DENTAL PHOTOGRAPHY-1
• Uses of photography in dentistry
• Camera settings and accessories
• Guidelines for clinical photography
Dental photography
• Dental photography is an innovative, safe
and easy to use method to document the
results after a completed dental procedure.
• It is a method that can be used for multiple
purposes including promotion, education,
and documentation of achieved results.
Dental photography
Dental photography allows the patient
to visualize his or her smile and oral
condition with the same acute
perspective as the dentist, which helps
the patient understand the rationale
for recommended treatment.
Purposes and uses
• Documentation
• Patient Records
• Case Presentation
• Quality Control
• Self-check
• Laboratory Communication
Purposes and uses
• Insurance
• Education/Publication
• Community Service
• Marketing
• Medico-legal Concerns
Examination, diagnosis, treatment planning
• During a first examination, the operator
could not see many details, and
photography is an effective method, as a
real second visit, to analyze the
preoperative dental status at a later date.
• So a complete set of oral images, collected
on first examination, is valuable to get to a
certain diagnosis, to provide dental
treatment options and is not only useful
for recording a baseline of oral health.
Examination, diagnosis, treatment planning
• Photographic record is useful in analysis of facial profiles and orthodontic
tooth alignment , to assess occlusal disharmonies, to evaluate prosthetic
rehabilitation or gingival health and periodontal pocket or even ridge
morphology prior to implant placement.
• Primary use of dental photography is certainly to assist the operator on
the initial examination of the patient, to help him in the diagnosis and
control of the medical care outcome over time.
Legal aspects
• It is possible to identify two main kinds of legally-relevant dental photographic
documentation:
• - The legal documentation, intended as photographic images documenting pretreatment
conditions as well as aesthetic changes that were achieved through delivery of dental care
• - The forensic documentation, including the identification of human remains and the
analysis of dental-related trauma, such as human bite marks
Legal documentation
• Photographic documentation is necessary not only to legally protect the
dentist, but the patient as well.
• In fact, potential discrepancies between the dentist and patient may also be
overcome in this way.
• Photographs should be taken of patients who appear to be suspicious or
overly anxious about the treatment they have agreed to receive, or who
have had previous legal activity with a dentist.
Legal documentation
• At least the starting and ending conditions in such procedures should be documented,
as well as any peculiar occurrences during treatment.
• In today’s medical/legal environment, a pre-treatment/post-treatment series of
photographs is imperative.
• Having this material available it is always possible to prove the starting oral situation
of the patient and the consequent changes due to the dentist decisions and therapies.
Forensic documentation
• Forensic dentistry refers to the application of
dental science, especially through photographic
documentation, to legal matters.
• The forensic dentist most usually assists in
identifying human remains.
• The photograph is often a vital aid in accurate
documentation of perishable evidence
Forensic documentation
• All photographs intended as evidence should be labelled with the
location, date, time, subject, and photographer’s name and may
include such information as camera, lens, film, lens aperture, subject
distance, shutter speed, or flash setting used.
Publishing and education
• Clinician needs also photographic skills in order to show his/her
cases to the scientific community, to colleagues and to students.
• As for the education, pictures cover a fundamental role in
publishing, intended as research articles and books.
• The reasons are nearly the same, as pictures help the lecturer in
understanding the text and effectively visualize what the written
passage is about.
Communication
• Digital dental photography is an exceptional tool for communication and
documentation.
• Many stock images or animations of teeth and dental practice can be
obtained from a dental library, dental software, internet downloads, but it
is preferable to use patient clinical pictures in order to enhance confidence.
Communication
• Showing pictures ranging from the starting status of disease to the
health status, achieved through the therapies, leaves an ever-lasting
impression, informing the patient of the potential hazards of this
disease.
• Generally intraoral conditions, which in the course of dental
treatment are subjected to change, can be recorded in detail by
means of photography.
Marketing
• The last purpose of dental photography that we will consider is for
Internal or External marketing.
• Internal marketing relies on team members motivating patients to
refer friends and family.
• If the team lacks sufficient verbal skills, provides only average
customer service, or does not build strong relationships with patients,
then any attempts at internal marketing will likely fail.
Marketing
• External marketing is used to obtain a high visibility to a large number of people,
personalized connectivity with potential clients and personal image enhancement and
self-promotion.
• Advertising in telephone directories, local televisions, newspapers or radio and
television is not obsolete, but probably the most effective method today is by using
the Internet.
Marketing
• E-mail remains a significantly more effective way to acquire customers than
social media, nearly 40 times that of Facebook and Twitter combined.
• Also the social media networks such as Facebook, Twitter, Google Plus and
LinkedIn present an extraordinary marketing opportunity for dentists.
Taking Dental Photos
• Selection of the most suitable equipment for extraoral and
intraoral photography requires knowledge of digital
photography .
• DSLR technology is considered to be the system of choice
for predictable dental photography.
• A DSLR camera system equipped with a macro lens (85–
105 mm) and an external ring flash mounted in front of
the lens is required for high-quality intraoral
macrophotography
• Compared to a point-and-shoot camera system,
the advantages of a DSLR setup include
excellent image quality, speed of operation,
increased depth of field, and adaptability.
• While the DSLR systems were traditionally
thought to be more complicated to learn,
bulkier and more expensive, today’s systems
are smaller and lighter, and are similar to other
systems in terms of cost.
CAMERA SETTINGS AND ACCESSORIES
• All DSLR cameras require a very specific setup for clinical dental
photography
Accessories
Mirrors
Glass
Metal
Retractors
Contrasters
Cheek retractors
• Contribute to the final outcome of intraoral photography.
• These essential accessories are used to retract the lips, labial and
buccal mucosa from the field of view.
• This allows the maximum amount of light to enter the oral cavity,
thereby improving visibility.
• Additionally, using retractors removes miscellaneous soft tissue
structures from the field of view (which would otherwise be
distracting).
Cheek retractors
• Cheek retractors are available in clear plastic or
metal, and are either single- or double-ended.
• Double-ended retractors provide both a small and
large curvature.
• This shape allows adaptability to a variety of mouth
sizes.
• Selection is a matter of preference; however, plastic
retractors are less noticeable in the image should it
prove impossible to eliminate it fully while framing
the photograph.
Cheek retractors
T-shape Fishtail-type
Cheek retractors
Plastic (T-shape modification)
Intraoral mirrors
• Are invaluable when taking occlusal and buccal-
view images because the photographic angle
does not typically allow for capturing these
photos from a direct view.
• Intraoral mirrors are available in several sizes,
and a standard set should include buccal and
occlusal mirrors.
• They are used to provide a reflected image
when areas of difficult access are being
photographed.3
Intraoral mirrors
• To prevent mirror fog, it is useful to warm the
mirror in a water bath, or simply ask an assistant to
gently blow air across the mirror with the triple-
way syringe.
• Mirrors are also available with handles, thus
simplifying occlusal and buccal imaging.
• Their use minimizes the possibility of fingers being
shown in the images (which is more likely with
traditional mirror systems).
Intraoral mirrors
• To protect the reflective surfaces
from potential damage, it is
strongly advised to wrap mirrors
separately for autoclaving
purposes, and not mix them
together with other instruments.
Intraoral mirrors
Intraoral mirrors
•Fog Free Micro-Fan
Contrasters
• Designed to allow some of the dental photos to be taken
with black background. Anterior
• This obscures the inside of the mouth and makes the image
more presentable for patients, lectures and publications.
• 2 Types:
Occlusal
-- Anterior
-- Occlusal
Contrasters
Anterior
Occlusal
Contrasters
BASIC IMAGES
• Ideally, the patient should be photographed in a
dental chair, which should be adjusted to enable
the photographer, without having to reach or
bend uncomfortably, to capture an adequate
view.
• For anterior, buccal and occlusal imaging, it is
easier to obtain consistent views if the patient’s
head is kept level.
• For the full-smile and anterior retracted views,
some operators prefer to shoot these images
from a direct horizontal approach rather than
from a slightly tipped-down approach,
• For lateral views, it is important to have the
patient use the narrow end of the metal cheek
retractor on the side being photographed,
while using the wide end on the contralateral
side.
Guidelines for clinical photography
• Take intraoral photographs in the landscape mode of
camera orientation. For extraoral photographs, use the
color quality of the flash. portrait mode.
• For intraoral photography, use a camera with a macro
lens or facility with the ability to produce 1:1 images.
• In general, use the smallest aperture to maximize depth
10 available for dental photography of field
Guidelines for clinical photography
• Calibrate the camera system to determine and become familiar with
the optimal settings for intraoral and extraoral photographs.
• Clean the target site of debris, excess saliva, blood, bubbles, impression
material, excess cement, glove powder before taking photograph.
Target area should be moist but not dessicated. Change surgical drapes
needed to avoid blood stained images.
• Isolate the target site (include only what is necessary in photograph)
Guidelines for clinical photography
• Use clear plastic retractors as appropriate to afford an unrestricted
view of the target area.
KEY TAKEAWAYS
• Dental photography allows the patient to visualize his or her smile and oral condition with the
same acute perspective as the dentist, which helps the patient understand the rationale for
recommended treatment.
• Before taking any images, clinicians should obtain written consent for photography, and take
steps to protect patient confidentiality.
• A digital single lens reflex (DSLR) camera is ideally suited for practices that wish to use
photography for documentation for lectures or publications.
KEY TAKEAWAYS
• Compared to a point-and-shoot camera, the advantages of a DSLR setup include
excellent image quality, speed of operation, increased depth of field, and adaptability.
• All DSLR cameras require a very specific setup for clinical photography,3 as proper
exposure setup and flash calibration are essential.
• Cheek retractors are key accessories that help retract the lips, labial and buccal mucosa
from the field of view.
KEY TAKEAWAYS
• Intraoral mirrors are invaluable when taking occlusal- and buccal-view images because
the photographic angle does not typically allow for capturing these photos from a
direct view.
• As a general rule, practitioners should take seven basic views to record a patient’s
clinical condition during the initial visit.
• Original images should be stored in a folder and labeled with the patient’s name and
date, and marked as “original photos.”
• Ahmad I. Digital dental photography. Part 1: an overview. Br Dent J. 2009 Apr
25;206(8):403-7.
• Ahmad I. Digital dental photography. Part 3: Principles of digital photography. Br Dent J.
2009 May 23;206(10):517-23
• Bengel W. Mastering Digital Dental Photography. 2nd ed. Chicago, IL:
Quintessence; 2006.
• McLaren EA, Terry DA. Photography in dentistry, J Cal Dent Assoc 2001;29:735-42.
