Only mobile cone beam imaging lab in Indiana is Culver-based business

Ruth Birk, a familiar name in the Culver area, is hoping to take a somewhat unfamiliar technology beyond Culver and across Indiana, and improve lives in the process.

Parked unassumingly in Birk's Culver driveway is the only mobile dental cone beam imaging "office on wheels" in Indiana, and one of a relatively small number in the entire U.S.

Birk is well aware that the best way to convey what cone beam imaging -- not exactly a household name -- can do is visually, and she's hoping for more opportunities to do so. If a picture if worth a thousand words, the sight of what the technology, which debuted in 1996, can do would likely result in more and more people seeking its use, and consequently more and more improvements in diagnosis and treatment of a host of dental-related problems.

Inside the In Motion Imaging LLC (the name of the company Birk started last year) van is a state of the art piece of equipment. One scan, she explains, contains a fraction of the radiation present in traditional x-ray methodology, but rather than the single, two-dimensional image produced by x-rays, cone beam creates a complete, three-dimensional image, capable of "zooming" in on portions of the picture smaller than a millimeter.

One of the most helpful aspects of the technology is the ability for dentists to view areas of the mouth for any angle: above, below, or any side. As a result, says Birk, dentists are likely to be able to diagnose those persistent, otherwise inexplicable problems...the pain or discomfort for which no other explanation exists, for example, but whose origin is visible only through the full visual range afforded by cone beam technology.

"It measures airway space to see changes in airway space for TMJ and sleep-related appliances. You can see fractures or broken teeth, or if there's sinus stuff going on.

Images are uploadable and can be sent to board certified radiologists to read them, she notes.

Further, dentists can plan surgical cases, implants the most precise changes to jaw position in corrective work, and more, once again down to the millimeter.

For the layperson, perhaps one of the most startling capabilities is its ability to generate a complete, three-dimensional image of the patient's skull, from top to bottom, as sure as if all skin and tissue were removed. It's an arresting sight which conveys the capability of the machinery.

Birk, a Licensed Dental Hygienist (or LDH), operates her business -- which has no ties to any specific dentist -- with assistant Denise Richards. The genesis of In Motion Imaging ( was Birk's attendance at a mid-winter meeting in Chicago where the company which distributes the equipment was represented. Birk was particularly attracted to the mobile aspect of the technology.

"If you're going to invest in a machine, you might as well invest in one that's mobile so lots of doctors can use it," she says. "It's an expensive piece of equipment for a dentist to purchase and there's a large learning curve in learning how to use it. A dentist would lose at least two days of production time in training his staff to use it. It provides for doctors a quality of service they don't have to invest in."

She likens the application of the technology to a medical doctor "sending you to a hospital for an MRI or CT scan. But being mobile, we go within a two hour radius to service doctors."

Cone bean technology was started by New Tom, the same company which manufactured Birk's own machine, in Europe in 1996.

The basic visual information, Birk explains, comes from a cone -- hence the name -- and it's a complete image. Compare that to a CT or "CaT" scan, which uses digital imaging to fill in "blanks" between "slices" of actual visual data. Plus, Birk says, CT scans bombard the patient with "a huge amount of radiation" (she says studies have shown cone beam scans have at least 75 percent less radiation, in fact, than CT scans).

"From my continuing education and in-office experience," she adds, "I've realized cone beam is beneficial not only for doctors, but patients."

There are stationary cone beam machines in Indiana, but as one might expect, most are located in a small handful of larger Hoosier cities.
One challenge, however, has been educating dentists to better understand the technology and its benefits, say Birk and Richards, who have sent a stream of mailings and brochures hoping to illustrate those matters.

She cites the example of one dentist -- a periodontist (that is, a gum disease specialist) some miles away who's a more recent dental school grad with "major debt."

"As a recent graduate, he knows about cone beam technology," Birk says. "He's coming right out of dental school with major debt, and he's interested in the technology and has the software to get these (cone beam digital) images."

In Motion Imaging, then, can provide affordable, localized access to cone beam technology.

"The van is a mobile office," notes Birk. "The machine has backup for the battery backup or it can run off an extension cord by regular power. We have redundancy and redundancy."

After a scan is taken of a patient, Birk and Richards create images and can burn a DVD for the dentist which includes a "mini" version of the software used to read images and generate data.

All of this requires a high-powered computer of the sort used in high-end gaming, though a dentist needn't have all that horsepower to view the generated graphics.

"This makes the technology available to everybody," Birk explains. "It evens the playing field. If you're living in Argos or Culver or Rochester, you have access to the same technology that you (otherwise) would have to go to Indianapolis or Chicago or South Bend to get, and the information comes to your dentist in Culver or wherever. That's a huge aspect when you start looking at the population base of Culver."

In a nutshell, she says, "the technology goes to the community. The doctor doesn't have to invest, and the patient doesn't have to drive."
So far, In Motion Imaging has scanned patients from Indianapolis to West Lafayette, Carmel to Auburn, but Birk and Richards are still on the road, taking the van to town after Hoosier town, attempting to help bring the technology to patients by way of sharing information about it with dentists.

"It's a paradigm shift for dentistry," says Birk.

Besides the In Motion Imaging website, the company may be contacted at 574-216-6633 or by email at