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Charles Payet

Smile Imaging – What Software and How to Manage Expectations

February 2, 2010 by Charles Payet

Here’s a question I received from a colleague by email recently, and it’s such a good one, it’s the perfect opening for a blog entry.  Thanks to Rich M. for asking (and I do welcome questions and comments, so please……leave a comment or send a question by email.).

Q: “One question on my list is whether you use imaging software in your presentations so patients can view current and proposed/expected outcomes.  I’ve been warned this could be a tricky area to get into due to a gap in patient expectations and actual outcome.  What do you say and what software for this purpose do you use (if you do use any)?”

A:  What we have here is really 2 questions; the first is about software and a “How-To-Do……?” and the second is about patient expectations if you do a computerized smile mock-up to show them what you think the outcome will be.  Let’s start with the software question first, because it’s actually the easier question to answer, although the technical aspect of making it happen is a bit trickier.

Software: If you want to make this process really easy on yourself, there are several pretty good services available that will do the smile imaging for you; while I don’t personally use them nowadays, I have used them in the past and gotten very good service:

  • SmileVision Lab
  • SmilePix 

This next service I have not used personally, but they are recommended by the DaVinci Lab, Dr. Woody Oaks, and others, so I figure they can do a good job, too.

  • SmileArt

This next service is actually a relatively easy one to implement in your office; naturally, there is a learning curve, but they offer pretty good support to get you up and running.  If I were doing more cosmetic cases these days myself, I’d probably go back to using this one, but I’m having more fun doing a ton of 6MonthSmiles Adult Ortho and Laser Periodontal Therapy cases.

  • Digital Dentist Cosmetic Imaging Service (The Lorin Berland Smile Style Guide/Library)

All these services have a very simplified set-up that you can implement very easily; the absolute easiest are the first 3, because all you have to do is take the pictures and email them; you usually get the completed Before/After Cosmetic Imaging back within 24-48 hours.  They offer a “Rush” option as well.

Here’s another significant benefit to working with both SmileArt and SmileVision:  they are both part of full-service dental labs with a focus on esthetic dentistry.  Therefore, they can help not only do the Before/After Imaging, they can actually provide the crowns/veneers/bridges/etc. to bring the case to a successful conclusion.

That said, what software do I personally use nowadays?  Well, if anything, I use Adobe Photoshop CS4.  This is a program I use almost daily as a photographer, so it’s what I’m most comfortable with, and I know how to do the things that most patients want to see imaged.  However…….for most dentists, unless you’re really serious about this, I do NOT recommend you go this route, because it has a VERY steep learning curve.  It also does require the most time.

Since this post has already gotten a bit long, I’ll answer Part 2 of Rich’s question, about managing patient expectations, in my next posting.

Additional Sources for Digital Dental Photography Education

January 28, 2010 by Charles Payet

While my goal is, naturally, to provide practicing dentists with virtually everything they need to know to seamlessly integrate digital photography into their practices, there are obviously many colleagues who’ve done a great deal of work in this arena already.  Among those is certainly a dentist whom every dentist should know: Dr. Frank Spear.  Besides being a terrific teacher and phenomenal practicing dentist, he has put together a long series of DVDs on topics that cover about everything you could want to know in dentistry – including photography.

With that in mind, I’d like to HIGHLY recommend that you take a look at his website, www.SpearEducation.com.  Talk about one incredible resource!  He has a series of DVDs devoted to photography, and they provide practical tips and techniques on everything, including color management of your printer and monitor (extremely important for shade communication to laboratories in demanding cosmetic cases), case presentation, and more.

Check it out!

Keep It Simple, Right?

January 10, 2010 by Charles Payet

When it comes to taking pictures for dentistry, one of the most common questions I get is along the lines of, “How do I know which settings to use for the different kinds of pictures?”  Since most dentists, as well as their staff members, are not professional photographers, the DSLR cameras I recommend often seem big and really complicated.

Here’s the truth: once you get the basic settings written down and memorized, there will only be ONE setting that you have to change on the camera body, which basically means that the big, complicated-looking, fancy camera you’re holding will be turned into a POINT & SHOOT camera, and about everyone can deal with that. 

So what settings do you need to use?  Using the KISS Principle, here you go:

FULL FACE:

  • ISO 200
  • Shutter speed 1/200
  • f-stop f/8.0

EVERYTHING ELSE:

  • ISO 200
  • Shutter speed 1/200
  • f-stop f/25

 As you can see, the ONLY setting you really need to change of the 3 is the f/stop.  See, I told you it would be easy!

Soon I’ll be giving a more detailed explanation of what those settings mean, as well as a few other settings to round out the complete list that you need to make dental photography truly simple.

4 Lens "Positions" for Dental Pictures with the Canon 100mm macro

January 10, 2010 by Charles Payet

In dentistry, there will typically be 4 “types” of pictures that you will take, regardless of the purposes for which you take them.  They are:

  1. The Full Face/Portrait
  2. Full Smile/Retracted Smile or Full Arch
  3. Quadrant
  4. Single-tooth (not very often except for endo)

When shooting each of these, I have found that there are certain “positions” of the Canon 100mm f/2.8 Macro lens that approximate these consistently and easily.  Remember: DO NOT HAVE EITHER YOUR LENS OR CAMERA ON AUTO; BOTH SHOULD BE ON MANUAL AND MANUAL FOCUS.  To make it nice and easy, check out these pictures, then download the “Cheat Sheet” for use in your office.

For a FULL FACE/PORTRAIT, position the lens like this:

For a FULL/RETRACTED SMILE and FULL ARCH:

For a QUADRANT or 1:2 Picture:

For a SINGLE-TOOTH:

I’ll soon have an equivalent set of pictures for the Canon 60mm f/2.8 macro lens, and eventually for Nikon and Sigma lenses.

RAW or JPEG for dental photography?

December 31, 2009 by Charles Payet

Here’s another thought that popped to mind this evening as I was playing with my new Canon 7D (oh god, how I love this thing already!), and it relates to 2 questions many colleagues ask:

1) Should I shoot in RAW or JPEG?
Simple answer to a complex question: UNLESS you are taking pictures that you need in RAW because you’re aiming for accreditation with the American Academy of Cosmetic Dentistry or a similar organization, I recommend you shoot in JPEG.  Why?  Well, there are no PMS (practice management software) programs of which I know that can handle RAW files; you need much bigger memory cards if taking a lot of pictures; RAW files do take longer to download; you need a lot more HD memory to store a large number of RAW files.  As a comparison:
     My work PC has roughly 44,000 pictures of patients that I’ve taken with all my digital cameras going back to 2002 (my first was an Olympus C2500L), and the My Pictures folder is approx. 130GB.  My home PC has approximately 20,000 pictures in the My Pictures folder, but because I shoot all my personal stuff in RAW, that folder is about 300GB!  So only 1/2 the pictures, but more than double the memory required.  And with the new 7D having RAW files of about 24MB each, that will increase fast!

While JPEG files do degrade slightly over time when opened and closed many many many times, with the current resolution of images, the likelihood that such degradation will be visible in your entire lifetime is practically zilch.  Ain’t gonna happen.  No need to worry about it.

If you ARE aiming for accreditation, why is it therefore important to shoot in RAW?  For a very simple reason: the RAW file is equivalent to a digital negative, and it is ALWAYS that equivalent.  Even if you edit it, the original is always there and can be recovered, so it’s impossible to “fake” pictures by editing them.  That way the examiners can be 100% positive that no-one is trying to sneak something by that was really Photoshopped.

2) OK, so I shoot in JPEG for intraoral/extraoral photography, what level of resolution should I choose?
Since JPEGs can be handled pretty easily by virtually any computer these days, and you can get a lot more pictures onto a card and HD, it makes sense IMO to shoot at the largest resolution (the “L” with the smooth curve next to it, not the steps).   Sure, you could shoot much smaller files, but what’s the point?  At some time you will probably regret having a lower-quality image that you can’t improve/upsize……but it’s easy and fast to take a bigger-than needed picture and downsize it.

Getting my new Canon 7D today!

December 29, 2009 by Charles Payet

Oooooooo, as a camera geek (who would love to have a LOT more gear than I do), I am very excited to (hopefully) be picking up my new Canon 7D DSLR today.  18MP, true 1080p HD video, ISO expansion up to 12800 with a VERY usable 3200 and 6400 ISO, the 8fps will be awesome for shooting my daughter’s competitive cheer events (Go Odyssey!)

As of right now, given the $1700 price tag, this is not a camera that most dentists will want for their office, and with the Canon T1i being a very good alternative for a much more affordable price (only $649), I am not recommending that you run out and replace any old DSLR you have for your dental photography with the 7D.

Unless you happen to be a photo geek like I am.  🙂

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