So you have a camera and are ready to use it in your practice now. The next question is, what images are best to get you started and actually use in your practice?
As you might guess, there are a lot of choices. In this article, we will keep it simple and cover six basic images that are quick and easy to incorporate into your practice. In follow-up articles, we will go into additional images to take you further.
If you are not using photography with all of your patients, I urge you to keep reading and think about how easy it is, and what a big impact these six images could have in helping your patients see what is going on in their mouths and what choices they could make to reach their goals.
Who doesn’t want to see their smile? I suppose there are some people that just plain do not care about their smile, but really...seriously...how often is that the case for patients coming into your office?
Sure, your patient might be fine with, or even love, their smile; if so, great! If this is the case, you and your patient can celebrate how well their smile works for them.
Dare I say, for most patients coming into to our offices, when they say, “I don’t want to see my smile,” what they mean in most cases is, “there is something I do not like and I do not think it can be fixed.”
To be clear, I am not talking about the patient that is OK with their smile. I am talking about a patient that does not want you to take this photo. If this is the case, ask them to still allow you to take the photo for your records, and reassure them that you are not taking this photo to discuss any treatment for their smile if they are not after anything in regards to their smile.
No matter their answer, taking and sharing this image with your patient is a great way to celebrate either how well things are working or what can be done to meet their goals.
Heck, if they just have zero desire to look at this image with you, fine, just give it to them and let them know it is their copy to take. Then move on and feel good about the fact that you have a great image for your records to track any changes and go back to if your patient so desires. Beyond that, the worst thing you could find out is that they do not like their smile, but are also unwilling to change it due to the things that would be involved to do so.
No matter what, I believe that these answers, whatever they are, are really good things to know. The key here, like so many things with our patients, is to find out their answer and what they are after. And here is a big key for us: be unattached to what their answer is; rather, be curious as to what their answer is.
Lips retracted, teeth apart
This image gets into function. For me, as with this image and the remaining four images we will discuss here, if they are unwilling to review them with me, we have a big problem, as these images are all related to health. While I am always OK not talking about cosmetics and esthetic stuff, we have to talk about the things I see in regards to health, as not doing so just makes no sense.
Seriously, think about it: imagine going to a physician for an exam and then asking them not to tell you what they see! Makes no sense, right? What would you think if you went to a physician and they withheld information they learned about your health? What would the Medical Board say about that? We are doctors too, and we owe it to our patients to always share what we see when it comes to health.
So, what can we see and look at with our patients in this image? The answer is, a ton of stuff, like the occlusal plane, gingival margins, decay, how the teeth flow in the arch from anterior to posterior, and how the buccal and facial surfaces of the lower arch are doing as they work against the upper teeth.
This image obviously lets us look at the occlusal surfaces of the upper teeth. Is there decay? If the teeth are restored, how are the restorations doing? Is there wear or erosion? Are there fractures? What about crowding or spacing? Are the anteriors proclined or retroclined?
Obviously, this shows us all the same things the maxillary arch shot did. The important thing to add is to be sure to compare what you see in the image compared to the upper image.
For instance, if you see lots of one thing, like wear, erosion or decay on one arch but not the other, you it owe to your patient to try and figure out why. Is there a habit or something pathologic affecting one area and not the other? There has to be something different going on, and while you might not be able to come up with the reason immediately, you ought to make note of it and come up with a long-term plan to figure out the "why."
Having photos like this and comparing how things look as time goes on compared to when you took the original photos is big. It can be eye-opening to see how things change, or don’t change, over time in your patient's mouth.
Right lateral teeth apart
The key for this photo is, just like the descriptor states, to take it with the teeth apart. That’s right: teeth apart.
Yes, teeth together has value and I love the teeth together image as well. Yes, I take the teeth together image a lot. But if for some reason I am trying to limit my photos to the smallest number, I am going to only take one lateral image per side. If that is the case, it would be this one. Why, you ask? Well, we get to see more stuff and only give up a little and therefore, the net amount of information I get is more than when the teeth are together.
So what’s the stuff we get to see in this image that we do not get to see in the teeth together image? For starters, we get another look at the mandibular occlusal plane at a different angle than the lips retracted/teeth apart image we discussed above.
We also get another, and often better, look at the incisal facial and occlusal buccal surfaces so we can see how they are interacting with the upper teeth. The only thing we miss in this image is the interdigitation of the upper and lower arches, and I will give that up considering all the extra information we get with the teeth apart if I am needing or wanting to limit the number of photographs we take.
And if, when you get good at this image, you want to get the teeth together images as a bit of spoiler, adding in the teeth together image adds less than two seconds to your routine. Just hold your same position and framing and have the patient close together and then snap a second photo.
Left lateral teeth apart
Needless to say, we get all the same information with this photo as with the right lateral. The key to remember again is, just like with the maxillary and mandibular photos, it is really important to compare the right and left images and if we see differences in what is going on between the two sides, we ought to ask why.
Well, there you have it. You now have a list of six photos that can make a huge difference in how you can interact and educate your patients in what you see. The key is to help them see what you see and how what you see together aligns with their goals.
Do the things going on align with their goals or do they conflict with their goals? If they align with their goals, great! Celebrate it. If, on the other hand, there are things going on that do not align with their goals, then you need to have that discussion with your patient.
One of two things will happen: they will either ask you what can be done to make said thing align with their goals, or they will need to change their goals and own said change and what they can expect with it.
To learn even more on how take these six photos, head to this online dental photography course.
My last and final tip is get really good at taking these photographs yourself and then teach your staff and your team to take them as well, which can be super cool as it helps free you up and empowers your team!