Dental Photography techniques

Taking dental photographs in manual mode

Now we have discussed the equipment you will need, let’s go onto the
settings you will be using to take dental photography. The mode you
will always use is manual as it allows the most customization. I covered
manual mode in detail here. Manual mode allows you to change:

 Aperture

 Shutter speed

 ISO

These three factors allow you to control the photographic exposure.

Exposure is the amount of light reaching the camera sensor. If you just
want a quick summary and to write down the correct settings, here are
the settings I advise.

Optimal manual Settings for dental photography

 Aperture is F32 for intraoral photography and F5.6 for portrait
photography

 Shutter speed is 1/250 seconds for both intraoral and portrait

photography

 ISO is 100 for both intraoral and portrait photography

Dental Photography Jargon

Aperture
Aperture is a hole through which light passes to enter into the camera.
It is measured in f-stop. A small f-stop means a large aperture and a
large f-stop means a small aperture. The aperture size affects the
depth of field of a photo. In intraoral dental photography, you are
using a large f-stop number which means a small aperture which in
turn means a large depth of field. In portrait dental photography (full
face), you are using a smaller f-stop which means a large aperture
which in turn means a smaller depth of field.

Shutter Speed
Shutter speed is the amount of time that the shutter is open. A camera
shutter is a curtain that covers the camera’s sensor so a larger shutter
speed means the sensor receives more light. Shutter speed is
displayed in fractions. In dental photography, you want a short shutter
speed (1/250 second). This is because a shorter shutter speed
decreases blurriness.

ISO
ISO is a measure of sensitivity of the camera’s image receptor. A high
ISO means a high sensitivity. An ISO of 100 gives a perfect balance for
dental photography.

The main views of dental photography

In dental photography, there are standardised views that dental
professionals tend to take. Here they are listed below with pictures and
some tips about how to take them:

Extraoral – Front Smiling Photograph

When taking this photo get the patient to move any long hair away
from the face and get a natural smile. It is important to take the photo
from the same vertical height at the patient. This photo can be done
with the patient sitting or standing.

Extraoral – Three Quarter Photograph View

This view is mainly used for orthodontics however could be useful in
restorative dentistry if altering Occlusal vertical dimension or occlusion.
Get the patient to move 45 degrees to the left. This photo can be taken
with the patient sitting or standing.

Extraoral – Lateral Photograph View

This view is again mainly used for orthodontics. Get the patient to
move 90 degrees to the left and make sure the camera is horizontal
with the frankfort plane. This photo can be taken with the patient
sitting or standing.
Intraoral – Buccal Smiling View

A close up photo of the patient’s natural smile. This photo is

particularly useful for any aesthetic restorative dentistry. Centre the
camera on the midline of the patient and make sure you are the same
vertical height as the patient. The patient is usually sat on the dental
chair for this photo.

Intraoral – Buccal Retracted View

The first photo using cheek retractors. Make sure to apply Vaseline on
the patient’s lips to make it as comfortable as possible. The cheek
retractors can either be held by the nurse or the patient. I often find
the patient will be the best person to retract their own cheeks. Centre
the camera on the midline of the patient and make sure you are the
same vertical height.

Intraoral – Buccal Retracted View (Right)

This view also uses the cheek retractor and I would always advise to
use Vaseline on the patient’s lips to make it more comfortable. Get the
patient to move their head to the left and keep their teeth together.
Centre the camera on the upper canine and keep the camera
horizontal to the frankfort plane. An ideal view would capture the distal
of the first molar.

Intraoral – Buccal Retracted View (Left)

Exactly the same as the buccal retracted view right however on the
opposite side.

Intraoral – Upper Occlusal View

This photo takes the occlusal surfaces of the upper teeth. As

mentioned in an earlier section, I would highly recommend getting a lip
retractor to retract the lip. Rest the mirror on the distal aspect of the
upper molars and use it is a fulcrum. You are aiming to get at least the
upper first molars on the photo. To prevent condensation on the
mirror, I would highly recommend pre- warming the mirror in some
warm water and asking the patient to breath through their nose. To get
the best photo make sure the camera is perpendicular to the mirror.
After you have taken the photo, you will need to rotate the photo 180
degrees and horizontally invert it.

Intraoral – Lower Occlusal View

The same as the upper occlusal view however now for the lowers. Ask
the patient to tilt their head slightly back and to pull their tongue back.
Rest the pre-warmed mirror on the distal aspect of the most posterior
lower molar. Again you will need to rotate the photo 180 degrees and
horizontally invert it.

Books for Dental photography

If this detailed post is not enough and you want to find out even more
about dental photography then Clinical Photography in Dentistry: A
New Perspective is a great book with good reviews.