In the age of digital dentistry, photography has become a critical skill for dentists. Good intraoral dental photography for dentists will serve as another diagnostic tool, and help you to effectively demonstrate the need for treatments to your patients.
Providing accurate extraoral photography to your dental lab — along with digital scans — will also help improve communication and give your lab technicians the extra information they need to achieve the best, most natural restorations for your patients.
Professional-standard before and after photos are also an excellent marketing tool to showcase your cosmetic dentistry work to potential new patients who are increasingly browsing social media and dental websites in search of cosmetic dental services.
Whether you’re a point-and-shoot beginner or a whizz with a DSLR camera, Dr James Tran shares his tips and advice on how to lift your photography game, improve communications with patients, and take best-practice dental lab photography.
Photography for dentists has become an important clinical tool. Dr Tran says high-resolution clinical dental photography can be used to identify fine cracks in teeth that may be otherwise difficult to spot. He says you’ll need a camera with a good macro lens and zoom capability to investigate the finer details of the tooth surface, but with the right equipment, your camera can become a valuable diagnostic tool.
Beyond diagnosis, Dr Tran says digital dental photography is an excellent way to improve communication with patients. Photos give patients a quick visual reference of any tooth damage or other dental issues they may not have been previously aware of.
“When a patient comes in for a standard check-up and is not in pain, it can be difficult to explain verbally that they have a broken or cracked tooth, or may have the early signs of bigger issues,” he explains. “If I can show them a photograph of the cracked tooth or other damage, it becomes much easier to explain the issue to the patient, why we need to treat it, and how I want to treat it. It’s true that a picture says 1,000 words.”
Clinical dental photography also helps the patient feel more engaged in their treatment. Reviewing photographs with the patient not only gives them a compelling visual reference, but also provides a space for the patient to ask questions about the proposed treatment and take a more active role in their oral health.
When it comes to cosmetic dentistry, digital dental photography has two key roles — clinical and marketing. Clinically, intra and extraoral photographs play a critical role in digital smile design.
Dr Tran says dentists should begin with intraoral photos to ensure the teeth are structurally sound. Then the dentist must try to capture several extraoral angles to give the dental lab a good facial reference to inform their digital smile design.
“We need to take a frontal photo of the patient smiling really wide so we can see how many teeth are visible,” he explains. “We also need relaxed-pose photos so the dental lab technicians can see the edges of their front teeth in relation to their eyes. We also want to take 45-degree angle photos, and also 90-degree profile photos.”
It’s also important to take a frontal photo with the patient’s head tilted forward with their chin to their chest and their eyes looking upwards toward the camera. While it isn’t a particularly flattering angle, Dr Tran says it’s an important inclusion for the dental lab.
“It makes the patient look like a serial killer, but it helps the lab see the edge of the bottom teeth in relation to the face. This gives them a good reference to design a natural smile that suits the proportions of the patient’s face.”
On the marketing side, good before and after photos are essential to showcasing your work and attracting new patients. But more on that later.
Designing dental restorations and cosmetic solutions is not just about the patient’s existing dentition. To achieve the best outcomes, dental technicians design the restorations to align with the patient’s facial features. That’s why we need good visual references of the patients face in the form of extraoral photographs.
It’s critical to get the horizontal correct and ensure there is no angle on the teeth. To do so, we look at the relation between the patient’s pupils and the edges of their nostrils. We also use the bottom lip to define the curve of the design. We apply a grid to the photos in our software, and are essentially using facial landmarks to define the smile and design an outcome that looks natural for the patient.
That design then provides an excellent baseline reference the dentist can review with the patient. We can make tweaks as per the dentist’s or patient’s requests, but we’re starting with a strong foundation that fits naturally with the patient’s face.
Good dental lab photography is also extremely helpful for getting the colour match as accurate as possible. Some dentists will simply request the shade they feel is right, however there are so many variables at play that this can be difficult to get right. It’s much more effective if the dentist can provide digital dental photography with the appropriate shade tab held up beside the patient’s teeth. Our lab technicians can pick up on nuances in the photo, and the visual reference helps us to achieve a more natural look for the patient.
Digital dental photography isn’t a replacement for intraoral scanning. Rather, it plays a slightly different role. As explained above, Dr Tran says that clinical dental photography is great for zooming into fine cracks and other damage or imperfections on the surface of the teeth, and for accurate colour matching.
“Scanning, on the other hand, gives you a really good 3D image of the teeth,” he says. “You can spin the image around to view it from different angles and zoom into different sections.
“This is really helpful for communicating with your patient, and is vital for designing the restorations. For the best treatment outcomes, you really need to give the lab intraoral scans and good clinical dental photography. They work together to provide as much information as possible to the lab technicians.”
Taking intraoral photos can feel invasive for patients. So it’s a good idea to do digital scans first, and identify any specific areas you want to photograph. This will help to ensure the process is focused and as fast as possible. And if you’re using a DSLR camera, make sure you have the correct settings in place before you start taking intraoral photos. The last thing you want to have to do is take a second or third set of photos because your camera is not set up correctly.
For extraoral photos, Dr Tran says some larger practices may have a dedicated photography studio room with lighting setup. This helps to minimise the time you need from the patient, and eliminates the need to set up and adjust camera and lighting equipment while the patient waits.
While smaller practices may not have the resources to set up a dedicated studio room, having a set process in place can still help to save time. Dr Tran says the best way to get this right is to spend time familiarising yourself with your photography equipment and know the extraoral angles you need to capture.
When it comes to reviewing digital dental photography with patients, Dr Tran says there are a range of ways to do so depending on your photography setup.
“It can be as simple as taking shots on a smartphone or tablet, and showing them to the patient on screen. Or if you’re using a high-resolution DSLR camera, you can show them on a laptop or even on a bigger display screen so the patient can see more detail.”
Lighting is by far the most important aspect of photography for dentists. For clinical dental photography, getting the lighting right in your photos is critical for the dental lab to achieve an accurate colour match. For marketing, lighting makes all the difference to the quality of your before and after photos.
If you’re using a smartphone or tablet for your digital dental photography, Dr Tran suggests starting with a simple ring light. These are available on a tripod with a phone mount for easy setup in small spaces. For better results, Dr Tran suggests upgrading to a twin flash. He says that while a twin flash is more technique-sensitive than a ring light, you’ll get much nicer photos.
“The next level up is your own set of strobe lights, or speed lights,” he says. “That will help you take some really nice box light photos that make the patient’s smile and skin look nice.” But strobe or speed lights will likely require a dedicated studio room or space, and there is a learning curve involved.
However, before you invest in a professional-standard lighting setup, Dr Tran says it’s critical to get the settings right on your DSLR camera. “It’s important to set the right white balance on your camera,” he explains. “You’ll need to take a photo of a white card and have that set in your camera so you’ll get more accurate colours. You can’t do that on a smartphone at the moment, so that’s one of the limitations if you don’t have a DSLR camera.
“Another thing you can try is using cross polarisation. This is a technique that uses a filter on the light source and a filter on the camera lens to reduce how the light reflects off the surface of the teeth. This is great when you’re taking photos with a shade tab. It will help your dental lab achieve a more accurate colour match.”
Before and after photos are the obvious move for cosmetic dentistry marketing. It’s the best way to showcase your work on your website, in marketing communications or in advertisements, and gives patients a fast visual insight into the level of transformation you can achieve.
However, to really express the emotion some of your patients experience when they see the final result of their cosmetic treatment, Dr Tran suggests video as the medium of choice.
“Some practices will take a video of the patient during the first try-in to capture their initial reaction to the transformation they are seeing. This can be really effective for marketing and can help show prospective patients the impact cosmetic dentistry can have on their lives. But not every patient has a big emotional reaction, and that’s okay. Those patients may be better candidates for before and after photos.”
And consider sharing try-in videos and before and after photos with your dental lab from time to time. They provide a fantastic opportunity for us to review our work and achieve constant improvement. It’s also great for team morale. As dental professionals, we all work for that wide smile at the end of treatment. The opportunity to have that positive impact on people’s lives is what keeps us striving to achieve the best outcomes.
Other than the lighting equipment discussed above, Dr Tran says if you’re using a DSLR camera, it’s important to understand which lens to use. He says a 100mm macro lens is a good option to capture close-up detail for clinical photography, and you’ll need a lens around the 85mm mark for good before and after portraits.
Dr Tran says the body of the DSLR camera is less important, however he suggests sticking with Canon or Nikon. That’s because most lighting, lenses and other accessories on the market are compatible with Canon or Nikon, but may not work with some less popular brands.
“When it comes to storing images, you’ll need an SD card and storage space,” says Dr Tran. “I have a pro plan with Dropbox that gives me two terabytes of cloud storage space. I use a laptop to drop the images from the SD card into the Dropbox either between patients or at lunch time.”
Keeping photographic evidence of your work can help to protect dentists against malpractice claims. Photos can also be a valuable record to refer back to with patients who are less than satisfied with the final outcome.
“If a patient believes you’ve chipped one of their teeth during the treatment, for example, you can refer back to the original photos to show them the chip was already there before you started work,” says Dr Tran.
Giving patients the opportunity to compare their own before and after photos can also help them see the transformation if they are having difficulty noticing the difference in the mirror.
Dr Tran also notes the importance of setting your DSLR camera to take raw images: “If you get brought up in front of the Dental Board, and they ask for photos and you show them a JPEG file from your phone, they might say it has been Photoshopped. Whereas if you have a DSLR camera set on raw, you can produce the original photo file if required.”
If you want to improve your digital dental photography, Dr Tran says there are many YouTube tutorials available on the subject, as well as many good photography courses for dentists available.
Photography for dentists does involve a learning curve. But improving your clinical dental photography is really worthwhile. Your dental lab will thank you for it with better restorations; your patients will reap the benefits of improved communication; and your practice will get a marketing boost with the quality of your work showcased in the best possible light.