Friday, December 30, 2016

Stop Thinking Like A Clinician When It Comes To Images

Ever feel like you're searching for a good reason to take exceptional images?

Having taught clinical photography and techniques for better internal marketing and increased patient engagement for 20 years, I've had to learn a lot about those subjects. That's why I chuckle a little bit whenever the topic of "why take clinical images" is brought up in a social media group. The answers I see are interesting and usually include: "to help with documentation", "to show your objective", "to show/give patients before and afters", "for diagnosis" and so on. Those are all excellent reasons, but the main reason most people come to my courses, the primary thing that finally gets them to introduce a strong clinical photography protocol is simply put, to make more money from their practices.

There, I said it. I brought up the topic of making more money. For some of you, it makes perfect sense and for others, money and dentistry shouldn't be said in the same sentence. After all, we are professionals, and we have a moral and ethical code to do what's in our patients' best interests. Money shouldn't play a role in our decision making process. Right? Well, not really.

Would you agree that if every patient understood their current dental/orthodontic condition, I mean REALLY understood it, they would be far more likely to accept the best treatment alternative to fix it? If they did understand it at the highest level, and your case acceptance rate went up, wouldn't you make more money?

Then why aren't you doing that?!?!?!

Sure, you may be sending home some before and after images or showing prospective patients your finished cases. Maybe you have an online gallery on your website or finished smiles adorn your office walls. That's all good but very few, and I mean VERY few clinicians are thinking like non-clinicians...and thinking like a non-clinician is the best way to communicate with your patients.

I want you to imagine an ideal scenario: You come into the room, show a patient everything that's going on with the case, spend just a couple of minutes talking and then you leave the room and a highly qualified treatment coordinator explains everything and "sells" the case. Sounds similar to what you may be doing? Every dentist should be at least doing that much, but it's woefully inadequate and filled with areas where the process can fail.

So, how about we step it up a bit and instead of your treatment coordinator explaining it, the patient actually explains it to themselves? Huh???? How does that happen, you ask? Easy.

The process is called "digital co-diagnosis" and I first wrote about it in a 3 part series in Dental Economics back in 2007. It's like digital case presentation, with one big difference: the patient diagnoses the case and the words come out of their mouth, not yours. Sounds odd, right? Here's how it works: I could tell you about a cavity, show you a picture and then tell you how to fix it, or using digital co-diagnosis, I could show you a high quality image and lead you down a path to where YOU tell me that you need a filling. Let me give you an example.

In orthodontics, we talk about bite related problems all day long. I could show you an image of your bite (class II end on) and then describe all the reasons why you should be class I.  I could talk about the TMJ, occlusion, wear, blah, blah, blah... (stuff that's important to us clinicians).  I could even show you a picture of a class I and show you the differences, hoping that I've made a good connection with you and that you'll start treatment, all the time thinking like a clinician, not a salesman. (Note: If I want you to buy what I'm selling, I better be thinking like a salesman. Oh, BTW, salesman does not mean an unethical salesman. Sales and ethics have nothing to do with one another but that's a different topic.)

Now imagine that I show you some images and don't say a word. I let you see everything that I'm looking at while I survey the dental landscape. Just for 30 seconds or so, but long enough for you to get a glimpse of your teeth like you never have before. Then, I ask you (and I am thoroughly shortening the process for right now) what differences you see between the image of a perfect bite that I have on the wall right next to the monitor, versus what you see on the screen. Perhaps I nudge you a bit with questions like: "Do your teeth come together like gears [showing the picture on the wall of a treated class I as I say it] or do they hit more 'point to point' like rocks hitting against one another?", "Which seems healthier with less long term wear; the gears or rocks hitting one another?" followed by "How would you classify your bite; gears or points hitting one another?" then "Would you like to talk about how to get your teeth to hit like the ones in the picture on the wall?"

I know the the differences may seem subtle, but there is a massive difference in patient engagement and case acceptance when a patient actually answers the aforementioned questions with answers like "No, they don't come together like gears. They look like points against points and it seems like it's less healthy than gears coming together. You mean there's a way to fix that? Sure, I'd love to talk about it." This is what I hear every day. Sure it takes a lot of practice and training to get the verbal skills right, but you'll spend less time with patients and get way more engagement and personal responsibility from the patients because they now understand, and this next thing is important, that it's THEIR problem and you're just their to help them solve it with treatment options. I've done this for two decades and have taught it for nearly as long and the changes in practices when they embrace this is monumental. So, where does clinical photography come in?

Having a well composed class I image on the wall next to your screen
 is a great way for patients to better recognize the need for treatment.

If you're asking people to spot things themselves and walk them down the path of self diagnosis quickly and effectively, one needs to have exceptional (not just decent) images. The patient needs to diagnose it themselves, so they need to see what's going on. You can even screen record the whole process with audio and send it home with the patient or parent if they need it for any reason. A better level of informed consent and understanding doesn't exist.

Don't worry, though. Exceptional images are one of the easiest things to learn, when taught properly. It just takes a ton of practice. If you put the same amount of time into training your team how to get images as you did other things you've delegated (hopefully a lot with good written policies and systems), you'll be awesome.

Sure, there are lots of good reasons to take clinical images, but once I started using digital co-diagnosis, I stopped sending home images, I stopped worrying about whether patients saw a stain or crack before treatment and I watched my case acceptance go up. More importantly, my patients commonly asked me (even more now that I'm an orthodontist and may be their 3rd opinion) "why has nobody else shown me this before?" I have no doubt that the other offices showed images and gave treatment options, but once you make the shift to exceptional images and digital co-diagnosis, you'll stop looking for other ways to communicate with you patients and spend more time on effective internal marketing, which I'll save for another time. ;)

Remember, think like a clinician when you diagnose, but NOT when you present options.

All the best, and remember, you can always reach me at doc@KriegerOrthodontics.com.

Wishing you an amazing, joyous and profitable 2017!!!

Tuesday, November 29, 2016

Increase Your Case Acceptance NOW!

In today's world, dentists are looking for any way to stand out from their "competition". While I genuinely believe that we do not compete against one another, but rather against things like vacations, tuition, car payment and the like, we DO need a way to make ourselves stand out.


There are expensive ways, like buying a yogurt machine for your reception area (note: NOT a waiting room) or maybe having a spa in the back of your office, but I would contend that the best way to stand out is to be the best in your community. More importantly, your patients need a palpable way of knowing that they are in the best office in town when they're sitting in your chair.


Digital case presentation is a cool way of presenting care, but one needs pictures to show patients, in exquisite detail, conditions that need attention. If you show a blurry, wet, out of focus image, they can't see a thing. But, if you show a clear, beautiful image, even the greatest detail can be found.

Look at the image below. Show it to a patient and don't say a word. They'll instantly see the large, failing amalgams, the cracks, undermining decay, etc. They will actually ask YOU how quickly they can fix it. How do I know? I've seen it with hundreds of patients.


So, how does one learn how to get exceptional images? It's easy. Just click HERE to be taken to my website, buy the starter set and be off and running the day you get the set. It will quite possibly be the best return on investment you'll ever get. Use code webtg16 and get 15% off while supplies last.

Make 2017 you best year ever and help your patients get to the highest level of health.

If you have any questions, just ask. 

Best wishes,

Tuesday, November 22, 2016

15% off our revolutionary DVD's, mirrors and starter kits while supplies last.

Everyone asks me how they can get great images. I have an answer for you and your images could be better by next week. Seriously. Why not make 2017 your best year ever? Just use the code "WebTG16" for 15% off of our DVD's, mirrors and starter kits.

As you already know, the keys to getting exceptional images are: Exceptional mirror and retractor use. If you do that right, you can get images like the one below from a cell phone. I'm 100% serious.
Learn our mirror and retractor techniques and iPhone images like this are a breeze.

Our DVD's, mirrors and starter kit will have you shooting better images the day after watching our techniques. Order the starter kit and you'll have everything you need to teach your team members how to get better images for increased case acceptance and awesome documentation.

With 15% while supplies last, what are you waiting for? We're here to help you!


Tuesday, May 3, 2016

Hands on Clinical Dental Photography Training

Hi Everyone!

As I've traveled around the world teaching clinical photography, I've had a lot of dentists ask me if I do personal consulting on how to get great images and how to use them for internal and external digital marketing to grow practices. The answer is: YES.

I've had groups come to my office in Dallas for training of the entire team with or without the doctor.

If you want to learn more about how I can personally help you and/or your team get spectacular clinical photographs and teach you how to grow your practice and increase case acceptance, just email me at Glenn@Kriegercontinuum.com and I can give you more details.

All the best,

Monday, March 28, 2016

The right mirrors for dental photography

If you're like me, you've been getting emails for a new fog free mirror system that gently blows air over the mirror and even has a light to make it easier to get good images. Some even have rubber handles on the ends to get a better grip.

Is this a great idea, or is it simply a waste of money?

Anyone who has spent even a bit of time with me knows that my goal is to get exceptionally good images with as little cost as quickly as possible. So, in theory, I am against any "gizmos or gadgets" that can be circumvented with good technique.

I'm a huge fan of two things: Simplicity and functionality. Every mirror should have 4 working ends (2 on each side and the same when flipped over) and should be designed in shape so as to assist you in getting amazing images.

If someone knows how to use retractors and mirrors, and how to set up their flash and use f-stops, they'll get awesome lighting every time, without question. I've never once ever used any additional tools to get more light and with good retraction, I can even get a great shot using just the flash on my iPhone.

This image was taken with one of my occlusal mirrors and my iPhone. No need for fancy gizmos when you have good retraction and mirror use. Learn good technique and great images come fast.

In terms of fogging, all you need to do is run your mirror under hot faucet water for 5 seconds and you'll have a fog-free mirror for the next 5 minutes. Yes, it's really that easy. I show that as just one of the many tricks on my DVDs for clinical photography.

In short, rather than spend the money on a tool that gets around the issue of poor lighting by adding unnecessary light, consider learning how to get great retraction and use the ambient light from the room to get extraordinary images every time.

If you and your team are ready to take the next step towards getting exceptional images every time, consider our starter kit and watch your clinical photography take off without any fancy rubber handles, lights or mirror fans.
The starter kit has everything you need to get started on your way to exceptional images.

As always, if you have any questions, please feel free to contact me with any questions or comments.

Sunday, February 28, 2016

Let's Show Great Images To Our Patients

I just typed in "Cosmetic Dentist" and visited a bunch of websites that popped up. I did what many patients might do and went to the "smile gallery" to see their work. It became clear to me that most were uninspiring and mostly very clinical. I can't imagine that any patient would get too excited about seeing images of a patient shot while they were in the clinic chair or against the wall of the operatory or a collage of clinical shots. I'm not posting most of the images I saw because it wouldn't be fair to show a patient's face, but suffice it to say that most of the images came up far short of what I would show on a website if I chose to show images on my website.

Do you really think that a patient will see this and say "Wow! This is the right dentist for me?".  Seems more appropriate for a board certification presentation.

Even when just a smile was shown, most sites of the "Best Cosmetic Dentists" (at least according to Dr. Google) showed images taken from incorrect angles.

If we're going to show off our work, let's at least shoot the two images from the same angle.
If we're going to show off our work to the general public, let's get AMAZING images that inspire folks. Honest, simple images that don't require patients having to go to a professional photographer (yes, most future patients can see through that marketing technique).

Click HERE to see a post I once did on how to get amazing portraits to grow your practice.

We all strive to do the best dentistry we can and we should also strive to have our photography match our outcomes.

All the best,

Wednesday, February 24, 2016

Why the Nikkor 85mm lens is a great (lighter and way less expensive) substitute for the traditional 105mm

I originally wrote this post almost two years ago, but I get the question so often that it seems appropriate to repost it.

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.

One thing of note is that the lower the number (85mm vs 105mm) the closer to the subject you need to be to capture the same composition. So, you will need to be a little closer to the patient or, crop your images more when you're working through your digital process. 

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, February 16, 2016

Have Your Team Shoot Intraoral Images With Their Phone

When I travel around teaching photography and classes, the first question I ALWAYS get is: "Which camera should I buy?" Fair enough question, right? Actually, not really.

As clinicians, we've been trained in all sorts of equipment. We care about the brackets we use, the wire materials, scanners, technology, etc, etc.. Fortunately (or unfortunately for some) the camera you use will have far less of an impact on your images than your understanding of how to properly use mirrors and retractors. I've seen dentists spend upwards of $3000 on a camera setup and not have the foggiest clue about how to retract cheeks, position a patient or which mirror is best.  I've even had people show up to my courses with full camera setups still in the original packaging, hoping that I can show them how to set it up and use it (which I am always happy to do). My point is that it's not about the camera, flash or lens. It's about composition.

There are two components to every image: Lighting and composition. The first is easy to understand. Your image is either too light or too dark. How to get exceptional lighting is more complicated and I've previously discussed the role of lighting and its effect on depth of field on this blog, so I won't touch on it right now. Composition is how the image is set up. Can you see everything you want to see and nothing else?  In short, did you properly use the mirrors and retractors?

Even with this $2500 camera setup, notice that the composition doesn't lend itself to great patient education or case documentation. Truth is, it's really easy to fix.

My contention has always been that well composed images with a cheap camera allow one to capture better images than an expensive camera with poorly composed shots.  If you properly use your retractors, you're getting the lips and cheeks out of the way and light is able to get onto the subject. For instance, here's a shot of a maxillary arch (unedited except for cropping) taken with my OLD iPhone.

Yep, taken with an iPhone 4s, but with proper use of mirrors and retractors and good patient positioning techniques. Sure, the resolution is a little low, but it's a four year old 4s for gosh sakes! Newer cameras would look way better.
Sure, a more expensive camera would have better lighting or depth of field and I'm not advocating that you should use your camera phone for all of your dental images. What I am saying is that if you can get a great shot with your camera phone, without the fancy lighting systems or lenses, it's proof that you're using your mirrors and retractors well. If you're properly retracting the cheeks and tongue and positing your mirror in the right way, you'll allow enough light onto the subject that you'll get a great image with our fancy flash systems. If your image is too dark, it means that you're not retracting properly and you can quickly refine your technique.

Have your team shoot a set of images using their camera phones instead of your normal camera system. It'll make them focus (pun intended) on how to properly use the mirrors and retractors. It's about as pure of a way to shoot as there is and you can't hide anything and together you can objectively grade their images as I discussed HERE. If they can master the camera phone technique, then shooting with any $2000 camera system will be a breeze...if you know how to set it up. But that's another discussion. :)

Wishing you the best,