It appears as though Dr. Farman has mistaken my mildly contrarian position for hostility to all things technological. I am not opposed to digital technology; I am simply not seduced by it. I readily acknowledged that dental digital radiography "is a welcome incremental advancement" and that it is here to stay; hence, "more than a fad."1
Dr. Farman’s emphasis on the value of image-guided operative procedures suggests that I ignored this advantage of dental digital radiography. In fact, Dr. Farman and I are in agreement on this issue. Perhaps he overlooked my endorsement of dental digital radiography for endodontics and some surgical procedures.
When Dr. Farman speaks of computer-generated guides for dental implant placement and models for oral surgical planning, he is referring to advanced imaging techniques, such as cone-beam computed tomography, that were not covered in Dr. van der Stelt’s article, save one paragraph in his "Conclusions and Future Directions" section. Nor was this covered in my editorial. Conflating advanced imaging techniques with dental digital radiography as commonly used in clinical practice does not contribute to the discussion, but merely confuses the issues.
Although I believe that Dr. Farman intended "blinkered" as a pejorative term, I prefer to think of it differently. Dr. Farman hails from Louisville, home of the Kentucky Derby, in a state famous for breeding horses. Horses are often blinkered during races to prevent them from being distracted and to keep them focused on task. So, yes, in that sense, I am blinkered. I remain focused on what is important about diagnostic imaging, and I am not easily distracted by the digital hoopla in the grandstand. And I encourage others to do the same.
The 11.5 percent of general dentists who have already embraced digital radiography for all of their intraoral applications are the "early adopters" in Everett Rogers’ diffusion of innovation model.1 However, not everyone has to be on the cutting edge of technology; some of us would rather not bleed. "Early majority" and "late majority" adopters1 may prefer to wait until the kinks have been worked out, and the prices have dropped. In the meantime, we can rely on film to provide us with the diagnostic images that we need to treat patients.
My editorial addressed the current state of dental digital radiography. As Dr. van der Stelt said, "digital radiography is no longer an experimental modality," but it certainly is not a must-have technology for contemporary dental practice.
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