How to improve your dental photography skills?

6 min readFeb 15, 2021

Photography is one of the most important parts of the dental treatment planning process. Whether you’re taking before-and-after pictures or occlusal photographs to show a patient what you’re trying to explain, dental photographs have immense value. However, while a good photograph can convince a patient to proceed with your treatment, a bad photograph can also have the opposite effect.

If the photograph doesn’t show what you want your patient to see, i.e., if there’s a gap between your sight and the vision captured on the photograph, the patient might become distrustful. Poorly-captured photographs can also affect your ability to plan the treatments conveniently. And poorly-shot before-and-after pictures can make patients suspicious of your skills.

Suffice it to say, if you’re venturing into dental photography, you must improve your skills and take reliable images. This article provides handy tips and strategies for dentists to learn dental photography or improve their existing skills.

The tools and equipment necessary for dental photography

Cameras

You can choose between two types of cameras — point-and-shoot cameras or DSLRs. Point-and-shoot cameras include lenses and flashes, and they’re easier to manage, suitable for quick snaps of patients for communication with your partners in the dental practice. DSLRs are more complex and require additional components, but they provide better images, speed, increased depth of field, and incredible customizability.

Lenses

You must choose lenses capable of macro (or close) focusing, i.e., capturing images that are close to the actual size of the subject. True macro lenses offer a magnification ratio of 1:1, indicating that the lens will capture the image at the original object size. Many DSLR lenses call themselves “macro lenses,” but you must focus on the 1:1 ratio rather than the claim.

Flashes

Most intraoral and extraoral images rely on flash illumination because the mouth doesn’t have a natural source of light of its own. DSLR cameras allow hot shoe mounted flash, i.e., the flash is mounted on top of the camera. A ring flash is the best type of flash for dental photography because it provides circular light to illuminate the entire mouth without shadows.

Cheek Retractors

Cheek retractors are essential for all dental photography sessions because they retract the lips, buccal mucosa, and other unnecessary soft tissues from view. They also allow more light to enter the mouth, providing greater visibility of the oral cavity. You should ideally choose double-ended plastic retractors because they’re the most comfortable for the patient, least visible, and adaptable to various mouth sizes. However, metallic retractors are more durable.

Intraoral Mirrors

Intraoral mirrors are essential for dental photographs because they allow you to capture occlusal and buccal images, regions that are otherwise obscured to the camera lens. A set of intraoral mirrors includes various sizes of both buccal and occlusal mirrors. You should ideally get intraoral mirrors with handles to prevent your fingers from appearing in the images, an unfortunate consequence of most traditional mirrors.

Heating Pad

A heating pad is one of the best means of preventing the intraoral mirrors from fogging up, one of the biggest barriers to clear dental photography. You can place the intraoral mirrors in a folded heating pad to prevent them from fogging up. This allows you to comfortably take pictures without the risk of the mirror fogging up.

Tips on taking different types of dental photographs

Full Face

The camera should be directly in front of the patient.
The patient should be against a solid-color background.
The photographer and patient should be close to the same height to ensure the camera is at the patient’s eye level.
The patient’s eyes can be used as the horizontal mid-point for the photograph.
The patient should smile naturally, showing their teeth prominently.
The patient should be slightly in front of the background to avoid shadowing.

Full Smile

Point-and-shoot cameras should be on macro-mode, or DSLR cameras should use 1:2 lens magnification.
The camera should be directly in front of the patient — not angle up or down.
Ask the patient to smile naturally. If they have trouble smiling naturally (some forget how to smile when they’re in front of a camera), ask them to bite down on the posterior teeth while smiling.
The focal point should be the central or lateral incisors.
The incisal plane can be used as the horizontal mid-point.
The anatomic midline should be the vertical mid-point.
Don’t adjust or tilt the camera if the incisal plane is slightly slanted.

Retracted Anterior (Frontal) View

The patient should be seated in the dental chair.
The lips must be retracted outwards using cheek retractors.
The image shouldn’t capture the retractors.
Clear plastic retractors are far more discrete than metallic ones.
Use the largest possible retractor to prevent the upper and lower lips from showing.
The occlusal plane should be the horizontal mid-point.
The anatomic midline should be the vertical mid-point.
Air-dry the teeth to minimize the appearance of saliva.
Two sets of images can be taken (with maximum intercuspation and slightly apart) to highlight the incisal edges.

Retracted Right and Left Buccal Views

The patient should be seated in the dental chair.
Direct view with cheek retractors is easier than a reflected view with a buccal mirror.
For the direct view, place the retractor against the side being photographed. Buccal “v-shaped” retractors are ideal, but standards “u-shaped” retractors also work.
The occlusal plane should be the horizontal mid-point.
The canine should be the vertical mid-point.
The photograph should prominently display the canine-molar relationship.
Two sets of images can be taken (with maximum intercuspation and slightly apart) to highlight the incisal edges.

Maxillary Occlusal View

The maxillary and mandibular occlusal shots necessitate using retractors and an occlusal mirror.
The patient should recline at a 45° and raise their chin.
Cheek retractors should be used to pull the patients’ lips upward and outward.
The buccal soft tissue and lips should be kept away from the teeth to ensure optimal visualization of the posterior and anterior teeth.
The occlusal mirror should be inserted until the edge goes beyond the most posterior tooth.
The mirror should be rotated downward, making the back touch the lower incisors.
Heating pads can be used to deal with the fogging, or you can ask the patient to momentarily hold their breath.
The photograph should include all the maxillary teeth with a complete view of the incisal edges and embrasures.
The anatomic midline should be the vertical mid-point.
The premolars should be the focal point.

Mandibular Occlusal View

The patient should recline at a 45° and raise their chin.
Cheek retractors should be used to pull the patients’ lips upward and outward.
The buccal soft tissue and lips should be kept away from the teeth.
The occlusal mirror should be inserted until the end stabilizes on the soft tissue beyond the posterior teeth.
The mirror should be rotated upward, its back touching the maxillary incisors.
The image should be taken at a 45° with the mirror.
If the tongue is visible, you can ask the patient to lower the tongue or move it to the posterior. If that doesn’t work, you can push it out of the way with the mirror.
The anatomic midline should be the vertical mid-point.
The photograph should include all the mandibular teeth with a complete view of the anterior incisal edges and embrasures.
The premolars should be the focal point.

Final tip — communication is key.

Sometimes, a dentist may get so caught up in the process that they forget about the patient’s emotional state completely. Having someone poke around your mouth with mirrors, metallic retractors, and cameras can be unnerving, so it’s worth easing their discomfort. You should communicate every step of the photography process and explain the purpose of each device used, such as the mirrors and retractors. That’s the best way to gain their enthusiastic cooperation, which is essential for effective photography.

This article was originally published in the Zircon Medical Magazine for leading dental professionals. The article was based on an interview conducted with Dr. Sebastian Horvath, the specialist in prosthetics at a group practice in Jestetten.