Is film really superior to digital? A colleague recently emailed me, claiming conventional film remains "the best" and the gold standard in dental radiography. Attached was a PDF from DrBicuspid.com summarizing a study from the Saudi Dental Journal. The research concluded that conventional X-ray film outperformed digital systems. My friend seemed almost wistful—research supposedly proves film’s edge, yet dentistry keeps shifting toward digital. Should we worry we’re shortchanging patients? Are we chasing convenience over quality? The DrBicuspid editor recapped the study neutrally, sticking to its findings. I won’t be so restrained. Fair warning: this post carries a touch of humor and a strong opinion. If you’re a die-hard film fan, you might want to skip it.
The “Research” in Question
The study took 25 extracted, root-canal-treated teeth and imaged them using conventional film, direct digital, and semi-direct (photostimulable phosphor, or PSP) systems. Two observers then rated the images for clarity in enamel, dentin, the dentino-enamel junction (DEJ), gutta-percha fillings, and simulated apical pathology. No objective measures—like pixel density or standardized scales—were used to assess “clarity.” It was all opinion. After some statistical analysis, the conclusion? Conventional film reigns supreme. Proven. With numbers.
This raises a question: what qualifies as research? With so much published material out there, it’s surprising this study even caught attention. Its controversial slant likely helped, but that doesn’t mean it deserves the spotlight.
It’s All Subjective
Here’s the crux: this study is entirely subjective, so it gets a subjective response. Ask most dentists today, and they’ll pick digital without blinking. There’s a small group—experienced, set-in-their-ways clinicians—who’ve spent decades with film. To them, it’s familiar, comfortable. A digital image on a bright screen? Foreign, maybe even off-putting. They’d rather hold a film up to the light than tweak contrast on a monitor. That’s fine—film works for them, even if digital cuts radiation exposure slightly.
For those of us trained in the digital age, film feels like a relic. It’s small, often smudged, over- or underexposed, and tough to decipher. Digital, though? I can adjust size, brightness, contrast, and sharpness on the fly—no extra patient exposure needed. My ability to diagnose leaps ahead with those tools. Film’s limitations just don’t compare.
Final Thoughts
This study boils down to two observers in Saudi Arabia preferring film over digital. That’s their call, and it’s noted. But the shift to digital isn’t about abandoning quality—it’s about enhancing it. Convenience is a bonus, not the driver. At oralradiologists.com, we’re focused on what delivers the best diagnostic value for dentists and patients. Digital wins that contest hands down. Give the paper a read if you like, but don’t let it sway you too far—progress isn’t turning back.