Picture this

Oct. 1, 2002
Photography has become an integral part of dental practice today. In the past, few offices took routine photos of their patients and treatment results.

Paul Feuerstein, DMD

Photography has become an integral part of dental practice today. In the past, few offices took routine photos of their patients and treatment results. The majority who used photos were either lecturers or practitioners who were documenting specific cases. Now, with a variety of cameras on the scene, we have an array of methods for taking photos and an expanded means of communication with our patients. More offices are taking a series of photos along with their new-patient series of radiographs. These images are used to communicate with our laboratories and with insurance companies. They also are excellent marketing devices for referrals.

Many offices use photos in lieu of charting. This allows the patient to see his or her mouth on a computer screen or in print, as opposed to looking at a charting of small, red and blue circles. A full-arch photo and a close-up of the anterior teeth allow the patient to see problems and co-diagnose.

Despite the emergence of easy-to-use digital cameras, such as Kodak's new 4900 kit, many offices are not equipped to use this technology. As I lecture around the country, I find that fewer than half of the offices do not have computers in the treatment areas. Most have a system at the front desk and at least one other area, which allows patients to see digital images and computer-enhanced future results. Without a monitor at the chairside, immediacy is diminished.

Enter the Polaroid Macro5 camera. This is a simple, foolproof camera that allows anyone in the office to get a perfect photo every time with different levels of magnification. This camera produces crisp photos within two to three minutes, allowing patients to easily see their current condition. In offices with monitors in the treatment rooms, this is still a desirable situation, because you can sit with the patient and be "up close and personal." Of course, a digital image can be printed, but this often involves running to a printer, changing paper, executing a print program, and losing the immediacy. If you want to "image" the patient's condition, it is a simple matter of scanning the photo with today's very inexpensive units.

This camera is a great tool for shade communication with the dental lab. A method called "photo layering," developed by Dr. Ed Walk at Tufts University, involves taking two to five photos of the same teeth and shade tab at slightly different light settings. The film itself is a little sturdier, more durable, and water-resistant for the lab environment. In my own office, despite all of the technology, we send out almost every lab case with a couple of Polaroid photos.

The Macro5 even allows you to copy radiographs with Polaroid's new copy stand. Just slip the camera in the stand, drop the radiograph in the designated spot, and shoot the picture. You will have an instant copy of the film without chemistry or special transparency scanners.

Offices with limited computer expertise and no desire to do computer imaging can do a composite mockup of proposed treatment, photograph it, and send the patient home with before-and-after photos prior to treatment. This is easy to do and is a great practice-builder.

A recent email on an Internet dental forum stated: "At a hygiene visit a few weeks ago, I took photos to show the patient how veneers and a new crown on her upper incisors would look. The patient asked about the cost and said, 'Don't even show me the pictures, there's no way I can afford them!' As she went on about her financial situation, I took out the photos and held them in front of her. She stopped in mid-sentence and asked, 'Oh,wow! Do you have a payment plan?'"

Although my office sports monitors galore, as well as a couple of digital cameras, we use the Polaroid Macro5 several times a day. Remember — the greatest obstacle to case acceptance is communication. If you currently are not taking photos, don't worry about how complex it seems; choose a simple system and get in the habit of taking them.

Your patients will have a better understanding of their treatment, and you will reap the benefits.

Dr. Paul Feuerstein installed one of dentistry's first computers when he placed a system in his office in 1978, and he has been fascinated by technology ever since. For more than 20 years, he has taught courses on technology throughout the country. He is a mainstay at technology sessions in New England, including annual appearances at the Yankee.Dental Congress, and has been a part of the ADA's Technology Day since its inception. A general practitioner in North Billerica, Mass., since 1973, Dr. Feuerstein maintains a Web site (www.computersinden tistry.com) and can be reached by email at [email protected].

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