tuxedo Sensor support.  Our team is equipped to troubleshoot any technical issues, recommend product solutions, and provide you with a 100% product satisfaction guarantee. We know what it takes to build a successful dental practice and we intend to support you in every way that we can.

Let’s Talk About if the Tuxedo Digital Intraoral Sensor is Right for your Practice.

Call us toll free at 1-877-APTERYX for a customized quotation or complete the form below and we’ll contact you.  We can schedule a demonstration of the Tuxedo sensor as well as our XrayVision software and filters, or review our unique, no obligation 30-day trial program.  Your satisfaction is guaranteed.


Custom Image Filtering Technology: Tuxedo Digital Intraoral Sensor

Not every image is created equal; various custom image filtering options are required to produce an image that directly coincides with the needs of the dental professional. A modern dental practice requires HD imaging technology in order to optimize its practice workflow and ensure a concise, accurate diagnosis and treatment plan for each and every patient that walks through its doors.

The Tuxedo Digital Intraoral Sensor and XrayVision 4 Imaging Software by Apteryx offers a wide array of customized, user-defined optimizations to ensure that our technology works for you in a straightforward, user-friendly capacity. Such optimizations include customized image enhancement filters, personalized default image settings, real-time HD image sharpness and contrast modification, and more.

HD image customizations allow users to select from a range of anatomical image enhancement filters depending on the application in use including: endodontic, periodontic, and dentin-enamel junctions. In addition to image customization options, XrayVision 4 software can also be customized to match your exact needs when acquiring images with the TUXEDO sensor. For example, users are able to define up to four default settings to quickly optimize the sensor’s HD imaging capabilities based on the goals and requirements of the dental professional.

Custom Image Filtering Capabilities for the Modern Dental Practice.

Call us toll free at 1-877-APTERYX for a customized quotation or complete the form below and we’ll contact you.  We can schedule a demonstration of the Tuxedo sensor as well as our XrayVision software and filters, or review our unique, no obligation 30-day trial program.  Your satisfaction is guaranteed.


HD Imaging for Dental Practices: Tuxedo Intraoral Sensor

We understand that the accuracy of your diagnosis is paramount. Digital sensors must provide clear radiographs to enhance your ability to diagnose. The Tuxedo Intraoral Sensor by LED Apteryx offers HD imaging for dental practices that’s all that and more, satisfaction guaranteed.

When using a digital intraoral sensor for image acquisition, the higher the resolution of the sensor, the easier you will be able to identify defects or clinical issues for your patients. The Tuxedo Intraoral Sensor offers a confirmed actual HD image resolution of 20 lp/mm.  Best of all, it provides you this imaging capability at up to 50% of the cost when considered alongside competing sensors with comparable resolution. In addition, the Tuxedo Intraoral Sensor features a streamlined, ergonomic design, plug-and-play direct USB connection, a reinforced cable for reliability and a 3-year, no deductible product warranty.

The Tuxedo Intraoral Sensor’s HD imaging capabilities align seamlessly with Apteryx XrayVision and XVWeb imaging software. There are simply no compromises.

HD Imaging for Dental Practices – Satisfaction Guaranteed.

Call us toll free at 1-877-APTERYX for a customized quotation or complete the form below and we’ll contact you.  We can schedule a demonstration of the Tuxedo sensor as well as our XrayVision software and filters, or review our unique, no obligation 30-day trial program.  Your satisfaction is guaranteed.