Sunday, July 29, 2007

But I already own an intra-oral camera...

You may be asking yourself "Why should I bother learning how to take high quality dental images when I already own an intra-oral "wand"-like camera?" It's a fair question, however, there are some really differentiating features between the two.

I first started using an intra-oral wand camera in 1993. It was awesome. We were able to show patients things like cracks, chips, soft tissue pathology and failing restorations. I was also taking images with an SLR camera, but slide film just had a ton of drawbacks (i.e.-time, cost, not knowing what you had until the image was developed, etc). So, the wand camera dominated use.

When digital SLRs showed up on the scene, it suddenly allowed us to overcome the drawbacks of slide film, however, I guess I am yet to answer the question "Why SLRs as compared to small intra-oral cameras?"

Most dental practice consultants, and lecturers will tell you that the difference between an "insurance" high volume practice and the "boutique" lower volume practice is the comprehensiveness of the treatment plans that are formulated. The boutique practice tends to take more time with patients during the diagnostic phase, and as a result, the dentist tends to more comprehensively diagnose (don't confuse this with wanting to put veneers on everything). This leads to having to see less patients per day with considerably higher dollars/hour being produced, all while creating greater health for patients as compared to the "one tooth at a time" approach adopted by higher volume practices.

Intra-oral wand-like cameras tend to show cracks, chips, etc. on single teeth and although they are valuable, they tend to perpetuate the "one tooth at a time" approach. It is nearly impossible (trust me, I've done this for a while) to match the comprehensive diagnostic information of a digital SLR using mirrors and retractors when comparing it to the image of a single tooth using a standard intra-oral camera. Plus, utilized properly, you can show patients an instant image using an SLR like a wand camera, if you want to, except the image will look far better.

I still use a wand-like intra oral camera from time to time when a patient doesn't have any other comprehensive needs and I want to demonstrate a small crack or chip. I also use it to show failing restorations with the desire to motivate patients to go through the next step, namely, study casts and high quality SLR images, although the right verbal skills will make this transition a very easy one.

Put the wand camera on the shelf for a day and replace those images will full arch, SLR images, and watch your practice begin to change nearly instantaneously. You'll start seeing less patients per day, your dollars per hour will go up and the relationships you create with patients while changing their lives will make the clinical practice of dentistry so much more fulfilling.

Wednesday, July 25, 2007

Digital dental image workflow suggestions....

So, you've bought a camera, gotten some training and have some awesome (hopefully) images to show for your effort. What should you do with them? This is one of the most common questions that my students have asked.

Well, you do have several options...

You could simply upload them to your practice management software and show them there. This isn't one of my preferred options. There are a lot of people out there (mostly sales reps) who will try to convince you that storing your images in proprietary software is a great idea. Although consolidation is a nice concept, there are a couple of reasons why I prefer to to keep my images out of my practice management software.

First of all, I rarely look at my images when I am in the treatment room. I use them primarily when I treatment plan and present treatment options. I don't feel that I need them hooked up to every computer. By using windows explorer (simple, free database management software on every PC) I can easily catalogue all of my images in the treatment room where I want to view and present my images. You can easily create a shortcut to that path on any computer so that the images could be seen on any computer.

Additionally, I just went through a software conversion involving two of the largest practice management software companies in the US. Wanna guess what didn't go over in the conversion? Yep, you got it right; the images. By keeping them outside your management software, you retain considerably more control over them.

Once I have catalogued the images, I use Adobe Photoshop (either "full" or "elements" versions work fine) to flip, rotate, crop, sharpen, morph and re-size my images. It's amazingly powerful and productive software that is a "must have" for the dental office.

Last, but certainly not least, I import all of my images into a presentation software such as Microsoft PowerPoint and add annotation, lines, arrows, music and effects and present it to the patients for the most powerful non confrontational case presentation you will ever see.

If the aforementioned ideas seem daunting, please don't be turned off. Once you learn how to do everything mentioned above, the entire workflow can be finished for an entire case by an assistant in less than 10 minutes.

Once you start playing around with a digital image workflow, you'll be thrilled as you see your case acceptance go "through the roof" and help a whole lot more patients get healthy.

Have Fun!!!

Wednesday, July 18, 2007

Dental Photography Using a Black Background

We've all seen those really cool looking and snazzy dental images with great close ups and beautiful black backgrounds. Ever wonder how they do it? It's really easy.

Sure, you can go out and buy a special device to help you get those images, but frankly, to me, it's a waste of money.

Here's you can get the same beautiful quality images without having to spend a lot of money and with great simplicity.

Ever seen those annoying (at least to me) black plastic things in the front and back of bigger 3 ring binders? I think that they are meant to help with keeping the pages in place (I frankly have no idea what they are supposed to do). They are usually shaped a little like a boomerang.

Take one out, cut it in half and shape the end like a tongue. Now, whenever you want to take an anterior close up picture, place the tongue shaped end behind the patient's front teeth. You'll find that the black background works perfectly and they are easily sterilized through cold sterilization.

If your staff should accidentally place it in the autoclave and ruin it, no problem. Just make another. It really is that easy.

Good Luck!

Tuesday, July 10, 2007

Perfect Lateral and occlusal shots

Hi all.

In my courses, I teach folks how to get perfect lateral and full arch occlussal shots virtually every time, without too much trouble. Let's define "Perfect", by my standards.

For lateral shots: Capturing the arch at 90 degrees (for a true Angle's Classification) with the occlusal plane parallel and down the middle of the mirror and the contra-lateral central to the distal of the second molar.

For occlusal shots: The entire arch, centered without nose, cheek or tongue in the image (yes, I said tongue), 90 degrees to the arch with the buccal surfaces of the teeth visible on all teeth.

It's really important to make sure that the patient is properly positioned, and that your mirrors and retractors are properly aligned. I use specially adapted mirrors and retractors, but it is sooooo easy to do that.

If anyone is interested, let me know, and I'll give more tips, but I wanted to start by defining what it is that we're looking to acheive in what era usually considered the more challenging images in the standard series.