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Ask The Experts

Ask the experts: How does a modern practice use intraoral cameras?

Sept. 1, 2020
We conducted a survey of dentists about their intraoral camera use and found some surprising data. Our experts look at the findings and discuss why you should be snapping more pictures.
Stacey L. Gividen, DDS

“I can’t believe that’s in my mouth. How soon can I get it fixed?” If you’re not hearing those words from your patients, then you’re not taking advantage of an important component of your practice arsenal: the intraoral camera. When a patient sees what you’re seeing, your natural inclination to defend your diagnosis doesn’t come into play. The pictures speak for themselves. It’s dentistry made simple.

In a recent survey conducted by Dental Economics and MouthWatch, the average number of intraoral cameras in a dental practice was four. The survey also found that 92% of practices use intraoral cameras regularly, with 37% saying they use them on every patient. Respondents said they primarily used their cameras to show pathology and for hygienists to document new-patient exams. 

Let’s look at some other numbers from the survey that impressed me. When patients were able to see their infections or issues of concern, the conversion rate of proposed treatment to delivered care jumped. The largest segment of respondents estimated that intraoral cameras resulted in an average increase of $5,000 in revenue per month. Some practices estimated an increase of $10,000. But even if you’re only bringing in $1,000 more monthly, which was at the lower end of the spectrum, that’s significant. 

Overall, our survey respondents estimated a value of over $7,300 per month in additional revenue generated from patients viewing images. The numbers don’t lie. Tell me now why you aren’t using intraoral cameras for every patient? 

One of the most important benefits of using an intraoral camera is patient education. The range of uses is vast—from showing the locations of tartar and plaque buildup, to showing fracture lines, broken restorations, and soft tissue lesions. I’ve found that most patients are visual learners. When they’re educated about their own health, that’s when compliance, confidence, and trust increase. 

While many dental suppliers will tell you that “you get what you pay for,” that statement isn’t necessarily true when it comes to intraoral cameras. Let’s be honest: taking a photo of a broken tooth, a restoration, tartar, or pathology isn’t rocket science. Comparisons of $200 cameras to $4,000 cameras are insignificant, making the excuse to not purchase one null and void.

Let’s put a scenario together. Say you have four chairs in your office—two hygiene and two restorative. You’re wanting to purchase intraoral cameras for every operatory. A company such as MouthWatch can equip all four chairs for less than $1,000, with installation taking an hour or less. The ease, simplicity, and convenience of having a camera in every operatory to efficiently show a patient what work needs to be done will easily pay for your cameras the first few times you use them. 

Because the primary users of intraoral cameras are generally hygienists, documenting restorative work mid-treatment can be invaluable to document potential “down-the-road” issues. For example, say that while taking out an old filling, a large fracture line is discovered. Fracture lines can lead to crowns or root canal therapy. Even taking photos of class II restorations that are difficult to spot on the radiograph, or of a small occlusal pit filling that would otherwise get second-guessed for a stain, will give patients the “awe factor” and validate your effectiveness as a provider. Furthermore, establishing trust with your patients is cemented. And that is priceless.

Joshua Austin, DDS, MAGD

While patient communication is probably the greatest advantage for using intraoral cameras, I want to discuss a few other advantages and uses that will help you turn a quick return on investment. 

Charting

Remember those red and blue pencils we learned to chart with? Some of you may still be using them. I’m not here to shame you about that. But I want you to think about what a chart stands for and exists to do. A chart is a supposed to be a paper visualization of the state of a patient’s mouth. Can a red and blue coloring book do that? I would argue no. 

For those of you who are more sophisticated with your charting, what are you using? Probably the charting feature in your practice management software. I want you to ask yourself the same question. Is that an accurate representation of the state of a patient’s mouth? Probably not, even for computerized software charts. 

The fact is that coloring in a tooth with a pencil or using a mouse to click a few boxes does not create an accurate chart. In my opinion, the most accurate chart is made with a camera. Not only is it a far more accurate representation of a patient’s mouth, it is far faster and easier to produce. Thirty seconds with an intraoral camera can produce a valuable record of your patients’ current dentition. Maybe that’s why over 92% of survey respondents with intraoral cameras report that they use them regularly and nearly 60% say they use them on almost every patient. It’s time to trash those red and blue pencils.

Insurance reimbursement

Like many of you, my practice participates in a few insurance plans. This means playing the claim game. 

We all have played the claim game. Submit a crown on tooth no. 3 on your 9:00 a.m. patient. In 4–6 weeks, the insurance company kicks it back and wants a radiograph. You submit the radiograph. In 4–6 weeks, the insurance company denies the claim. To protest, you need a photo. Maybe you forgot to take a photo. Claim denied. 

Even if you did take a photo and the claim gets paid, it is now three months later and you’ve put more work into this than you should have. Yay! Everyone loves the claim game! 

If we would just submit photos with our original claims, the claim game becomes much shorter and less frustrating. Instead of Monopoly, the claim game turns into Chutes and Ladders. Having an intraoral camera handy in every op makes this simple. While you’re waiting for anesthesia, snap a quick pic before the prep. If your dental hygienist is taking photos, you might not even have to do it. You might already have the photo. But even if you already have a photo from the hygiene visit, another one never hurts. There is no such thing as too much documentation.

Risk management

Did we mention that there is no such thing as too much documentation? Having a bunch of photos on file never hurts. Let’s say a patient comes in twice a year for cleanings. Once a year, your dental hygienist snaps 6–8 photos. After five years, you will have around 3 MB of photos for that patient. That is nothing, storage-wise. There is no downside to having these photos. You never know when you might need them. 

A couple of years ago, I had a patient named Adrian who swore to me that his bite changed after I did a crown on him. He had a class III bite and was convinced that he didn’t have that before. Luckily, I had photos from his new patient exam several years earlier. His bite was exactly the same that day as it was the day he showed up complaining. A few minutes with his photos on the screen showed him that, in effect, he was wrong. And he admitted it. He said “Wow, Doc! You were right. I guess I just never noticed it before. Good thing you took those photos, huh?” Can a paper chart do that? Can your practice management cartoon chart do that? I don’t think so.  

The takeaway

Getting into the habit of taking photos only yields positive results for your practice. Intraoral cameras such as MouthWatch’s are inexpensive and simple to use. Photography can take your practice to the next level, and the right cameras can help without breaking the bank.  

STACEY L. GIVIDEN, DDS, a graduate of the Marquette University School of Dentistry, is in private practice in Hamilton, Montana. She is a guest lecturer at the University of Montana in the Anatomy and Physiology Department. Dr. Gividen is the editorial co-director of Through the Loupes and a contributing author for DentistryIQ, Perio-Implant Advisory, and Dental Economics. She serves on the Dental Economics editorial advisory board. You may contact her at [email protected].

JOSHUA AUSTIN, DDS, MAGD, writes the Pearls for Your Practice column in Dental Economics. After graduating from the University of Texas Health Science Center Dental School, Dr. Austin associated for several years. In October of 2009, he opened a solo general practice in a suburban area of San Antonio, Texas. Dr. Austin is involved in all levels of organized dentistry and can be reached at [email protected].

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