A Standardized Approach to Extra-Oral and Intra-Oral Digital Photography

Summary

The present protocol describes a method to capture intra- and extra-oral photographs for digital documentation in the clinical practice of dentistry. The protocol highlights all the critical components involved and the commonly utilized settings to capture dental photographs for clinical documentation.

Abstract

Contemporary dentistry mandates a more comprehensive and personalized analysis of each patient. Technological advances in digital photography have played vital roles in diagnostic accuracy, treatment planning, execution of therapies, and outcome evaluations, including esthetic enhancement. Digital photography also provides an excellent platform for patient education, communication, and co-management of cases with other healthcare providers. However, intra-oral photography often faces challenges such as inaccessibility of areas to be captured, different moveable vs. fixed tissues involved, contamination with saliva or blood, and differing illumination needs on various locations. Thus, a more standardized and systematic approach is proposed for intra- and extra-oral documentation via digital photography to overcome the existing technical challenges. The current work will outline the appropriate equipment specifications (camera bodies, macro lens, and flashes), positions and postures of the operator and patients, proper techniques of tissue retraction, the use of appropriate intra-oral mirrors, and the essential elements such as aperture settings (F-stop), ISO, shutter speed, and white balance. This article aims to provide all dental professionals with an approachable linear array of guidelines to produce simplified and standardized visual tools for more efficient and effective documentation.

Introduction

The approach to the clinical practice of dentistry has evolved over the decades to include a conceptual framework of clinical reasoning based on empirical evidence¹. As such, digital documentation now serves as an integral part of the framework on which clinical decisions are made, and evolution of care is observed². The purpose exceeds mere primary legal records and now encompasses a plethora of extensions that include active mode of communication with patients, educational tools for dental members, educators, and colleagues, visual aids for technicians, and finally, effective marketing

Protocol

The protocol involves standardized documentation of patients' clinical presentation as routinely administered at Columbia University College of Dental Medicine, New York. No patient data were utilized for this publication; the co-authors R.B and J.M.D.O are depicted in the photographs themselves, illustrating techniques described in this protocol and providing consent to publish the images involved. Replicating the procedure under clinical settings will require written informed consent from the patients.

1. Acquisition of extra-oral photographs

1. Utilize a ring flash and an extra-oral photography reflector (se....

Results

Techniques illustrated in the protocol section were employed to acquire a sequence of extra- and intra-oral photographs. Figure 8A demonstrates the patient in different positions. The three composite positions include repose, natural smile, and widest smile. The photographs are taken in the suggested composite positions to illustrate the facial changes observed in the patient while in function. The musculature surrounding the oral cavity is influenced by restorative work performed in the ora.......

Discussion

Traditional evaluation tools in dentistry such as periodontal charting and model impressions of the oral dentition used for generations consistently provide clinical data; however, they have limitations¹⁶. Several clinical pathologies and soft tissue presentations are not accurately represented in traditional modalities of dental evaluation. Thereby, electronic documentation via dental photography is now considered a valuable tool. The clinical photographs reveal the patient's current.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Armamentarium for photography
Buccal Mirror #15- Narrow mirror	Doctoreyes	Ultrabright #15	Width 40 mm with ultrabright coating
Camera	Nikon	D7500
Occlusal Mirror #13- Large Mirror	Doctoreyes	Ultrabright #13	Width 70 mm with ultrabright coating
Ring Flash	YongNu	Macro ring lite YN14EX