In my previous article “Flash Systems for Dental Photography,” we highlighted the equipment and settings that are most ideal for dental photography.  While these settings and equipment are important, photographer positioning also plays a key role in producing great clinical photos. Different positioning considerations are necessary for direct and indirect photos. These dental photography tips will help you achieve the optimal clinical photos for supporting strong treatment outcomes.

Dental Photography Tips for Direct Photos

Direct photos are those taken without a mirror. These include extraoral headshots, repose, and frontal retraction shots. The key to positioning for these photos is to ensure that the photographer keeps the camera parallel and in the same plane as the object being photographed.

Proper positioning for direct photos, demonstrating the camera aligned with the subject for optimal results
Figure 1: Proper positioning for direct photos, with the camera in the same plane as the subject being photographed.

If the photographer is on a different plane and not parallel to the subject, the resulting image will be distorted. This provides false information about the position of the head and teeth and will lead to issues when attempting to perform facially generated treatment planning.

Illustration showing incorrect positioning: a) above the subject plane leading to distorted image c), and b) below the subject plane resulting in distorted image d)
Figure 2: a) Positioning above the plane of the subject and b) below the plane of the subject. These will lead to distorted images c) and d), respectively.

In many cases, it may be necessary to ask a patient to tilt his or her head up or down to achieve a parallel-angled shot. Asking patients to tilt their head up or down can help to place them in the proper plane without the photography having to compromise their ergonomics.

Photo showing a) correct ergonomic positioning with patient's head movement, and b) potential ergonomic issues when patient's head movement is not considered
Figure 3: a) Having the patient move his or her head to achieve an ergonomic position, b) Ergonomic issues that can occur when a patient is not asked to move his or her head.

Tips on Positioning for Indirect Photos

Indirect photos are those taken with a mirror. Photos commonly taken using a mirror are the occlusal photos of the upper and lower arches as well as the lateral photos of the left and right side of the mouth in maximum intercuspation.

Positioning for indirect photos requires additional skill and consideration. Because the photo is being taken using a mirror, it is imperative that the photographer is in the proper position to prevent any distortion.

In particular, the photographer must ensure he or she positions the camera at a 45-degree angle to the mirror while having an assistant hold the mirror at a 45-degree angle to the teeth.

By positioning the camera and mirror in this manner, the photo will appear to be a direct image of the teeth being photographed. If the proper angulation is not attained, the image will be distorted and will provide inaccurate information for treatment planning.

Photo demonstrating the proper positioning of the mirror and camera for capturing indirect photos
Figure 4: Proper positioning of the mirror and camera for indirect photos.

Photographer positioning is crucial for both direct and indirect photos, playing a key role in creating accurate and undistorted images. Following these dental photography tips will ensure the photographer is positioned properly. Additionally, guiding the patient to position his or her head accordingly helps produce the most ideal clinical photos for treatment planning and case presentations.

Andy Janiga, D.M.D., practices at the Center for Dental Excellence in Nashua, N.H., and is a contributor to Spear Digest.