Communicating with Images

Women practicing dentistry today have probably noticed two things about our profession.

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Digital cameras improve patient communication, and keep the details within everyone¿s reach.

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Women practicing dentistry today have probably noticed two things about our profession. First, cosmetic dentistry is increasingly more important to our patients, with people turning to their dentists for help improving the appearance of their smiles. And second, the more we incorporate cosmetic dentistry into our practices, the more we depend on photography. With today’s digital technology, that means many of us are considering digital cameras.

In my case, I made a decision to focus exclusively on cosmetic dentistry years ago. This decision followed a personal revelation. Just after I graduated dental school in 1982, a friend of mine asked me if I’d like to do something about the spaces between my teeth. Bonding was new to dentistry then, but I was intrigued and agreed to give it a try.

What happened next changed my life. In the days after the procedure, I noticed a lot of soreness in my facial muscles. I thought it might have been do to the placement of the anesthetic, but I was wrong. “You’re smiling more,” my friend told me, “and it’s making your face muscles sore.”

I was amazed. And what was most remarkable is I’d never realized I’d been hiding my small teeth. So I began to wonder: If cosmetic dentistry can make this big a difference for someone who doesn’t realize she’s self-conscious about her smile, what could it do for someone who does?

At that point, I decided to become a cosmetic dentist.

From film to digital

I have always relied on photography because I focus on cosmetic dentistry. For many years I captured my photos on film.

Today that’s all changed. Our practice uses digital photography exclusively. This type of photography is a natural fit for our practice, one reason being that we want our patients to know we run a state-of-the-art practice. We show this in a number of ways - some of which are decidedly low-tech. We’ve aimed for a spa-like atmosphere in the office. The walls are painted a warm pink, the lighting is low, and we use aromatherapy candles to create a soothing mood. When patients arrive, they can stop by our juice bar as they wait for their appointments or fill out paperwork.

Technology also plays a part. We have computers in every room running Kodak SoftDent practice-management software and charting module. Our X-rays are also captured digitally and integrated into our practice-management software, using the Kodak RVG 6000 digital radiology system.

As a computerized practice, using digital photography is practical from a technical standpoint also. When images are captured digitally, it’s easy to integrate them into our computerized patient records. Even without this consideration, I’d still opt for digital photography because of how well it supports patient communications.

The first patient photographs we capture are usually taken during the initial visit. Typically, we capture the 12 views recommended by the American Academy of Cosmetic Dentistry:

• Full face at 1:10 magnification (1 view)

• Front, right, and left smile at 1:2 magnification (3 views)

• Front, right and left retracted at 1:2 and 1:1 magnification (6 views)

• Upper and lower occlusal at 1:2 magnification (2 views)

If the patient has concerns about specific teeth, we might take additional photographs to help support treatment planning.

The nice thing about digital photography is that the images can be displayed immediately. So if we don’t get a good image, we retake it before the patient’s appointment is over.

These initial photographs are a great help to me as I develop a treatment plan. I’m often able to see things on the photographs more clearly than I can during a live exam. The camera’s flash eliminates shadows that can obscure structural elements of the teeth. The images frame and magnify the patient’s teeth and smile, which can sometimes permit a more objective view. And of course, I can view the photographs in less-distracting surroundings than is possible with a patient in the chair in the middle of a consultation.

The photographs really shine during the patient’s return visit, when they form an integral part of the case presentation. During the presentation, we display the photographs, along with our digital X-rays, on our consultation room’s computer screen. We also provide printouts so the patient can look at the images in hardcopy form. (If the restoration or cosmetic job involves more than six teeth, we also use initial stone models of the patient for the presentation.)

The images help me explain what I recommend as well as how the treatment will proceed. They help the patient communicate with me. Patients can point to areas on the image, ask questions, or give feedback on my recommended treatment plan. I like this because we are co-diagnosing. Just as important, I get a chance to interact more with the patient about her/his expectations and to ascertain that they are realistic. This keeps us both on the same playing field.

Of course this would be possible using film photography; however, with digital photography, it is much, much quicker, and I have more flexibility in how I build the presentation. Using a combination of on-screen and hardcopy images, for example, ensures the patient can use the medium that makes him or her most comfortable.

Digital photography also makes it easier to create before-and-after simulations for patients. This is something I’m planning to add to my treatment presentations when my staff and I are fully trained on our cosmetic imaging module. It will be very useful in helping patients understand how my recommended treatments will enhance their smiles.

Choosing a camera

Digital photography, I’ve found, is also easier for my staff to master than film photography. Part of this is because many digital cameras have automatic focus and zoom features.

It is also important to look for functions that help dental staff do their jobs. We have recently incorporated the Kodak DX6490 dental digital camera into our practice, and our staff really enjoys using it. The camera is small and light. It also has built-in distance and framing guides, so our patient photographs are framed consistently. The staff uses these tools all the time, and as a result, our photographs have been much more uniform since we started using this camera. It also helps reduce framing mistakes by ensuring that important areas of a particular view aren’t cut off in the photo.

The Kodak DX6490 dental digital camera lets us download images into our computer network directly, which is another convenient feature. Our other camera wrote the images to a memory card; then, to get them to the network, we had to take the card out of the camera and insert it into a card reader on a computer.

We currently download images in two different ways: Our computers are all equipped with USB cables, so we can plug the camera into any workstation and send images to the network. We also use a docking station that came with the camera. We just set the camera on the dock and press a button to send the images to the network.

The docking station is located in the hallway between our operatories. Since it also recharges the camera batteries, it’s a convenient, central location for storing the camera when it’s not being used.

In the years that I’ve practiced dentistry, I have found that images are a great communication tool. They help patients feel like they’re contributing to the treatment plan, making them partners in the redesign of their smiles. Now, with today’s dental digital cameras, any woman dentist can experience this for herself, in her own practice. It’s as easy as the click of a button.


Nancy Summer Lerch, DDS, FAGD, AAACD
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Dr. Lerch is in private practice in New Haven, Conn. She serves as an examiner for the accreditation process for the AACD, and is president of the New England Academy of Cosmetic Dentistry.

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