Speaker: Dr.

Omar Kamal

Course: Dental Photography Simplified

Program: Dental Photography Program

Uses of Dental Photography

1. Medicolegal Documentation
- for protection of both the dentist & the patient and preserve their rights, as it acts as
real evidence to show both you & the patient what was done and was not.

2. Monitoring Conditions
- to determine & expect the prognosis & success rate of the procedure done
- it depends on the follow ups & patient stricting to the regulations given by the dentist
- follow ups may be 1, 3, 6, and/or 9 months, 1 years and so on …

3. Lab Communications (to be discussed in details page no. 4)

- for accurate selection of shades in restorations which requires picture of
a. patient teeth (tooth other than to be restored)
b. shade guide
c. number of shade selected (2M2, 2M3, etc…)

4. Patient Communication
- to show the patient the procedure steps, his preoperative and postoperative condition
& result
- to convince the patient with what is good for him/her
- to show the patient what he/she will look like at the end of the procedure for ex.
Mock-ups for digital smile designing (DSD).
- to show & teach the patient how he or she will deal with the outcomes of the
procedure and to give them instructions for success of the procedure.
- therefore, you are gaining the patient loyalty & trust.

5. Treatment planning
- in major cases, for analysis & stepwise treatment planning.
- in cases that requires “Teamwork” of different doctors.
6. Self-improvement
- for you as a Dentist
a. allows you to detect the difference in your work with time
b. to detect the mistakes and correct or improve them
c. to document, marketing & show other patients and dentists your work and
workflow.

7. Practice Portfolio
- for Building your C.V., by documentation of your cases & talents

8. Copying Radiographs
- to digitalize, transform & transport your hard copies of X-ray films into soft copies
that is eligible to be sent & shared (In case there is No X-ray sensor)

9. Co-Diagnosis
- for consultation, seeking information & putting a treatment plan with other dentists.
- Linking different specialties.

10. Digital Case Presentation

- to show & present the story of the procedure.
- for any “academic level” either student, master
holder or PhD, to standardize & professionalize
your way of documenting cases.

11. Staff Training

- to train your students, assistants & staff members how to manage, treat & prevent
Diseases & Complications
- for education tips & tricks.

12. Marketing
- to show your work to other patients
Lab Communication

A. Impression making
- to clear & see differences between the convexity and
concavity, so that gives you indication for the primary cast.

B. Shade selection
- for example, in case of Shade selection for Composite restoration in Anterior teeth
> Saturation (Value): Degree of color saturation
So that for Dentin shade selection you would select more saturated (Yellowish).

> Monochrome (Black, Grey & White): for Enamel shade selection

Snapseed
Mobile app
You can install and use it for
Enamel & Dentin shade selection
by editing the picture taken on
the app
The Fundamentals of General
Photography
> Picture is formed by “Light”
- amount of “Light” forming the picture determines the “Details of the picture”, so that
to avoid over or under exposure and loss of details.

How to Communicate & Deal with your Camera ?!

(The five Fundamentals)
> At the beginning you need to know the proportions & factors that control your
camera and determine the quality of your picture.

1. Exposure
2. Aperture
3. Shutter speed
4. Depth of field
5. White balance

1. Exposure
- amount of light to which the picture (sensor) is exposed to.
a. Overexposure: sensor has exposed to too
much light (Whiter)
b. Underexposure: sensor hasn’t exposed to
enough light (Darker)
c. Proper exposure: sensor has exposed to
proper amount of light

2. Aperture
- Adjustable opening that determines the diameter of
the lens, and therefore determines amount of light
(how much) that reaches the sensor.

> important point to be considered that the

I. Aperture affects the depth of field as follows:

 a. wider opening = shallow depth of field = blurred
why ?! due to scattering (No parallelism) of light rays.
b. narrower opening = higher depth of field = more details
Why ?! due to parallelism of light rays as they expose the sensor.

II. Aperture symbol in Photography: “F number”

> F-number has Inverse relationship with the opening of the lens
a. lower “F number” means wider lens opening
b. higher “F number” means narrower lens opening

III. Relation between F number & Depth of field

- they have inverse relationship as follow:
a. Higher “F number” = shallow depth of field = out of focus (blurred)
b. Lower “F number” = more depth of field = in focus (details)

> therefore “Aperture” / “F number” determines

1. Amount of light reaching the sensor (less/more)
2. Field to be viewed (How blurry the background is) (blurry/detailed)
3. Depth of field (shallow/deep)
 For intraoral pictures For extraoral pictures
(face & shoulders)
High “F number” between Low “F number” between
20 - 36 8 – 16
As we need more details As there is no need for the background &
depth of field

In Dentistry

3. Shutter speed
- shutter/barrier that covers the “Sensor”
(sensor: is the plate that receives the light to form the picture).
> Amount of Time during which the sensor is exposed to light
- more exposure to light means less shutter speed = Whiter picture
- Not
lessall
exposure to light
cameras reach up means high shutter speed
to 36, but starting
= Darker picture from 20
to 22 is acceptable in
d
In Dentistry
> You need High Shutter speed, but enough to allow exposure of sensor to light.
- Time must be parts of second ranges from 1/100, 1/125, 1/160 to 1/200 parts of
seconds

Why this range ?!

a. Not less than (1/100): to avoid “Motion Blur”
b. Not more than (1/200): to allow for flash syncing

N.B:
I. According to your budget, there are “Flashes” in the market which are provided
with “High speed sync” (HSS) feature, that allows you to increase the time over
1/200 and still syncing with the shutter speed

II. There are other factors as: Vibration reduction and using stabilizing instruments as
“Tripod”

III. Relation between “Shutter speed” & “Aperture”

- Dependent relationship, because if there is:
a. Wide lens opening (low F number) &
Slow shutter speed (more time of exposure)
>>> More time & area of sensor exposed to light >>> Whiter picture

b. Narrow lens opening (high F number) &

Fast shutter speed (less time of exposure)
>>> less time & area of sensor exposed to light >>> Darker picture

4. Depth of field
- factor that controls the blur and details appearance in the depth of
picture.
For ex. Picture that shows Class IV in upper central in details &
blurs the rest of teeth (out of focus).

5. White Balance
- factor that determines the color according to normal morning sun light.
> The Light has “Temperature” measured by “Kelvin”.

a. Low Temp. (1000, 2000, 3000 K) > Candle Yellowish light

- which means that during shade selection shade will appear (Yellowish / Darker)
for ex. (A2 shade will appear as A3 shade)
b. High Temp. (7000 K and more) > Bluish light
- which means that during shade selection the shade will appear (Bluish / Brighter)
 for ex. (A2 shade will appear as A1 shade)

In Dentistry

- Color Temperature should (as sun light in the

afternoon 12 pm) ranges between:
5300 K – 5600 K

N.B.
I. Never select your shade under Halogen, Tungsten or Fluorescent Light.

II. You Must adjust your Camera settings to be “Flash Conditioned white balance”
Not Automatic settings.

ISO
- Image Sensor's Sensitivity to light
- determines the Degree of (Clearance / Noisiness) in the picture.

ISO ranges from (100 – 6400)

In Dental Field

> ISO should range between (100, 200, 400, and 800)
> Never Use “Automatic ISO”, every setting should be “Manualized”.
> In case of more noisy picture, it
will lead to difficulty in determining
- Line & Point angles of teeth.
- Gingival margins & Zenith points
in case of Gingivectomy or Crown
Lengthening.

> Nowadays, ISO isn’t considered as an important setting to be

dealt with or care about … Why ?!
Because We Now depend on the “Flashes” as (Ring flash, Twin flash, etc..)
Histogram
function in your camera that analyzes the picture
taken, to provide you with information about
amount of Exposure.
N.B.
I. Underexposed picture are difficult to be edited
Because there is little amount of exposure (Dark
more black picture)
II. Exposed to the left can be edited to reach
desired neutral exposure
III. Neutral Exposure (Ideal) means saving time
& money in editing & manipulation
IV. Exposed to right can be edited to reach the
neutral exposure
V. Overexposed pictures are difficult to be edited
Because there is much amount of exposure (Bright whiter picture)

Start-up Settings for Dental Photography

Aperture (F- Shutter speed ISO Flashes

number)
- Intraoral (22-36) - Stay above 1/100 Best to stay at 100 Manual mode.
to avoid “Motion to 200, to avoid
- Extraoral (8-16) blur”. noisiness. N.B. flashes has
power it may range
- Stay below 1/250 from (1/1) up to
To allow for (1/32).
syncing with
flashes.

Dental Photography Equipment

1. Cameras
2. Lenses
3. Light
4. Retractors
5. Mirrors
 6. Contrastors

1. Cameras
> Contains the “Sensor”
Why there is different types of Cameras ?
- Classified according to type of “Sensor” into:
a. Full frame
b. Crop Sensor
c. Micro four thirds
d. Mobile phone sensor

In dental field, there is no

need for the full frame
camera, the “Crop Sensor”
is more than sufficient.

Which one should i select “Canon” or “Nikon” ?

Canon Nikon
Easy to use user interface More professional user interface
> Types of Bodies to be used: D5200
1300 / 700D D7100
750D / 800D D90
60D D700
5D mark II D800
6D
5D mark III
N.B. Any “body” of Canon DSLR
cameras can be used in our field
EXCEPT:
a. 2000 D
b. 4000 D
why?!
Because they do not accept “Flashes” of
other brands (third party flashes) which
are more cost effective than expensive
flashes of Canon itself.
2. Lenses
> Types of Lenses
A. Focal lenses as (18-55) lens
B. Prime lenses as (Macro lens) which we use in Dentistry,
- The Focal length of prime lenses is constant never changes & measured in
millimeters as follows:
85 mm
90 mm
100 mm
105 mm

Types of Macro lenses used in dental field acc. To “Brands”:

A. Canon
I. Canon 100mm L f 2.8
II. Canon 100mm non L f 2.8

B. Nikon
I. Nikon 85mm VR macro
II. Nikon 105mm VR macro
 C. Third party Lenses
- Sigma 105mm lens for Canon camera
- Sigma lens for Nikon camera

- Tokina 100mm f 2.8 AT-x M100

- Tamron SP AF 90mm f 2.8

Light
> Types of Light
a. Continuous light
b. Brust (flash) light

Ring Flash Twin/Dual flash

Focused light Two Artistic / shaping / 3D light

Better to be used: Posteriorly Better to used: Anteriorly
 Canon Nikon
Sigma Yongnuo
Yongnuo Meike
Metz
Types of “Portable Flashes”

Types of “Studio Flashes”

Strobe light & Soft box Speed light

Soft box: used for “Diffusion of Light”, > You can use “Bracket System” to
but “over diffusion” of light, leads to install separate flashes.
softness & loss of details of the picture. - for ex. You install two flashes one on
the right & one on the left to act as twin
flash.
Clinical Accessories
A. Retractors B. Mirrors C. Contrastors

A. Retractors
Types of “Retractors
According to “Material”
a. Plastic -has subtypes either-
I. Combined/Automated
-has connector which controls its power of retraction
-different size 1, 2, or 3
-require proper selection of size for proper positions as rest or occlusion.
II. Separate
-preferred over the combined, because the patient controls the
power of retraction & can be used unilaterally over one side.
 b. Metal -require proper manipulation of light, to avoid
reflection of light over the teeth-

B. Mirrors
Types of “Mirrors”
According to “Material”
a. Gloss
-Adv.: low weight.
-Disadv.:
~ if not properly finished & polished, it may lead to
Ghosty/Double Image.
~ Easily Broken, even if the patient bite over it

b. Stainless steel
-Adv.: Not easily broken
-Disadv.:
~ if not properly coated & finished, it will scratch easily.
~ Heavier in weight than gloss mirrors.

Mirrors Fogging
~ How to avoid ?!
1. Tool from -Jacobi- with handle the produces light &
contains a fan.
2. Triple air way syringe
3. Heating of the mirror by the torch

~ Why Fogging occurs?

Due to difference between body temperature & mirror (room) temperature

Mirrors Scratching
~ keep attention to the scratches on mirror surface, as they appear as black lines in the
pictures

NB
In Mobile photography
Mobile flashes don’t have the white balance that is equivalent to sun light, So use led
lights that are attached to mobile.

C. Contrastors
- Optional tool
Types
~ acc. To Shape
1. Flat 2. Corridor 3. Lingual
~ acc. To Flexibility
1. Flexible > Expensive
2. Rigid (not flexible) > Cost effective

N.B.
1. preferred colors for Contrastors: Black, Silk blue

2. Also, black papers or gloves

can be used.

3. It is important to leave
enough space between the
contractor & teeth to be
captured to produce an effective
depth of field.

Extra-oral & Intra-oral Shots

Extra-oral Shots
~ For “Facial Guidance”
1. Frontal Smiling View
2. Frontal Retracted View
3. 12 O’clock view
4. Right & Left side view
5. Occlusal View

~ Patient Should be: Seating in “Upright” position, NO Tilting.

Intra-oral Shots
~ depend on the “Operation Site & Side”
A. Occlusal Shots
~ Patient is seated acc. to operation: Mostly “Supine”
~ Mirror must be forming 45° angle with the teeth to be captured
~ Camera must be forming 45° angle between the teeth & mirror at 1 meter distance
Upper Occlusal shots Lower Occlusal shots
~ Dentist position either ~ Dentist position is: 6 O’clock Only
- 6 O’clock Why ?!
- 12 O’clock Because if it was 12 O’clock the mirror
will reflect the Patient face not the Teeth.

~ One of difficulties in lower shots is

because of the “Tongue”
Which is avoided by instructing the
patient to touch his palate with the tip of
the tongue, then retract the tongue using
the Mirror.

B. Buccal Shots
1. Unilateral support of the side opposite to the one to be capture
2. Mirror is used to retract & reflect the side to be captured forming 45° angle with
the teeth.
3. Camera must form 90° on the mirror.

Mobile Photography
~ Mobile Camera can be used in dental field,
> But there is Two problems must be dodged, which are:

A. Mobile Flash temperature (White balance)

~ Because mobile flashes are within “Candle Yellowish light” = 2000-3000 K

~ Dodged by using “External Lights”

1. Smile lite By Style italiano
1
2. MDP light – mobile dental photography
3. SDL – Smile Dental Light By Photomed
4. Lamp U
5. Cocolux
6. Optimized Kit By Dr. Omar Kamal
 2

4
3

Optimized Kit By Dr. Omar Kamal

~ 2017: Version 1
~ 2018: Version 2
~ 2019: Version 3, which contains total of 72 led lights, 36 led lights on each side.

B. Focal Length in Mobile Cameras is only (28 mm)

~ Which produces non-standardize pics with different ratios, Especially in Anterior
teeth, leading to “Central Dominance”.

~ Dodged by: Zooming & taking a step backwards to act as you are increasing the
focal length.

Done by :
Mohamed Magdy Barakat