dental photography | photographic protocol in dentistry
Good case studies are better than any marketing
Photo protocol in dentistry is a demonstration of respect for patients, the main contribution to a trusting and transparent relationship.
Christian Kotchmann was the first to introduce the possibilities of dental photography for dental treatment planning and showed us the possibilities of portrait photography for presenting a future smile.

This article was originally written by me in 2021, and you have to admit that a lot has changed and I wouldn't put such a big emphasis on professional digital cameras now. Now, in 2023, I will update it with material on mobile dental photography.
cell phone photo report
The reasons why digital cameras have succumbed to cell phones are simple and clear to anyone who has tried shooting with a DSLR in manual mode, and even with external light. Every time you change location, the camera and light settings need to be adjusted. It happens not infrequently, a client sends me photos for publication on the site, and they are not sharp, or dark, or on the contrary lighted. The doctor did a total work, filmed the result, but the focus was not in, and that's it, we have to reshoot. It is actually difficult to handle a camera.
Therefore, let's leave the section about cameras to advanced enthusiasts, and look for a simpler solution.
Now when it comes to preparing cases for the website and organizing photo proofs I send my clients a different list of techniques to buy, about 3 times cheaper.
So, I'm going to give you the gist of it, based on my personal feelings. I am a practicing dentist, so I hope that my review will be useful to my colleagues. I ordered this flash without any super expectations, because I do not take such purchases very seriously. I was just curious. It turned out to be a great flash. I take photos of patients' mouths with my regular iPhone 11, but the photo quality was amazing! I will attach a photo of the teeth to the review so that potential buyers can look and decide for themselves. This is the phone + flash. I did not use the lens for macro photography.
In general, the thing is interesting and convenient. But by and large it is useful only due to the bulbs. I would not say that the photos without and with a macro lens are very different. Though if to be picky, perhaps with the objective lens is sharper. But, for example, distal teeth, and even in a mirror with a macro lens, to take a picture will be problematic, because for focusing requires too small distance from the object to the lens. In my opinion, all this design has a place only until you have money for a normal DSLR with accessories) The design looks and feels quite strong and reliable.
from Aliexpress
It is very important to avoid brightly colored objects in the frame.
Purple gloves, blue retractors, all of these reflect light and change the shade of the teeth in the photo. Therefore, use only monotone, black, white or beige retractors and gloves!
As soon as a colored object appears in the frame, the white balance shifts and these photos lose objectivity.

Portrait photography



What do we need for a portrait shoot?

camera
Shooting conditions with external light sources are easy, technically any camera from 500$ to 2500$ can cope with them. Still, I bought a professional full-frame Nikon D750 camera for myself. This is a professional camera of the last generation. It is sold on the secondary market at a very favorable price of about 70 000 p. The model that came to replace it - D780 costs about 150 000 rubles.
The plus side of the camera - it gives a great picture and instantly focuses and it wants to use it not only in the portrait, and to shoot on it the whole life of the clinic.
Minuses - the body of a professional camera is made of magnesium alloy. It weighs a lot, and it will be hard and uncomfortable for a girl therapist to work with such a camera.
new D780 -1 600 €

portrait lens
It is important to realize that it is not the camera that paints the picture, but the glass - the lens. It is better to buy a simpler camera, but choose the perfect glass.
The best choice for Nikon is a portrait macro lens with a fixed focal length of 105mm. The same macro lens that you use for intra-oral shooting is also suitable for portraits. I bought it also on the secondary market for about 600 €

pulsed light
We need soft fill light on both sides. For this purpose, we install two medium-sized softboxes at a distance of 0.5 to 1 meter from the patient.
The light sources can be 2 studio monoblocs that are mains powered. Or 2 portable flashes that are battery powered. The second option is convenient because it does not require power from an outlet.
light sources for portrait photography

2 studio monoblocks
You can buy a ready-made studio equipment kit that includes everything you need including tripods and a synchronizer.
Pros:
instant charging
large softbox
Cons:
take up a lot of space
require mains power

2 on-camera flashes
You can use camera towers as a light source, their advantage is their compactness and the fact that they are not tied to the network. The disadvantages come from the same points. Smaller softboxes don't have as nice a light pattern and take longer to recharge between photos.

2 portable monoblocks
In my opinion, the most convenient option combines the pluses of the previous two. It is as fast and powerful as the studio source, it is connected to a large lightbox, and it is powered by a powerful replaceable battery and does not need wires.
The manufacturer does not offer a ready-made kit, you need to buy two pulse sources, 2 tripods, 2 lightboxes and one synchronizer.
Camera settings
These are the settings that you can set from the beginning and will need to change depending on the strength of the light source and its distance from the object.
F ≈ 20-25
1/160
ISO 100
dental photoprotocol

All patients go through a checkup with a therapist, let's find the easiest and fastest way to take pictures for them.
I deliberately separate approaches to dental photography for different specialists. They have different requirements and there is no need to burden the therapist with complexities that he or she does not need.
Introducing protocl in the clinic practice is not an easy task. It is an agreement that all treatment will now take 20-30% longer. And not every doctor will meet this proposal with enthusiasm.
If a general practitioner is told to accompany every treatment with a detailed photoprotocol, he or she will refuse.
But if the photoprotocol is effortless and can be conducted by an assistant, its introduction into the clinic will be easier. Objectively, photoprotocol does not require medical education, it can be conducted by any neat person. Therefore, I think it is appropriate to assign this function to an assistant. Look at it also from the point of view that for the assistant, participation in the photo protocol raises its significance and importance. An experienced doctor will see it as a waste of time. Use employee motivation for the benefit of the whole.
The difficulty of taking pictures with a professional camera scares doctors away. Its settings are easy enough to change, just scroll one of the rings on the camera and the picture becomes dark or over-lit. Working with a pulsed light source is not easy either, because you don't see the final picture until you take the shot, and then it takes time to correct the camera or the light source. Also, please take into account the weight of the camera and the fact that the therapist is often a girl.
If I were a therapist, for all my love of cameras, there's no way I'd be shooting with one, I'd be using a smartphone.
Just one thing to solve, finding a good source of constant light. In search of this solution, I found the Instagram of Yuri Gomzin, an orthopedist who organized the release of dental photography kits using a phone.

The cost of the set is 38,000 p.
Smartphone - 20,000 r.
Easy Length kit - 18,000 r.
When a therapist comes to the point where they want to take more than just documentary photos for the record, to take artistic photos, the cell phone will need to be put aside and look at how orthopedists shoot.
We are used to seeing beautiful pictures of orthopedists with beautiful ceramic restorations, but look at how the work of a therapist can be presented.
Look closely at the reflection on the enamel, you will see a large fill light source. Let this be another reminder that standard ring flash and bipolar are poor choices.
I guess we all know the maestro of composite restoration, Dr. Scherbakov, and I wanted to show you his Brazilian counterpart.
Orthopedic photoprotocol equipment
aesthetically demanding dental photoprotocol
There are many beautiful photos of ceramic crowns, but I have never seen such beautiful residual limbs as Vitaly Ivanchenko's. I think it would be superfluous to say how the patient's attitude towards the orthopedist changes when he has such photos.
Vitaly regularly conducts training in tooth preparation. I think he would make his course even stronger if he added information about how he takes such beautiful photos.
@stomatolog_31
Instagram of an orthodontist doctor showing a superior light solution for dental imaging
We have come to the topic of choosing a professional light for your camera.
The most important thing in any photography is light.
Look for your light until you get the desired picture.
I will now share my observations on those solutions that are available on the market, show you how bad the standard solutions are and how to come to a beautiful filling light.

Dental imaging in orthopedics is a key to the patient's heart that is not easily picked up.
Traditionally, dentists have been offered bipolar and ring flashes. In the slides below, I invite you to take a close look at how the pattern changes with standard sources and with increasing flash spacing and softboxes.
I see a lot of doctors working with ring flashes, but you have to realize what the reason for the widespread use of ring flashes is, it's all about price. They are simply the cheapest and give the worst picture. Perhaps for documentary shooting of a single crown this option is suitable, but as soon as you even slightly think about the aesthetics of the frame, you start looking for bipolar flashes and matching softboxes. And in my opinion this is something you should buy right away.
With bipolar flashes it is important to keep two factors in mind. It should be possible to spread them wider and mount softboxes on the flashes. Nikon has the DentalKit, and it has 2 bipolar flashes mounted rigidly to the lens with no way to spread them wider and they have small reflectors that act as softboxes. And we realize that this equates them with a ring flash. We look at the first two frames and we see a similar light pattern. To avoid this, it is important to have devices that will allow you to spread the flashes wider and install light diffusing softboxes on them.

The larger the size of the light source, the softer and more even light you will get.
As you can see, the most even fill light without harsh glare comes from spaced bipolar flashes. Let's estimate how much such a set will cost.

The cost of the light is 95,000 p.
PhotoMed R2 Bracket Original flash mount bracket - 35,000 p.
Nikon Speedlight R1C1 Kit bipolar flash units - 60,000 p.
Expensive kit, it can be made cheaper by changing the original flashes to analogs, the flash mount can also be assembled on other components. If you set such a task, the cost can be reduced to about 30,000 p.
But there is another way to achieve a beautiful fill light and much cheaper.

Usually orthodontists keep a photographic record to monitor the dynamics of treatment, but the quality of the pictures is usually far from ideal. The main problem is poor light and as a consequence glare and uneven lighting. Let's turn for an answer to one experienced orthodontist and see how he solved this problem.
I would like to introduce you to an orthodontist who has become a model of a young professional for me - Ivan Makarevich.
@makarevich.ortho
Instagram of an orthodontist doctor showing a superior light solution for dental imaging

сверху - кольцевая, снизу большой круглый софтбокс
As you can see the picture is very different. Many doctors get a picture like in the top picture, let's see how to collect the light that will give the picture on the bottom picture.
Remember, above we discussed how the size of the light source affects the glare and uniformity of the light. And here we can see even more vivid confirmation of this fact, which was shown to us by a huge source flooding everything with light. By the way, there is a high probability that the portrait with it will turn out beautiful.
Photo protocol equipment for surgeons
detail capture

Surgery has been my main interest during my time at ZimmerDental. I am happy to share three accounts with you as a source of creative ideas and inspiration.
There are many surgeons who are proficient in the photoprotocol. If you want to keep up to date with how surgeons are presenting their cases, join the Oral Surgery group. And I would like to draw your attention to doctors who have made photography more than just documenting cases. Surgeons who use light and shadow to create an eye-catching image, I would say it's a kind of art.

@dr.berberov
In addition to being a gifted surgeon, Georgi regularly runs dental photography courses specifically for surgeons. I have been to one, and in my opinion, it is an excellent practical course in dental photography for any specialist, but especially for surgeons.

@dr.georgedmitrievskiy
Georgy Dmitrievsky is a surgeon and an artist. His photographs are interesting both from the point of view of surgery and from the point of view of how he manages to photograph so beautifully.

@advanceddentalphoto
Denis Doroshenko is Mikhail Dzyuba's photographer, together they produce visually mesmerizing and clinically interesting shots.

The most challenging part of dental photography is shooting surgery. In sterile conditions, it is simply impossible to control the camera, direct the light and at the same time control the subject itself.
Therefore, for quality surgery photography, a third person, the photographer, is involved in the surgery. You should not demand aesthetic pictures from the surgeon. Anesthesia passes, there is a lot of blood, it is important to keep the surgical field clean, there are a lot of tasks, objectively, not up to photography at such a moment.
I would recommend you not to wait for the surgeon to pick up the camera, of all doctors it is the surgeons have the least time for this. You need good shots, ask the second assistant to participate. Absolutely all assistants should know how to operate a camera. When I worked at ZimmerDental and needed pictures from a major surgery, I would come to the surgery and take the pictures myself. And even in this case it slowed down the surgery significantly, because for a good shot I naturally asked the doctor to delay at the right moment, on the lap it significantly added time for the patient under anesthesia.
It is not necessary to photograph the surgery to show patients a clinical case. It is sufficient to take a good photographic protocol of the condition before implantation and after prosthetics and possibly show soft tissue healing. This will remove many questions from patients and encourage them to come to your clinic.

Try going the way of a patient searching for a clinic on the internet
Open the advertisements of clinics offering implantation and see how many of them provide their clinical cases. There are practically none! It does not seem strange to you to invest hundreds of thousands of rubles in advertising and show the patient models of implants, what any clinic can show.
And clinics can not show what really interests the patient, because they have not learned how to qualitatively conduct a dental photoprotocol.
What kind of light to buy
Let's formulate what criteria this light must meet.
Not too big.
Not fixed on the camera so that we can direct it.
soft, so that it fills the entire surgical field with light without shadows.
We will need two flashes with 15-22cm softboxes.

“before and after” on the website
Let me remind you that I build websites for clinics, and here is an example of how you can put a clinical case on a website.
And if you want to quickly and easily post your own clinical cases on the site, give me a call and I'll show you the amazing possibilities of filling your site without having to use a programmer.
How much does the camera and lens cost?
Dental photography for a camera is a very easy task. You don't have to buy a professional full-frame camera to do the job.
Nevertheless, I bought a full-frame camera for myself, the second one in my practice, because professional cameras are faster, more accurate, allow more in difficult conditions and I shoot everything on it, both portraits, interiors, and the plot, and complex surgical operations.
A good full frame camera gives you a feeling of permissiveness, it can handle everything, even when it's difficult. I got hooked on photography when one day I was given a professional camera with an expensive lens, and wherever I pointed it, I always got beautiful and interesting shots. Instant autofocus, sharp, colorful, with interesting blurred backgrounds, it seems you turned into a professional photographer in an instant. After that, ordinary cameras disappear, you only want to work with such a tool.
And then, I also did this trick many times, I gave a professional camera in the hands of a person and watched how the expression of his face changed, after that you don't want to shoot on average cameras and dark glasses.

Choosing a used camera and lens is best left to the professionals. I confidently recommend these guys as the best in the business.
Last generation full frame cameras are available now. The Nikon D780 has come out and the D750 has come down in price. It's just a great camera that used to be bought for $2000, but now you can buy it for $1000 off the shelf in good condition. I have such a camera and I shoot everything on it, and training events held by my surgeon friends, and a large 3-hour operation.

Nikon D750

Nikon D780

macro lens 105mm F2.8
If you use Canon and don't want to switch, please, Canon's lineup includes the 5D mark3, a powerful last generation camera that leaves all of today's mid-rangers behind.

Canon 5D Mark3

Canon 5D Mark4

100mm F2.8 macro lens
Camera light options
I'm sure you realize that any doctor can shoot with any of these light options. This is just a selection based on my observations of high level doctors. What helps them achieve a high aesthetic in photography.

therapist's light
Easy Ligth kit - 18,000 p

orthopedic light
PhotoMed R2 Bracket Original - 35,000 p.
Nikon Speedlight R1C1 Kit flash units - 60,000 p.

orthodontic light
Flash - 17 000 p.
Lightbox - 3 000 p.

surgeon's light
2 flashes - 35 000 p.
2 softboxes - 5 000 p.