For a long time I used to naively reason that I don’t take clinical pictures as often as I should because I need to invest in product “X.” I thought when I have all the necessary armamentarium, I’ll be able to take clinical pictures consistently.

I've realized that the key to taking routine clinical pictures was not the armamentarium or my lack of discipline. There was an absence of a systematic approach. If you find yourself in this bind, I propose that you look at the following four key aspects. Implementing these may bring about the consistency you have been looking to achieve.

1. New patient exam protocol: Taking a full series of pictures should be a standard part of every new patient exam. Every clinician who has done this for a year or more will tell you how this investment is well worth the effort. If you try to cherry-pick cases for pictures, your guesses will be wrong at least 50 percent of the time. Once you have a workflow in place, this exercise will take no more than 10 minutes. You’ll soon find out that skipping the process of taking photos to save 10 minutes is not worth at all.

When the operatory is set up for the new patient exam it should by default have the "Photography tub" which would have everything needed to accomplish the complete picture series. This includes the following:

  • Camera
  • Mirrors
  • Retractors
  • Mirror warmer (We use an electric heating pad.)
  • SD card

2. Staff training: Invest time in training your chair side assistant and hygienist to take these pictures. Clinical pictures with mirrors are usually convenient with an assistant; however, one operator can take other photos. If the staff is taking the patient photos, you know it will be done with consistency.

3. Picture management: Having a smooth workflow of managing the pictures ensures that the valuable pictures taken are put to effective consistent use. Try the following protocol:

  • Use one memory card for each set of individual patient photos.
  • Transfer photos on an iPad or other tablet by an SD card reader. Tablets can be a great tool to talk about the clinical findings during the exam as described here.
  • Transfer the pictures to each patient's chart and an external hard drive.
  • Back up photos on an off site back up drive.

4. Slideshow preparation: Train a team member to place the pictures in a specific established sequence into slideshow presentation software like MS Power Point. You can add and modify this basic slideshow further based on a particular clinical situation. But a staff member can easily complete the initial arrangement since it is a simple repetitive sequence of steps for every slideshow preparation.

These keys will help in the following ways:

  • At the end of each exam appointment these steps will allow for a quick "show and tell" (by loading images on a tablet) and you can give the patient a tour of the mouth and draw their attention to the clinical findings you discovered during the exam.
  • If you decide that you want to invite the patient back for a separate consultation appointment, you will have a basic slideshow draft ready for a quick edit and presentation.
  • Consistent picture taking will help you build a library of "before and after" pictures of your own cases. You will not find yourself apologetically looking at a wonderful completed anterior esthetics or implant case thinking, "I wish I had a 'before' picture to go with this beautiful looking 'after' picture.

Vivek Mehta DMD, FAGD, Visiting Faculty, Spear Education. Follow him on Twitter @Mehta_DMD.


Comments

Commenter's Profile Image Suraiya Shaikh
May 9th, 2013
Very well concised concept of digital photography ... great checklist again for Pictures to be incorporated in the practice.
Commenter's Profile Image Marc Asmar DDS
May 9th, 2013
We use the Eye-Fi wireless SD transmission card. It automatically moves all photos taken to a receiver/storage computer. This one $54.00 investment saves my assistant 15 minutes before lunch and 15 minutes at the end of the day alone. We take about a 1000 photos a month. This is 2 hours a week! Well worth the money and time! Highly recommend.
Commenter's Profile Image Muna Strasser
May 10th, 2013
What a great article and a great idea, Marc! Thanks for sharing!
Commenter's Profile Image Stomatoloq
May 10th, 2013
Mastering digital dental photography (Wolfgang Bengel) http://ru.scribd.com/doc/126925612/Mastering-digital-dental-photography-Wolfgang-Bengel?secret_password=iq57yg6u2bdy1z9573v
Commenter's Profile Image Benson Shulman BSc CDT
May 10th, 2013
Aside from shade communication, photographs help us in the lab with details such as the patient's lip contours, smile line, and general facial structure. Things we can't imagine from models and macro shots of the teeth alone. It definitely helps a high-end ceramist to produce our best work. The more information we get, the better. Also, if your lab technician is well-versed in photography he/she can be an excellent resource. Being a "serious amateur" photographer for many years, I have aided my dentist clients to select high-end dental photography camera+lens+flash from a used-camera outlet at a fraction of the cost of those prepackaged outfits marketed to dentists; and instructed them on settings.
Commenter's Profile Image Dr Roman Holowaty
May 11th, 2013
Excellent review
Commenter's Profile Image Doaa Ahmed
May 11th, 2013
Thanks Dr.Vivek for sharing. Which camera would you think is the simplest with settings to start up with?
Commenter's Profile Image Doaa Ahmed
May 11th, 2013
Thanks Dr. Vivek for sharing. Which camera would you think is the simplest to start up with?
Commenter's Profile Image Vivek Mehta
May 12th, 2013
@ Ahmed Doaa : I believe the Cannon 3Ti with a 100mm macro lens and Metz wireless flash would be the simplest setup. For under $2000 you can be set to take a very good quality routine diagnostic clinical pictures as well as shade pictures for lab communication
Commenter's Profile Image Bob Marolt
May 13th, 2013
Since we began to take photographs on new patients 12 years ago our case presentations are so much simpler. People believe what they see. We now are taking a photo series on recare patients, and while this takes some planning and a shift in how we schedule, I believe that our diagnostics will be better and patient understanding will be enhanced.