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,
Glenn

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,
Glenn

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,
Glenn

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,

Glenn

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,
Glenn