Since 2001 (when I started teaching clinical photography) I have gotten dozens of emails every month from GPs and Specialists asking me about which camera they should buy for their practice. They ask (fairly) about things like flash systems, camera bodies and lenses as well as what types of settings they should use. I'm always happy to oblige. However, I can always tell which dentists have taken that next step in their photographic development when they start asking me about mirrors and retractors. You see, no matter the camera used, mirrors and retractors are truly the key to getting amazing dental images, not the camera used.
You can literally use your camera phone (as I did in the picture below) and get some really usable images if you know how to handle mirrors and retractors properly.
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| Yep, taken with an iPhone 4s, but with specialized mirrors and retractors and proper patient positioning techniques. Sure, the resolution is a little low, but it's a three year old 4s for gosh sakes! Newer cameras would look way better. |
Conversely, even if you have a $2500 camera setup, you can get miserable images if you (or your staff member) doesn't master the basics of mirrors and retractors. (Look familiar?)
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| Even with this $2500 camera setup, notice that my student got this shot wrong even with my modified occlusal retractors because of a simple patient positioning mistake. This is so easy to correct. |
First, you need to fairly rate your images. If you don't already have a system in place to do that, please see my earlier blog post which can help you get started rating your images in a fair and honest way HERE.
It's simple to understand. If I were to remove the lips and cheeks from your patients, do you think you could capture a truly perfect set of images with perfect Angle's classification representation (a whole discussion for a future post) with everything centered and great lighting with almost any camera? Of course you could! So, let's make the lips and cheeks an almost non-issue by learning how to properly retract them. Sounds simple enough, right? Well, as most of you reading this can attest, it's not quite that simple. Problem is, you're probably using mirrors and retractors that are working against you.
Having taught clinical photography globally since 2001, I've seen the deleterious effects of most mirror and retractor designs on image quality. I don't know who designed them, but I can only say that I've seen thousands of dentists in my hands-on courses struggle with their use. You simply cannot use traditional mirrors and retractors and expect to get great lateral and occlusal images. Period.
Think of the lips as a giant circle with some degree of elasticity. The circumference has a limit as to how big it can get. You can't stretch someone's lips over their head. So, if you're trying to get a maxillary occlusal image, why are you placing retractors that also stretch the lower lip? If you've ever tried to get a maxillary (or mandibular) occlusal image and just can't seem to get the patient to open wide enough, it's a function of you retracting the opposing arch. What you need to do (aside from proper patient positioning, which is also key) is to only retract the upper lips for that maxillary shot. That's why I modified my retractors. Suddenly my full occlusal images became simple.
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| With my modified retractor design (available for purchase HERE) the pressure is taken off the areas that you don't want to stretch for certain images like the lower lips for an upper occlusal shot. |
Next, I focused (pun intended) on my mirror designs. I was sick and tired of seeing my thumb in the occlusal shots and not being able to get the second molars in my lateral shots. Plus, I was having a hard time stretching the patient's lip far enough to get the whole side, with proper Angle's classification. Again, I modified my retractors for this shot and changed my mirror design. It took 8 attempts at mirror design, but I finally created a later mirror that was narrower at the end (to go back farther) and wider in the middle (to push away the lips) and a specialized retractor with a way to use them together for unparalleled lateral arch shots.
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| These are my specialized lateral arch mirrors. Rhodium coated for unsurpassed reflectivity. Shown here are the medium and large but they come in three sizes (small not shown) as well as three sizes of specialized occlusal mirrors. They are available only through my website but before even considering ordering them consider learning the proper techniques (one shown below) found on my DVDs also available HERE. |
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| Notice the specialized retractor not pulling the right side when we are capturing the left side? The mirrors and retractors are only half of the equation. One needs to learn how to use them properly. Of course, this image is for illustrative purposes only. If I were to be shooting this, I would get closer and shoot only the second molars to the centrals. |
Sure, as a professional dental photographer it is part of my job to find new ways to get the best images in the room, but the best part of the story is that I have seen dental students get images as good as mine once they learned how to properly use my unique mirrors and retractors.
The next time you or your staff complain about your images, remember the iPhone picture above and seriously look at your techniques and your mirrors and retractors instead of your camera. I guarantee you that with new techniques and equipment (not a new camera) your images will look exceptional. It's worked for tons of dentists around the world who have already made that investment.
Instead of investing in a new camera, consider my DVDs, mirrors and retractors and get a much, much bigger return on your investment. A full starter set (available HERE) of my mirrors, retractors and DVD's will get you way further, much quicker and less expensively than any investment in a camera system. My own camera system is 5 years old and I have no plans on switching any time soon because, it's more about your mirrors retractors and methods of use than your equipment.
I'm always here to answer any of your questions, so feel free to keep on sending them to Glenn@KriegerContinuum.com .
Best Wishes,
Glenn
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