Saturday, December 20, 2014

Macro means macro....well, almost.

Yea, it's been a while since my last post. I apologize to all of you for taking as long as I have between posts, but I was busy with my orthodontic residency and seeing that I just graduated, I figured I'd get back to posting.

I just wanted to take a moment to explain something that I see as a common error when teaching clinical photography.

If you've ever visited this blog before, you know that I offer a lot of advice and answer many questions about which camera system to buy. Though I repeatedly discuss the idea of buying a macro lens such as 85 or 105mm (Nikkor) or 100mm (Canon), it seems that even that simple advice can be misunderstood.

Examples of Nikkor 105mm (left) and 85mm (right) macro lenses. These lenses are specially designed to allow in-focus images from extremely close distances

A macro lens such as the 85mm Nikkor, is a fixed lens, allowing the user to get focus at incredibly close distances to the subject. It is NOT the same as a lens such as a 18-105mm zoom lens. Sure, the latter lens has 105mm included within it's range, but it is not designed to allow you to get an image in focus from less than a few feet.

All too often, students or friends will tell me about their friend or family member who is a photographer who told them to buy a certain setup, or they got a great deal at a big box store that included a free zoom lens that they hope to use in the office.

This is the Nikkor 18-105mm lens.  It is a normal zoom lens, not designed for macro photography. If you buy it and try it for dentistry, you may get great portraits, but your intraoral images will be out of focus.

Just remember, if you're not using a macro lens (Nikkor calls them "micro") it is the wrong lens for dentistry.  The free lens that comes with the camera can look tempting, but it simply won't give you what you need.

As always, feel free to email me at Glenn@KriegerContinuum.com with any questions.

Best Wishes,

Sunday, June 8, 2014

Everything You Need To Know About Dental Camera Systems (Well,Almost Everything)

During the 7 years this blog has been up and running, the most popular posts, by far, relate to which camera systems are best for dentistry. I also get a ton of questions on the subject, and since it's been a year since I last wrote about camera systems, I figured that no would be a good time to revisit the subject (and others).
This is what all of your images should look like, and best of all, it should be fun and really quick to capture them.

I want to make it clear right here, that I do not get paid by anyone to sell their camera systems. So, when I recommend a company, it's because I believe in them from the thousand of students and 15 years I've spent teaching clinical photography.

So, let's start by looking at camera price because that's the most common question.

Mistake #1: Don't try to go cheap. It could actually work against you.

The "sweet spot" for digital SLR cameras for dentistry is in the $900-1000 range. There's absolutely no reason to pay $1500-2000 for a dental camera. Remember, we're talking only the camera. Not with the flash and lens. The more you spend, the more "bells and whistles" you're going to be getting and since you should NEVER take your practice camera out of the office for personal use, you'll never be using the extra gadgets that come on a more expensive and bigger/heavier camera.

The biggest mistake I see is people buying cameras without really knowing what to get or why. That's why I made the first DVD. If you think that a $600 camera like the Nikon D5300 will save you tons of money over a more expensive $1000 Nikon D7100, well, you're wrong.
Buying the less expensive D5300 actually doesn't save what you think it will.

How? Well, how do you expect to get photos using your camera. You need a macro flash system. The best system available now is the R1 wireless system from nikon (See post on flashes HERE) which costs about $450. However, if you bought the D5300, which does NOT wirelessly support the R1 flash, you need to buy the R1C1 flash system instead, which DOES wirelessly support the flash, but costs an additional $250. So, in the end, by buying the 5300 instead of the 7100, you'll get poorer images because of a cheaper camera, it'll weigh much more than the 7100 because of the bigger R1 commander unit on top of the camera to wirelessly control the flash and it now has more to break because of the commander module, all because you wanted to save $300 which turned out to actually be a total of about $50 after the R1C1 purchase.

Look for a great, relatively light and compact camera that gives great images and doesn't break the bank.

My recommendations: If you like Nikon for clinical photography (as I do) the D7100 is an amazing camera that will serve you well for the next decade and beyond. If you like Canon, go with the 70D instead of the T5i Rebel and you won't be disappointed. If you do not own a camera yet, or aren't sure of Nikon or Canon, in my humble opinion, the Nikon D7100 is the best camera on the market (at least right now) and beats the Canon 60D for a couple of reasons. Click Comparison and Flash Systems for Canon vs. Nikon  to understand more.

The Nikon D7100 is currently the best valued camera for clinical dental photography-in my humble opinion.

Mistake #2: Don't make a huge investment in a camera system and then not know how to even set it up or how to properly (and easily) use it.

Would you ever buy a piece of dental equipment without knowing how to use it?!?!? Every day, dentists buy a camera and either make the mistake of thinking they'll put it together and "just use it" or worse, hand it off to their assistant expecting that they will somehow channel the energy of the universe and figure out how to get images on their own.

If you've read any of my posts or seen one of my lectures, then you know that the dental camera, when properly used, can change your practice literally overnight.  You can watch your case acceptance go through the ceiling instantly if you shoot a lot of high quality dental images. Emphasis on HIGH QUALITY. This means that your images have no mirrors or retractors in the way, the lighting is perfect and everything is in focus. If you think you're images are already gorgeous, or you're not sure where you rank, please click HERE to learn more about a great way to grade your images.

Learn to properly grade your own images so that you can see where you need to get better.

Leran how to set up and use your camera system and how to properly position mirrors and retractors (the right mirrors and retractors) so that you can get awesome images every time. I've said it many, many times before and I'll say it again here.  Once you learn how to properly use the camera, mirrors and retractors, you'll see how easy (YES, EASY) it is to get great dental images. But you have to learn, and unfortunately, there are very few good resources out there.

Mistake #3: Choose your photography experts carefully. There is A LOT of misinformation out there.

I apologize in advance for the comments that are about to follow. They will seem arrogant, and for those of you who know me personally, you know the respect I have for experts in dentistry. However, there are many out there holding themselves as experts in clinical photography and unfortunately, many of my students have gotten some really bad advice by listening to them. I don't care who you listen to as long as the advice makes sense. I've taught this subject for 15 years, and it wasn't until I was asked to actually teach the clinical photography portion of a class that I was paying to attend that I realized how different (and simpler) my approach to clinical photography was.

I've watched a lot of YouTube videos from "experts" in clinical photography showing the same mistakes that I see students in my classes making. I'm sorry for saying this, but the techniques I've seen from EVERY one of them actually are so wrong and circuitous that I've laughed out loud. Not some, not most, but all. Yep, I said, it. I see people giving absolutely wrong advice on mirror placement, retractor use, patient positioning, assistance. So, you think I'm being a little cavalier in my statements, then consider this first:  As a clinical dentist for 20 years, I want my system of capture to be:
                    Quick-less than 5 minutes for a full set
                    Comfortable-The patient should be 100% comfortable during the process
                    Simple-The words "color temperature" and "white balance" shouldn't be used
                    One person-meaning that the doctor or assistant can shoot without more assistants

...and most importantly (and this is where I see most failures online)...the images should look unimaginably gorgeous EVERY TIME. Period. No excuses.

Take a look at my blog post from 7 years ago HERE. Yep, 7 years ago with an older camera and flash system. Those images took about 2 minutes for all 4. Do you think my patients can see everything I'm trying to point out? Yep. Did I have trouble selling my best care all the time? Nope.

Making my DVD series was neither easy or fun, but I did it because there is simply a huge need to show dentists how to quickly and easily get amazing dental images. Consider purchasing the DVDs  HERE, watch them with your team and you will literally be getting better images immediately afterwards. It will change the way you look at dental photography. Use the code "Thanks15" on checkout and get 15% off everything on the website because you were interested enough to read to this section of the blog.

Mistake #4: Don't expect to use regular mirrors and retractors to get amazing images.

It is so easy to learn how to use mirrors and retractors, but unfortunately, like the myth of the 2x/yr cleaning (which wasn't actually developed by dentists) all traditional mirror and retractor designs seem to have come from a planet where the mouths of patients can actually accommodate them.  On this planet, dentists simply cannot expect to get exceptional images on patients using the "tried and true" shapes and sizes. How do I know? I watched thousands of  students in my hands on courses struggle with their images using the same mirrors and retractors that are being used around the world.
You may not notice it, but this image shows my different mirror and retractor. There are subtle differences in their design, but they do make a huge difference in composition. Of course, if I weren't illustrating the retractor (yes, only one retractor for this shot) and mirror, I would zoom in closer and only the teeth would be in the shot.
Sure, there are patients here and there on whom you can get great images using traditional designs, but they are really the exception, not the rule.

Having trouble with your lateral arch shots or your full occlusals? Ever had a patient not be able to open wide enough to get the full arch? It's partly patient positioning but mostly your mirror and retractors. They're just shaped wrong for most of our difficult shots. That's why I went out of my way to create new shapes and sizes that I perfected by trying them out with my students at my hands on courses. I tried to get them sold through dental supply houses, but nobody was interested (because there simply isn't a lot of money to be made on mirrors or retractors).

Try my mirrors, retractors and DVDs and I can promise you that your images will look far better than you ever imagined possible.

Conclusion: Buy the right camera for your practice, make an investment in a proper set of mirrors and retractors and learn how to use your camera in the simplest and easiest way possible. I know that it sounds funny to even have to say those things, but most dentists are either using the wrong setup or don't really know how to use the right one that they already own. However, when it all comes together, the results can change your practice...quickly.

As always, I look forward to your questions and comments at Glenn@Kriegercontinuum.com

Best Wishes,
My DVD series will make the process of buying, setting up and properly using your camera system a breeze.

Sunday, June 1, 2014

Dental Portraits for Better Marketing

Go look on the web at dental websites and you're bound to see a ton of "before" and "after" images. Some good, some bad. The concept of pre and post images for advertising purposes is a long topic unto itself, and maybe I'll cover that in some future post. For now, I'll keep it really simple. The difference between novices and experts when it comes to dental portraits is depth of field.

Collins dictionary defines depth of field as follows: "the range of distance in front of and behind an object focused by an optical instrument, such as a camera or microscope, within which other objects will also appear clear and sharply defined in the resulting image." 

In other words, great depth of field means that an object and its background are all in focus together. This is exactly what we want when shooting intraoral images. We never want anything out of focus. 

With high depth of field, notice how everything from the retractors to the second molars are in focus. It's what we want for intraoral , but NOT for portraits. Note:I never include retractors in my intramural images but did so for this image for illustrative purposes. 
For portrait shots, to make them look really good, consider getting the background out of focus and actually having poor depth of field. The look will be far superior.

Richard Avedon, arguably the greatest portrait photographer of all time, was a master of depth of  field. Notice how the background behind a young Bob Dylan plays a role, but simply fades away.

High depth of field means that everything, including the background is in focus. It tends to take the viewer's attention away from the subject and more on things that play no role.  Don't make this mistake in portraits of your patients.
Shallow depth of field is the hallmark of great photographers who want the face to stand out. Combine that with the amazing dental ring flash posted previously on this blog and you're good to go.
So, now you can hopefully see the difference between OK and amazing dental portraits. It's all about the REALLY, REALLY easy task of managing f-stops and lighting. The higher the f-stop, the greater the depth of field. The lower the f-stop, the less the depth of field.

If you want to have fun, see my previous post  HERE about the 18" ring light from Stellar. With the right color background, your images will look like nobody else's.

The 18" Stellar ring light makes all the difference. Note: This has not been processed in any way after capture and was taken with a 20 year old lens at my friend's office on the spur of the moment.

Notice the difference in depth of field between these two images. Which is preferred is all based upon personal preference. They were both lit only with the Stellar light and nothing on the camera.

If you want to learn really quickly and easily how to handle depth of field and lighting, consider our DVDs available HERE.  One covers how to get great patient positioning for all images and the other how to set up and use your camera for optimal efficiency.

As always, I'm here if you need anything.

Best Wishes,

Saturday, May 24, 2014

Learn How a Camera Phone Can Give Better Dental Images Than An SLR

Quickly answer the following question: Which is more important in getting spectacular dental images? The camera system used or the mirrors and retractors?

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.
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?)
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.
Ever been there? If so, you know what I'm talking about.

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.

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.

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.

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,

Wednesday, May 21, 2014

A Review of the EyeSpecial C-II Dental Camera by Shofu

The new EyeSpecial C-II is a bold step in the right direction by Shofu, but the cost may be prohibitive.
I'm always looking for new, cool gizmos and gadgets to help clinicians get better dental images, so when I recently opened a dental magazine and saw a picture of the new Shofu EyeSpecial C-II by Shofu, and what it promised, I became very excited. I made sure that at my attendance at the American Association of Orthodontists meeting in New Orleans I would check out the camera.

I went to the Shofu booth and was allowed to handle and play around with the camera and I have to say, it delivers on everything it promises. It's light, easy to clean, easy to handle, gives more than adequate images and its program modes make most of the standard shots really easy. In short, a great camera. I could go on and on about how much I liked it and why I think it's a great camera, but then they told me about the suggested retail price and the love affair abruptly ended. They want $2795 for the camera. Yep, nearly $3000. Now, I'm not one to usually complain about price, but in my humble opinion, that's an almost obscene price to charge for a glorified point and shoot.

Sure, it has some great programming modes and it does things that I haven't seen any other point and shoot do, but spending $3000 on this camera, to me, just seemed about 2-3 times too much.

I tried to explain to the Shofu representative that at that price point, nobody is going to want to buy the camera. I tried to explain that the camera was far more expensive (yes, FAR more expensive) than a Nikon D7100, a Nikkor 85mm Micro lens and a wireless R1 flash, which gives far better pictures and is way more versatile. For users who want a simple camera to use, I couldn't find one reason to recommend this camera when you could buy a myriad of dental point and shoots for literally 1/4 the price.

I've dealt with thousands of dentists who've had questions about cameras. There are basically two types of dental photographers. Those who want to approach dentistry like artists and get the absolute best image they can and they would NEVER want to use this camera due to the lack of versatility (i.e.-different lenses, flash positions, etc). Then there are those who just want dental images. Nothing amazing, just simple documentation and that's it. Why would they drop $2795 on a camera? They wouldn't.

So, the EyeSpecial C-II is a great example of a fine product that simply costs too much. If the price ever gets cut in half, run out and get one, but until then, there are way better options for the money.

As a final example to drive home my point, I asked Shofu how they ever expected to sell this camera at their asking price. I literally implored the representative to better understand that there was no way this camera was ever going to sell a ton of units at that price. Though defensive, she proudly exclaimed that this camera was selling very well and that to date, they have sold a total of 100 cameras globally in a few months, a number that was much lower than I expected.

In the end, the market is going to decide whether the EyeSpecial is the right camera for dentistry, but for the reasons mentioned above, I simply can't get excited about it.

Best Wishes,

Sunday, May 18, 2014

OK, So I Took Dental Images. Now What Do I Do With Them?

Let's assume you're one of the thousands of dentists who've contacted me over the last 15 years while I've taught clinical photography. You've figured out which lens, camera and flash system to use. You created a photography workflow that works in your office. You've even gotten to the point where you're capturing images on a regular basis, but you've come to the realization that you need a better way to store images. Well, I'm here to help.

Maybe you're just looking for a better way to organize your personal photos. This process, with simply different naming conventions, will work beautifully.

While traveling the globe teaching my 2 day course, I used to show dentists all of the reasons why a well catalogued image archive was vital to growing case acceptance. Then, we'd walk through the entire process from creating a database all the way through presenting care using my unique Digital Co-Diagnosis system.

I'm going to share the first part with you on this post.

First, go check out my post from 2 years ago about why windows explorer (or "Finder in Apple computers) is the absolute best way to store images. https://www.blogger.com/blogger.g?blogID=1633945094564766702#editor/target=post;postID=7114437143644401070;onPublishedMenu=posts;onClosedMenu=posts;postNum=0;src=postname

Below will be a series of screen shots which will show you, step by step, how to set up a database on your computer. This series was originally created 2 years ago for Windows 7, but works almost exactly the same on all Windows machines from the last 10 years.

On future posts, I may show things like how to morph images, create effective power points, etc, if there is interest.

Please email me if you have any questions.

Best Wishes,
Dental photography image storage

Dental photography image storage

Dental photography image storage

Dental photography image storage

Dental photography image storage

Dental photography image storage

Dental photography image storage

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Saturday, May 10, 2014

The Right Lens for Dental Clinical Photography

It kills me every time a dentist writes to me something like: "I've got this great camera and lens setup that I got handed down from my brother when he got a better camera, but I can't get good images. Can you help me use it better?"  More often than not, they have a zoom lens such as an 18-200mm or 55-300mm or something like that. NONE, I repeat NONE of those lenses are appropriate for dentistry. They are not macro lenses, which means that you can never use them up close to the subject. Almost all dental photography (with the exception of portraits) uses macro photography. If you don't use a macro lens, your images will be out of focus.
This Canon 17-85mm lens is amazing to use, but the "-" between the 17 and 85 signifies it's a zoom lens and NOT appropriate for dental use.

All lenses for dentistry are macro, except Nikkor lenses (Nikon's subsidiary that makes lenses for Nikon) which call them "Micro". 

The brand you choose is important for the camera you use. For instance, if you use a Canon body, use a Canon (or Tamron or Sigma) lens. If you use Nikon, you can use a Nikkor (or Tamron or Sigma) lens.  In this post, I'm not going to get into the idea of why I'm not a big fan of using "off brands" of lenses. Buy all from the same brand, so that when something goes wrong, there's no finger pointing by one company to another. Hand it in to the repair center and let them sort it out. It's worth the extra few dollars you'll pay on the equipment.  However, here I am going to briefly discuss the type of lens you should use.

Basically, with Nikkor and Canon, there are only a few choices. For Nikkor, you can go with the 85mm or the 105mm. For Canon, you can choose the 60mm or the 100mm (the less expensive of the two 100mm lenses Canon makes is fine). The 60 mm lens is simply too tough to use in dentistry. The lower the number the closer you need to be to the subject and with a 60mm lens, for a shot of just the front teeth, you'll literally be 3 inches from the patient. Not good. The flash will never be in a position to work well. So, for Canon, you've got only one choice, the 100mm lens.
This Canon EF 100mm f/2.8 Macro USM is a great choice for Canon users. DON'T buy the more expense $1050.00 100mm Canon lens. You don't need it.
For Nikon, the 105 is an amazing lens, but at almost $1000 I simply cannot recommend it over the way smaller and way lighter  85mm lens , which costs half the price. In case you're wondering, photo quality doesn't suffer at all. I've shot both and can't tell the difference in ANY use of the image.

This AF-S DX Micro Nikkor 85mm f/3.5G ED VR is an amazing lens at a great price for Nikon users.

Shot comparison of 85 vs 105mm Nikkor Macros. I can't see a difference and for an extra $500 I don't see the value.

Don't go crazy on this subject, but also don;t fall victim to buying the wrong equipment. As I said, I have DVDs to walk you through the entire process of buying, setting up and using your camera, flash and lens for maximum effectiveness, and minimal problems found HERE.

As always, I'm here for you should you have any questions or problems.

Best Wishes,

Tuesday, May 6, 2014

Don't Be a Shaquille O'Neal Dentist

So the NBA playoffs are in full swing and I just couldn't help watching some of the games while other life priorities were banging on my door.  Nonetheless, something occurred to me while watching the end of a few games.  A component of basketball seems to share a tremendous parallel with dentistry; Free throws.

How, might you ask, do free throws have anything to do with dentistry? Great question.

There are more than a few 7 figure athletes who have less than stellar free throw percentages. Harken back to the "Hack-a-Shaq" days when teams would slow down the legendary Shaquille O'neal by making him shoot free throws, which he was notoriously bad at shooting. A lifetime .527 free throw percentage means that this man, who made 15 all star teams, and  was only one of 3 players ever to win an NBA MVP, All-Star game MVP and Finals MVP in the same year, was almost as likely to miss a free throw as he was to make it. How could anyone possibly be considered a complete player when one can't consistently make the only uncontested shot in basketball from only 15 feet away? Alas, there are many who don't consider Shaquille O'neal a complete player for just this reason even though he's a shoe-in for the Hall of Fame.

But I digress. Back to dentistry...

How many dentists work their tails off training to prep the best crowns or place implants perfectly, or travel to 3 day courses for $6000, or hone their smile analysis techniques or practice management ideas and NEVER take their clinical photography seriously. I'm referring to the overwhelming majority of dentists who, like Shaq, view a part of their profession as something they will simply accept as being inferior to the rest of their skill?

I am beseiged with daily questions from dentists with "cosmetic" "implant" "esthetic" (and a whole other array of adjectives ) practices.  I've gone to their websites which scream their accolades and how much better they are than the rest of the dentists out there. Yet, these same dentists ask me simple questions about clinical photography (no shame there) but when I offer suggestions that require just a modicum of work, they say that images aren't that important to them. How can anyone be incredibly proud of their dentistry and not be willing to take literally a few hours to practice their photographic skill? Not only will it let you learn more about your dentistry by doing retrospective analyses of your work, but properly used, can help your practice grow immensely.

How many times have you sat in lectures of world renown lecturers only to see a photographic misrepresentation of the occlusal plane or Angle's classification. Somehow we look past these very real problems in records to ogle the beautiful porcelain or gorgeous soft tissue. I'm not saying that porcelain or soft tissue don't matter. On the contrary, they are the things that help us strive to become better clinicians. However, how many clinicians, who are WAY better than I will ever be, refuse to use an SLR because it's "too heavy" or their staff doesn't want to use it. Or perhaps they're willing to learn intricate grafting procedures but don't want to take 15 minutes to learn how to use simple histograms, the key to consistent lighting and great depth of field.

In the end, you WILL be judged on the quality of your images. Don't you want to be viewed as a "complete" clinician? Or, would you rather shoot 50% on the easiest of clinical procedures to master?

It's really your choice and best of all, you're not alone. I'm happy to help in any way possible. Just ask.

Best Wishes,

Friday, April 11, 2014

A Unique Way to Increase Case Acceptance

Sorry all. I've been a little busy the last few months, but I felt that I just had to post another entry related to case acceptance, and of course, clinical photography.

Back in the day, before digital technology, we had to present images to patients using actual paper photos, slide projectors or for those who were really sophisticated, a Caramate. We had to send the film out to be developed, turned into photos from slides and had no ability to mock up anything, short of acetate or masking tape and a black sharpie. Yet somehow, we got patients to say "yes" to the treatment plans we presented.  The success that many of us had without technology illustrates that one doesn't need fancy technology to "sell" treatment.
This is a Caramate-basically a TV with a built in slide projector that presented the image on the screen below. Yet, we got case acceptance.
By the way, I have absolutely no problem discussing the dirty word "sell" related to care. If you perform great dentistry and want people to pay you to do it,  congratulations, you're in the selling business. Unfortunately, selling has been given a bad name.  Personally, I have no problem with it as long as I'm honest, non-paternalistic and give patients all options. That said, there's a way to get people to say "yes" as opposed to the "I'll call you tomorrow" response heard too often.  It's called "Digital Co-Diagnosis".

About 15 years ago, I attended my first digital case presentation course. It was interesting to learn the technical side of things, but I was blown away with how reliant the teacher was on technology. It was all bells and whistles,  techniques on getting the "show" to look real nice and shine like a diamond. That's OK, but at some point you need to have some real substance, lest you treat the patient to a multimedia show with no "close" for case acceptance.  The role of images was so unimportant in the process that in the middle of the course I was asked (as a paid attendee) to teach clinical photography to the rest of my course mates. The teacher, who holds prominent positions in the world of digital technology was unable to help them. It was at that moment that I realized that digital technology alone cannot replace the value of a great picture.

So, I went home to Seattle and started tinkering with the process of digital case presentation. After months of experimentation, I stumbled across a process that made all the difference. I came up with a process to let patients diagnose the case themselves, without bells and whistles, without having to do much but present my best care.

The first week I used this process, I had two large cases say "yes" for $50,000's worth of dentistry. Aside from telling you about the technique, the only place I can help you is with the core component of the process; exceptional images. You see, today I still see the major problem of dentists relying on the "show" to sell the case rather than letting the patient "own" their problem. Once they own it, you'll never need to hear them ask you "so why are we doing this treatment?" when you're about to anesthetize them for their scheduled appointment.  Patients will fight a whole lot less about a bill when they own their problem. Wouldn't it be great to have a tagline (private, of course):"At Main St. dental, it's YOUR problem, but we'll help you solve it." It really is that great when patients own it. So, how do we get them to own it? Great images.

Instead of showing a filling and telling the patient how you can fix it (you owning the problem), how about walking the patient through the process of self discovery instead? Show them the image and then ask "So what do you notice about the teeth?". If they don't see it, ask them about the molar. They may say something like "It looks a little chipped" or "the edge looks rough". That's a great opening, so instead of saying "yes it is, we should crown it", perhaps you ask another question like "Why do you think that's the case?". You get the idea, right? Walk the patient down the path towards self discovery like a prosecutor making a case to the jury. When the patient says "Is that decay?" or "That filling looks really old" they own the problem. They can understand it and realize that it's their problem. Again, you need exceptional, not just good images to make it happen.

If you have amazing up close images (for heaven's sake please don't tell me you're using a wand camera) your patients will be able to see this stuff from a mile away. Your case acceptance should go through the ceiling. Instantly. When I used to teach this at my courses,  I'd get letters from dentist telling me that they were doing $100,000 more a year since implementing this idea. It's not new or reinvented. It simply uses older, proven case presentation techniques with exceptional clinical photography at the center.

If you want your images to stand out in your community and for your case acceptance to jump, consider purchasing our DVD's, mirrors and retractors which are unlike anything else in dentistry. The quality of the images will be just what you need to help see a surge in your case acceptance. They're available HERE.

I'd love to help in any way possible. Aside from your wand camera (useful for many other applications other than digital case presentation, which I will discuss another time) just pick up whatever you have, learn my techniques for using mirrors and retractors and go get 'em.

I'm always here if you need anything.

Best Wishes,