Prepared by Todd R. Schoenbaum, DDS & Richard G. Stevenson, DDSwith support from the UCLA Division of Restorative Dentistry

and the Academy of Operative Dentistry Founder’s Fund

Introduction to Digital Dental Photography

Welcome to the world of Digital Dental Photography

All information is accurate and current as of 2012. Future developments in photography will require revision of the

information contained within.

What is Dental photography good for?

•Patient Communication

Patients understand their needs and complications much better when they can see a picture of their own pathology

•Lab Communication

Particularly for treatment in the aesthetic zone, technicians need more information than just a single shade tab.

Photography greatly simplifies the shade taking process; providing the ceramist with a “palate” of shades rather than trying to match a single shade.

•Interdisciplinary

Communication

Photography greatly enhances the ability to communicate between disciplines for complex treatment.

•Diagnosis and Treatment Planning

Even with radiographs, charting and mounted models, there is much diagnostic information to be gained by including photography to comprehensive treatment planning.

Basic Armamentarium

dSLR

Point & Shoot

Intraoral

There are 3 camera types for dental photography

There are 3 camera types for dental photography

IntraoralAdvantages:- no mirrors needed- small and lightweight- simple

Disadvantages:- subpar image quality

Point & Shoot

Advantages:- small and lightweight- lower cost

Disadvantages:- not upgradeable - inconsistent magnification

There are 3 camera types for dental photography

dSLR

Advantages:- highest image quality- upgradeable- various lighting options

Disadvantages:- heavy- expensive

There are 3 camera types for dental photography

Although intimidating, once properly calibrated the dSLR is the most popular and versatile choice for dental photography.

dSLR

There are 3 components of a dSLR for dental photographyCamera

BodyMacro Lens

Macro Flash

Camera Body The models and specifications of

camera bodies changes very rapidly.

A dSLR body for Dental Photography should at a minimum have the following requirements: - 10 MP resolution- APS-C sensor- 3” LCD screen

More expensive models may have many extra features, most of which are of little use in dental photography

Macro Lens

The lens needed for dental photography is a Macro (or Micro) specific lens with a focal length of 85-105mm.

•This is not the lens that comes on the camera when purchased as a kit at a consumer store. •It cannot be a zoom lens.•It must have magnification marking on the lens.

Ring Flash

Dual-point Flash

- Easier to use- Smaller- More consistent lighting - Not very good at showing incisal translucency or line angles

- More difficult to use- More flexible lighting options (i.e. diffusers)- Difficult to use for mirror shots- Best option for aesthetic dental work and shade photography - Works best with a special mounting bracket for dentistry

Photography accessories

Intraoral Photography Mirrors

Occlusal XL Buccal #1Wide

• Front surface coated to avoid double images

• Occlusal mirror is used for the maxillary and mandibular occlusal images

• Buccal mirror is used for quadrant, buccal, and lingual images

• must be handled with extreme care to minimize scratches

Tips: - keep mirror warm to avoid fogging (i.e. water bath, heat pad, coffee cup warmer)- use the biggest mirror possible- never place mirrors on or near metal instruments

Cheek Retractors

•Used to hold the cheeks off the buccal tooth surfaces and allow more light into the mouth

•Usually positioned by the doctor, and held by the patient

•Available in different sizes and made of metal or plastic

•They should not be visible in the photo

Anterior Contraster (optional)

•Used in anterior shots to “black out” the background

•Enhances the ability to see translucency•Used in conjunction with retractors

dSLR Camera Settings

Shutter Speed: 60-250

Aperture: f/8 for full face f/32 for intraoral

ISO: 100-400

White Balance: Flash or Custom

Image size: Large JPEG or RAW

dSLR Camera Settings

Exposure Mode: “M” Manual or “Av” Aperture Priority (Usually set on the dial on top of the camera)

Flash Mode: eTTL This is an automatic mode that works well for beginners. Advanced users may choose to experiment with manual flash exposure settings.

Focus Mode: “MF” Manual FocusNot to be confused with the exposure mode set above. This prevents the autofocus from changing the magnification setting. Focus will be achieved by moving the camera. This may initially seem more complex, but the mouth is generally too dark for autofocus to work properly.

Magnification

Magnification:- Controlled by turning the lens barrel - Macro specific lenses have magnification markings on them- The magnification is set on the lens- Do NOT spin the lens to focus (it will change the magnification)

- We will be using three magnification settings:

- 1:15 for full face image- 1:3 for most intraoral images- 1:1.5 for closeup images

Rotate to change

magnification

What images to take?

Basic Diagnostic Image Series

(6 images)1. Full Face smiling- stand approx. 2 meters away- use autofocus for this image only- patient’s head should be vertical

Magnification 1:15; Aperture f/8

2. Lips in Repose (“M” position)- turn off autofocus; set magnification to 1:3 and aperture to f/32- Instruct pt to say “emma” - used to determine incisal display at rest

Magnification 1:3; Aperture f/32

Magnification 1:3; Aperture f/32 Magnification 1:3; Aperture f/32

Magnification 1:3; Aperture f/32

Magnification 1:3; Aperture f/32

3. Maximum Gingival Display (“E” position)- instruct patient to say “eeee”- used to determine lip mobility and gingival display

4. Retracted 1:3- insert retractors, dry teeth- teeth should be slightly separated - retractors need to be pulled out and forward

5. Maxillary Occlusal- place patient in a fully supine position- insert retractors; dry teeth- insert occlusal mirror- shoot from 12 o’clock position6. Mandibular Occlusal- place patient in a fully supine position- insert retractors; dry teeth- insert occlusal mirror under tongue

Posterior Restoration Image Series

(3 images)1. Shade Image- taken before preparation or rubber dam- best to shoot in RAW format for color fidelity- position shade tabs as close as possible to teeth to be matched- use one tab for occlusal, one tab for gingival- use the appropriate shade guide for the porcelain to be used

2. Pre-operative Occlusal- Use buccal mirror- Teeth and rubber dam should be clean and dry- If not using a rubber dam, use the cheek retractors

Magnification 1:3; Aperture f/32

Magnification 1:3; Aperture f/32

3. Post-operative Occlusal- Use buccal mirror- Teeth and rubber dam should be clean and dry- If not using a rubber dam, use the cheek retractors

Magnification 1:3; Aperture f/32

Anterior Restoration Image Series

(6 images)1. Full Face smiling- stand approx. 2 meters away- use autofocus for this image only- patient’s head should be vertical

Magnification 1:15; Aperture f/8

3. Pre-operative Close up- set magnification to 1:1.5- use retractors- clean and dry teeth- use contraster to better capture translucency

Magnification 1:1.5; Aperture f/32

Magnification 1:1.5; Aperture f/32 Magnification 1:3; Aperture f/32

Magnification 1:1.5; Aperture f/32

Magnification 1:3; Aperture f/32

5. Preparation- set magnification to 1:1.5- use retractors- clean and dry teeth- use contraster to better capture translucency

4. Retracted 1:3- insert retractors, dry teeth- teeth should be slightly separated - retractors need to be pulled out and forward

6. Post-operative- set magnification to 1:3- use retractors- clean and dry teeth- use contraster to better capture translucency

2. Shade image- set magnification to 1:1.5- use retractors- clean and dry teeth- make note of shade tabs if labels cannot be seen in the image

Comprehensive Diagnostic Image Series

(16 images)

1. Full face smiling2. “M” (Lips in repose)3. “E” (max. gingival display)4. “F” (A-P relation)5. Right smile6. Center smile7. Left smile8. Pre-Operative shade image9. Right retracted10. Center retracted11. Left retracted12. Right close-up13. Center close-up 14. Left close-up15. Maxillary occlusal16. Mandibular occlusal

#1

#2 #3 #4

#5 #6 #7

#11#10#9

#12 #13 #14#8

#15 #16

Like any new skill…

This will take practice and dedication to master

Prepared by Todd R. Schoenbaum, DDS & Richard G. Stevenson, DDSwith support from the UCLA Division of Restorative Dentistry

and the Academy of Operative Dentistry Founder’s Fund