Digital photography is becoming as important as standard equipment and other practice-building tools for the dental office. Digital images can become a part of your computerized recordkeeping or be used to demonstrate past or current oral conditions to your patients. Digital images also can be used in treatment planning with your patients and in communications with specialists and the dental laboratory. Better than a Polaroid, digital images can be viewed immediately and downloaded and saved on a personal computer. You can print out individual images or send them as attachments via email. As with other records, you must maintain privacy for these records.
Digital cameras are simple to use, quick to learn, and give superb results. Relative to most other capital investments, cameras are very affordable, as is the cost of the storage media. Digital cameras and traditional cameras are alike in many ways. The biggest difference is in the way images are recorded. With traditional films, images are captured on silver-based film. A digital camera records an image on a charged coupled device (CCD) or on a complementary metal oxide semiconductor (CMOS). Regardless of the recording device, these chips contain a field of extremely small, light-sensitive photodiode cells. Each of the cells emits an electronic signal proportional to the amount of light that strikes the chip.
Digital photographs are made up of tiny squares called picture elements or pixels. Each pixel is represented by a red, green, and blue transistor. The computer divides the screen or printed page into a grid containing millions of these pixels. The computer or printer uses the values stored in the file of the digital image to specify the brightness and color of each pixel in this grid. Controlling this grid of pixels is called bitmapping; digital images are called bitmaps.
The quality of the digital image, whether printed or displayed on a screen, depends on the number of pixels used to create the image. The greater the number of pixels, the greater the resolution. More pixels add detail to an image, sharpen edges, and increase resolution. Most digital cameras have 2- or 3-megapixel resolution, although 4- and 5-megapixel resolution is becoming more common. A camera with at least a 3- or 4-megapixel resolution can produce a good quality 8-by-10-inch print. Settings on these same cameras can be adjusted for a lower resolution for Web publishing, email attachments, and small prints.
Most digital cameras have different types of zoom lens capability. The zoom feature is either activated optically by taking the picture at a longer lens setting or the image is enlarged digitally. Digital zoom provides enlargement of the center part of the image (similar to cropping), using fewer pixels and producing lower-quality images. Look for cameras with more optical zoom and less digital zoom capabilities.
Most digital cameras compress and save images in a variety of different formats, most commonly jpeg or tiff files. The two main types of removable storage cards are Compact Flash and Smart Media. Smart Media cards are thinner and lighter; they store less data but at a lower cost. Storage cards are erasable and reusable. They can be removed from the camera and plugged directly into a card reader or into some printers. Images also can be downloaded directly from your camera onto your PC via serial or USB connectors.
Once an image is captured, you have multiple options, a feature unique to digital photography:
- View the image on the camera in its playback mode; then either delete or save it.
- View the image immediately on a monitor or television.
- Store the image on your computer's hard drive.
- Manipulate the image using graphics software that will change color/contrast, crop the picture, or introduce special effects.
- Paste these images in an electronic presentation such as PowerPoint.
- Print out an image and use the hardcopy in many different ways.
- Send a copy of this image via email (maintain patient privacy).
There are many ways to use digital cameras in your dental practice:
- Take full-face photographs of your patients. Include them in your practice-management programs for patient identification. Create marketing initiatives, such as "treatment summary letters," "cavity-free clubs," or "first visit to the dentist" pictures. If your patient gives you permission, you might consider using a full-face photograph to demonstrate before-and-after records, particularly for aesthetic dentistry.
- Take photographs of the pre- and postoperative views of your work. Print out images in color on photo-quality, glossy paper so your patients can have a permanent record of their treatment to take home with them. They'll love it, and they will tell their friends!
- Take close-up smile photographs. Use a cosmetic software package to enhance or modify the images. Produce powerful case presentation and treatment-planning letters and slide shows.
Seeing images of their teeth can be highly motivating to your patients. Send copies of these images (e.g., a glossy print, a file on a floppy disk, or as an attachment with email) to assist and work more closely with your laboratory technician. Shade selection can be enhanced, as can the final aesthetic results of a treatment.
- Take close-up photographs of anterior or posterior teeth. Review these images with your patient in diagnosis, case presentation, and treatment planning. Share images with specialists for their use. Photos make communication easy and concise. Digital images also can be sent to third-party payers as documentation of recommended treatment.
Go online and research information about digital cameras and how to use them. Here are some helpful Web sites:
Taking digital photographs of your patients and their teeth is an essential component of the new-millennium dental practice. Digital photography enhances the ability to diagnose, treat, and record images for recordkeeping.
Better yet, the images are paperless and can help you move toward having a paperless office. Capturing, storing, enhancing, studying, and appropriately sharing digital images is a part of today's — and tomorrow's — dental practice.
Jeff Dalin, DDS, FAGD
Dr. Dalin practices general dentistry in St. Louis, Mo. He is editor of St. Louis Dentistry Magazine and chairperson of the Greater St. Louis Dental Society Critical Issues Response Team. Contact him at [email protected] or (314) 567-5612.