How to Take Compelling Intra-Oral Photographs

By Therese Vannier, RDA/OMSA May 1, 2018

If a picture is worth a thousand words, then a dark, blurry photograph isn’t worth much. Photographs that accompany cases are meant to shed light on the procedure at hand, essentially telling a story about the patient’s situation for clinical and insurance purposes. They can be full arch images taken pre-op or captured in the middle of surgery. Either way, it’s important that they be accurate, clear and easy to decipher. Here are some things to keep in mind when taking intra-oral photographs so they turn out the best they can be.

Select the right camera

Digital single-lens reflex (DSLR) cameras are perfect for dental photography. Your ultimate decision about which one to buy will depend on your budget, as well as things such as the camera’s lenses and sensitivity to light. Digital cameras allow you to snap a photo and immediately check to see if you have a useable image. Photographs can then be loaded onto your computer and sent off to insurance companies or your dental lab within minutes.

Warm the occlusal mirror

The ideal size for an intra-oral occlusal mirror to capture full arches is 2 7/8” x 5 ½”. In order to keep fogging to a minimum, place the mirror in warm water for a minute or so, then dry and wrap the mirror in a clean paper towel just prior to insertion. 

Lube the lips

Moistening the patient’s lips with Vaseline will keep them comfortable and help the cheek retractors and intra-oral mirror slide in easier. 

Use good retraction

Cheek retractors will help you get a great shot so you can tell your story. Begin with the retractors on the inside of the bottom lip, then gently rotate up. Don’t be afraid to ask for patient participation. They’re usually happy to hold the retractors in position as you snap away.

Position the mirror

Position the mirror against the opposing arch and ask your patient to breath through their nose, since mouth breathing will cause the mirror to fog. Keep the tongue out of the shot and push the mirror to the back of the patient’s mouth. Make sure you can see the facial and palatal surfaces of the centrals. And remember to give your patient breaks.

Get the right angle

The right angle is no angle. Try to keep your camera on a flat plane and point it directly at the patient’s mouth. Holding the camera at an angle can distort your image and detract from the overall quality.

Be flashy

A strobe flash is ideal for providing a bright light source. Close the windows and dim the lights if you’re using a flash. A ring flash is a fabulous tool for taking intra-oral photographs. It provides virtually shadowless lighting because the flash tube is wrapped around the camera lens.

Keep it steady

Avoid blurring by holding your camera as steady as possible. Use your dental chair or your other hand to help stabilize the camera. 

Stay focused

Make sure the image is crisp and clear. Since premolars are in the middle of the depth of field, focus on them for the best shot.

Be consistent

Before and after shots are key components of illustrating your work. When taking these photos, be sure they are consistent in terms of distance, angle and lighting. Even the best work looks underwhelming if the before and after shots lack uniformity. 

Sign off

Make sure you have your patient’s signed consent and model release form before you send or share images. It’s a good idea to take a photo of the signed consent form after the clinical images are captured so you have a record of it.

Take a course

Clinical photography courses are available at dental conferences, institutions and online. Most offer hands-on training and equipment recommendations.