Dental imaging integration vendor question pack

Dental imaging integration is where most PMS evaluations go wrong — vendors say “yes we integrate” and the clinic finds out post-purchase that “integrate” means “launches the sensor manufacturer's desktop app via keyboard shortcut”. This question pack is designed to surface what “integration” actually means in concrete operational terms before contracts are signed.

Use it during vendor demos and follow-up technical calls. Score each answer: green (clearly resolved), amber (partial), red (deflection or vague). 5 reds means walk away.

Section 1 — Sensor SDK and capture (5 questions)

1. Which specific sensor models do you support natively?Don't accept “all major brands”. Get a list with model numbers (Carestream CS7600, Dexis Titanium, SoproDirect, Schick 33, etc.). If they can't produce one, integration is shallower than claimed.
2. For each supported sensor, what's the integration mechanism? Native SDK / TWAIN driver / vendor desktop launcher / DICOM C-STORE? SDK is best (deepest integration); desktop launcher is essentially no integration.
3. Where does the radiograph land at chairside capture? Direct into the patient chart in your PMS, or into a separate folder / system that requires manual attachment? Direct is the goal; manual attachment costs 1–2 minutes per visit.
4. If the sensor manufacturer releases a firmware update, what breaks? Vendors with proper SDK integration handle this transparently; vendors using the manufacturer's desktop app inherit every breakage.
5. Can a clinical assistant capture without leaving the patient chart? One-click / one-foot-pedal capture without alt-tab is the test. If they need to switch applications, integration is shallow.

Section 2 — DICOM (5 questions)

1. Do you support DICOM C-STORE for receiving radiographs? If yes, panoramic / CBCT machines that export DICOM can land radiographs directly into the patient record without intermediate desktop software.
2. Do you support DICOM C-FIND for querying external imaging systems?Useful when a referred patient's radiographs live in an external CBCT centre.
3. What DICOM viewer is built into the chart?Native viewer with multi-frame, pan/zoom, annotations, measurements? Or does it pop up an external viewer?
4. Can the DICOM viewer handle CBCT (volumetric)? Many PMS DICOM viewers handle 2D radiographs but punt CBCT to a separate desktop app. Verify if you do CBCT.
5. Are radiographs stored in their original DICOM format, or compressed/converted? Compression that loses metadata or alters image quality is bad for clinical accuracy and bad for medico-legal defence.

Section 3 — Chair-side workflow (5 questions)

1. What does a routine bitewing capture look like, end to end? Have them demo it. Time it. Count clicks. If it takes more than 5 seconds from sensor-ready to image-on-chart, the workflow is wrong.
2. Can the dentist annotate / measure / mark up the radiograph at chairside? Many PMS view-only the radiograph and force the dentist to a separate tool for markups.
3. Does the radiograph capture trigger a treatment-plan entry? Capturing a periapical of tooth 36 should auto-suggest the relevant clinical note and procedure code, not require separate entry.
4. How are radiographs grouped per visit vs per tooth?Both views matter — “all radiographs today” and “all radiographs of tooth 36 ever”.
5. Foot pedal / hands-free capture support?Hygiene matters; cross-contamination from touching mouse/keyboard mid-procedure is real. Vendors that ignore this haven't designed for clinic reality.

Section 4 — Patient-chart integration (5 questions)

1. How do radiographs link to specific teeth, surfaces, or treatment plans? Tooth-led linking (“radiograph of tooth 36”) beats date-based (“radiographs from 12 March”) for clinical recall.
2. Can a radiograph be marked “baseline” vs “follow-up” for a specific condition? Periodontal monitoring, endodontic follow-up, implant osseointegration tracking — all need baseline / follow-up tagging.
3. Side-by-side comparison view of radiographs? Comparing pre-treatment and post-treatment radiographs side by side is a routine clinical motion.
4. Patient-facing radiograph share — does it work securely? Sometimes patients want copies (e.g. moving clinic, second opinion). Secure, time-limited, audit-logged link generation matters.
5. How are radiographs handled in the patient's treatment plan / case presentation flow? Treatment- planning conversations with patients benefit from radiographs loaded into the plan view, not pulled up separately.

Section 5 — Long-term data + export (5 questions)

1. Can I export every radiograph in DICOM format with original metadata intact? Critical for migration, medico-legal, patient transfers.
2. Where are radiographs physically stored?Singapore region (PDPA + clinic preference), or another jurisdiction?
3. Backup retention — how long, how recoverable? Dental records have long retention windows (15+ years for some procedures). Backups must reach back that far.
4. If we leave your service, what happens to our radiograph archive? Get this in writing in the contract. Bulk export, time window, format, included in subscription or one-time fee.
5. Can we self-host or hybrid-host the imaging archive?For multi-location groups, hybrid is sometimes useful. Most cloud-only vendors don't support this.

Section 6 — Per-brand notes

Carestream

Common in older Singapore clinics. Native SDK exists; most modern PMS support it but with varying depth. Ask specifically about CS7600 vs CS8100 — different generations, different integration paths.

Dexis

SDK available but less open than Carestream historically. Some PMS integrations rely on the Dexis desktop app rather than native SDK.

Sopro

Intra-oral cameras (not radiographic sensors). Integration via TWAIN typically. Verify intra-oral camera capture lands in the chart, not just a folder.

Schick

Schick 33 / Schick AE. Integration via SDK in most modern PMS, but some still use the Schick desktop app. Verify.

NewTom (CBCT)

Volumetric imaging. Almost always exports DICOM. PMS integration is via DICOM C-STORE typically — verify CBCT-specific viewer support, not just 2D.

Planmeca (CBCT + 2D)

Romexis is their own software. Many clinics keep Romexis for the CBCT viewing while integrating PMS for the chart. Verify whether your PMS can DICOM-receive from Planmeca and whether the viewer is sufficient for your CBCT use cases.

Pre-evaluation prep checklist

• List every imaging device in your clinic (model + year)
• Note which devices are network-connected vs USB-only
• Estimate radiograph capture volume per chair per day
• Identify CBCT vs 2D needs separately
• Count years of historical radiograph archive (for migration scope)

During-evaluation observation list

• Time the bitewing-capture-to-chart-display cycle
• Count clicks for routine capture (target: ≤2)
• Verify the demo uses a real sensor, not a pre-recorded image
• Ask the demo presenter to capture from a different sensor brand than originally shown — see if integration generalises
• Verify DICOM export end-to-end (capture → archive → re-import)

Scoring

For each of the 30 questions: green / amber / red.

• 0–2 reds: vendor is genuinely deep on imaging integration
• 3–4 reds: workable, but expect friction in those areas
• 5+ reds: imaging integration is shallow; budget for ongoing pain

For the software side — DICOM in the chart, native sensor-bridge integration, tooth-led linking — Oralstack scores green on most of these by design. See /workflows#imaging and our sensor-bridge article.