Monday, 26 December 2016

Upcoming dental Photography workshop

Upcoming dental Photography workshop
Address RH- 1, Gulmohar CHS,
Sector 6, Plot no. 89,
Kopar Khairne,
Landmark: Near Sanjeevani Hospital,
Navi Mumbai 400709
Course Fee : INR 17,000/- 
To register Click Here

Thursday, 14 July 2016

Think before your clicks part 2

This article has been co - authored by Dr. Bernie Villadieg0
Dr. Bernie B. Villadiego- DDS, graduated from Creighton University School of Dentistry in 1989 and went on to complete a general practice residency program at Los Angeles County/USC Medical Center. He established a private practice with an emphasis in esthetic and reconstructive dentistry in Chatsworth, California in 1993. An Accredited member of the American Academy of Cosmetic Dentistry, Dr.Villadiego is a graduate of several cosmetic residency dental programs at the Esthetic Professionals Dental Education Center in California. He is also a visiting faculty/clinical instructor with the Spear Education at Scottsdale Center for Dentistry in Arizona. He has also completed a functional/occlusal residency program at Texas Center for Occlusal Studies in Texas. An avid photographer, Dr. Villadiego has lectured on the use clinical photography for diagnosing and record keeping as well as the use of glamour photography in dental marketing

In part 1 of “THINK BEFORE YOUR CLICKS” we addressed a few reasons like DISTORTION, NOISE, LACK OF RECORDING ACCURATE COLORS/SHADE, LACK OF RECORDING IN RAW FORMAT etc. as to  why mobile phone photography is considered as substandard for dental documentation.This article in association with Dr. Bernie shall put light on other problems related to mobile dental photography. 

Apart from high quality images a DSLR gives us a huge flexibility when it comes to attaching a wide range of lenses and accessories like high end flash systems and diffusers which have become an integral protocol to record high quality dental images.
Many clinics are now equipped with STUDIO LIGHTS (STROBES) which you might have seen in a professional photo studio while making family portraits. Yes the ones with a big black and white softbox attached to it. (Yes they are now being highly recommended for dental photography!!) Every wondered why they keep 2 Studio lights 1 on either side at 45 degree? It is because this gives the best possible natural effect to your skin tones and the light looks much more natural.
It is a good idea to remember one golden rule:
When the light source is upfront the images are always FLAT and loose dimension as well as a 3 D effect.
Examples of such light sources are: In built flash of a DSLR, RING FLASH etc.
A good image is not just a play of Light, but light and SHADOWS play a vital role in giving the subject a third dimension. Without shadows the image is too flat to appreciate depth.
Why this is important in dentistry?
Well, even in dentistry we want light and shadows and NOT LIGHT ALONE.
Line angles, point angles and buccal convexities are supposed to have a good light reflection whereas embrasures (especially gingival embrasures) are supposed to have shadows in them so as to give a good 3 D effect to our images. 

This is where a TWIN LIGHT system comes into picture for dental professionals.
Be it Canon (MT24EX) or Nikon (R1C1) Twin light is the IDEAL light source for dental documentation because they are positioned laterally which give a more natural and pleasant effect to our images. They illuminate the line angles sharply and give subtle shadows in embrasures. Moreover they can be twisted and turned in 3 axes so that the light source can illuminate the area of concern accurately.

We can also add diffusers/ soft boxes/ reflectors/ bouncers onto the flash to make the light more soft so that we can even appreciate the surface textures and shades better.
It is time to ask can we do this in MOBILE PHONE PHOTOGRAPHY. Certainly not!
Mobile phones give you NO SPACE to add accessories. Now a days we have seen macro lens attachments for mobile phones which are nothing but a piece of poorly designed glass and it just deteriorates the image quality even further. 


It is practically impossible to record the colors/ shades accurately if you do not have custom white balance settings in your camera. Together with the help of a NEUTRAL GREY CARD and custom white balance settings in a DSLR we can come extremely close to the actual Hue, Value & Chroma of a tooth which is impossible in a mobile phone.

Besides like already discussed in PART 1 LED lights in a mobile phone aren’t color corrected and hence they make the worst light to use for dental documentation.
They are too feeble and hence ambient (available) light effects are easily recorded. Available light like the chair light of your set up can badly affect your images in mobile dental photography.
One may buy extra LED panels but even they can be mounted and is to be hand heled or mounted on light stands making the use very cumbersome.


Almost all international journals and associations/ institutes are extremely careful about privacy. They not only want to confirm that the documentation is your own but they need all the METADATA (EXIF) data which now a days also has your GPS coordinates that confirm the case / documentation has been done by yourself.
AACD uses raw images to prevent fraud in documentation protocols and examination.

There is NO provision for recording a RAW file in mobile phones.
RAW files are digital negatives and can be opened by specific software’s only hence much more protected.
RAW files are lossless compressions of the original image captured by the sensor. JPEG files on the other hand are compressed to more than 5 times and hence do not have adequate details.

A DSLR when used can shoot both RAW+JPEG files at one go. This is in fact the recommended setting for documenting our dental cases. 


The BIGGEST drawback of using a mobile phone for dental documentation is the lack of a STANDARD called magnification ratio.
This function is ONLY available with MACRO lenses where in you set the magnification first ( e.g. in anterior aesthetic cases as per AACD guidelines we have to set a magnification of 1:1 or 1:2 first and then record our pre and post-operative shots)

In the above image of a 100 mm macro lens MAGNIFICATION ratio is seen in YELLOW font and when the focusing ring is rotated the magnification ratio changes. One can set the desired magnification first and then shoot. This gives greater standardization with respect to image composition which is impossible using a mobile phone. When one standardizes the magnification ratio he also standardizes the distance from which the image has to be taken.
This increases the chances of pre and post-operative images looking same. 
An example of standardization of composition using a single magnification ration of 1:1A picture collage makes it easier for the viewer to relate to the case and summarize the entire protocol. Watermarking with your name is a must to prevent theft of images and prevent copyright issues. 


It is not a good choice to use mobile phone documentation in dentistry for all the reasons discussed in the article THINK BEFORE YOUR CLICKS.
It might have limited use to communicate a surgical procedure to your patients/ colleagues, short margin of crown to your lab etc. but it is to be kept at an informal level among peers only.
There is NO COMPARISON of a DSLR and a mobile phone for documentation.
Aesthetic dentistry has NO ROLE of mobile phones in documentation.
A valid advice would be “Use your phones for communication not documentation.”

Sunday, 26 June 2016


Can we really use mobile phones for professional dental photography?

It is no secret that mobile phones are an important part of our lives. The first thing that most of us do when we wake up in the morning and the last thing we do before retiring  is usually check for any message from colleagues/family or probably google for something online. Mobile phones, internet to be precise have made a huge impact in our lives and this includes our professional lives as well.
It wouldn’t be wrong to say that they have become an indispensable tool for continued dental education, with so many WhatsApp groups and Facebook groups taking part in mutual exchange of vital information including sharing of case reports. With the use of a single phone and internet one can surf innumerable videos, audio blogs, scan articles, presentations, and attend LIVE webinars / whatsappinars as well. Never before did we have so much power in our hands when it came to procuring information.
The biggest reason for it to become so popular is that it is extremely handy, always available and capable of outperforming what it is actually meant to be used for. One such use is photography which it is of course capable of and has already outperformed many digital cameras of the past due to enhanced technology but we as a dentist have to understand weather it is time to restrict ourselves or go with the flow. This is because we have particular standards that we need to follow when we document our cases which do not imply to a hobbyist photographer. This problem has arisen because the protocols haven’t been openly discussed in the past.  The dentists aren’t aware about what standards are needed to be followed before making a good documentary.
“There comes a time when you have to choose between turning the page and closing the book.”
This article intends to open up the horizon of thought process that a dentist must be informed about before taking the next image with a mobile phone or a DSLR.

BASIC expectations from a camera that can be used for dental photography

In order that a camera can be used for dental photography it needs to satisfy some basic requirements.
In order to understand these basic requirements we need to ask ourselves the following questions about our expectations and answer them truthfully.

For a camera to be used for professional dental photography …
  1. Should it record distortion free images OR would you be comfortable with distortion in your images? An example of distortion for a better understanding would be as follows:
    Difference between mobile phone and DSLR photography

    IMPORTANT: ABOVE IMAGES ARE OF THE SAME TYPHODONT. Image on the left looks more like a Horse Jaw (Horse Jaw effect due to Distortion caused by wide angle lens) Unfortunately we have accepted the left image to be normal because we have never seen what ideal situation must look like.
    A distortion free image on the right looks exactly as it is in the patient’s mouth.

    1. Should it record true colors or incorrect colors are acceptable?
    2. Should the images be free of so called Visual NOISE or noise and poor quality are acceptable for your documentation?
    Below is an example of Noise: They typically look granular and make images blurred when image is blown up in size (cropped). To appreciate NOISE one must view the image in 100 % view. Images with noise must never be used for publications

    Compare the above mage with the image below.
  3. MINIMUM to NO NOISE in DSLR cropped image
    1. Should the images be affected by ambient (available) light (e.g.: dental chair light/ our clinic lights set up like tube light or LED) which keeps on changing every time both in color temperature and intensity when we make an image OR irrespective of ambient light we must get consistent results with our image documentation?
    2. Your camera is such that it shoots only in JPEG format and virtually removes all chances of publication OR would you prefer having a camera which also gives you a RAW file also called as digital negative which is mandatory for all international level publications?

    Our main aim as a dental professional would be to record any given situation as it is in the patient’s mouth without any digital modifications.

    Hence if your answers to the above questions were:

    1. NO DISTORTION in images
    2. TRUE COLORS must be recorded
    3. NO NOISE IMAGES for the best publication quality
    4. IMAGES MUST NEVER BE AFFECTED BY AMBIENT LIGHT (Only then pre-operative and post-operative images will match for a given situation)
    Its time you switch to a DSLR because mobile phone cameras are worst at it.

    GROUND REALITY and true facts hidden behind the scenario

    It is of various types and known by various names most often referred to as BARREL DISTORTION which is most significant and obvious.
    All of us must have heard of fish eye effect distortion as well.

    Distortion & focal length of a lens are related to each other as follows
    DISTORTION is inversely proportional to focal length of a lens
    This means that at lesser foal lengths (like in case of wide angle lenses) distortion is maximum and at telephoto focal lengths (focal length more than 50 mm) distortion goes down.
    (E.g.  For an 18-55 zoom lens which comes free with every DSLR camera at 18 mm focal length distortion is maximum and 55 distortion is minimum but never the less distortion is present even at 55 mm focal length)

    It has been observed that at 100 mm distortion is minimum or negligible

    If you have ever seen the DETAILS or properties of ANY image clicked by your own mobile phone camera you might have realized that their focal length is between 2 to a maximum of 5 mm. (Depending on cameras of different makes) this makes it to the extremes of wide angle lenses and hence they exhibit maximum distortion.
    (For people who want to dig deeper into the matter the mobile company shall say that it is equivalent to approximately 35 – 40 mm focal length of a 35 mm camera, which though might be true, is still way behind the desired values to avoid distortion.)

    Compare this with a 100 mm macro lens which virtually gives you ZERO distortion.
    Hence always insist on a 100 mm macro lens for dental photography
    100 mm macro lens

    1. The image processors and sensors of a mobile phone camera are far too inferior to detect and record true colors. As compared to that a DSLR has a huge dynamic range and is capable of not only detecting and recording true colors at appropriate settings but is extremely efficient with HUE, VALUE AND CHROMA.
    2. Mobile phones usually work with compromised settings of exposure pyramid with less than normal shutter speeds, high ISO and low aperture values. This is possibly the worst combination of settings and one has very little control over the same. This results in HIGH NOISE images. Most of us don’t realize this because all these settings are automatically controlled by a meter which in itself is highly inaccurate in a mobile phone camera. Moreover megapixels are just a marketing gimmick that most of us fall for.

    3. Mobile phone LED lights are the worst lights possible for dental photography because they aren’t color corrected, they are upfront, they aren’t flash lights but continuous source LED’s which are possibly the worst lights to work with and lastly they aren’t powerful enough to give you freedom of desired settings for dental photography. It is due to these reasons that mobile phone photography is easily affected by ambient light like dental chair light, fluorescent light or CFL/ tube light of clinic etc. This is NEVER the case with DSLR cameras because their flash is extremely efficient for all our dental photography requirements. There are always higher chances that pre and post-operative pictures will match with a DSLR.
    (NOTE: YES dental chair side light doesn’t affect DSLR photographs provided you know how to manage the settings well. Hence it doesn’t matter if the chair light is on or off during documentation.)
    1. Lastly DSLR gives you the ability to STORE DIGITAL NEGATIVES of every image that you click and it is called as a RAW format file. Just for comparison if a JPEG file of an image is of size is 5 Mb the RAW file is usually close to 22 Mb which means that it has way more information compared to a JPEG format file. RAW files on the other hand are privacy protected and need a special software to open them and hence considered as one of the most secure formats. They have all the METADATA in them including your copyright signatures which can NEVER be changed. In recent time’s publication make it a point to ask for a RAW file along with jpeg files to confirm if the content is actually owned by oneself or downloaded from internet/ stolen. RAW files have higher medicolegal values unmatched by LOSSY JPEG files. Jpeg files are possibly the worst files to work with. They have already lost a lot of information and can be easily stolen, downloaded and photo shopped.

    Thus it is important for every dentists to know all these finer aspects of dental photography to make an informed decision.
    Does mobile phone photography even stand a chance in front of a DSLR? We shall discuss more on this topic in PART 2. THINK BEFORE YOUR “CLICKS”
    For any queries or suggestions you can feel free to write to us on
    For more interesting articles on dental photography please visit our website
    Dental Photography School is India

Thursday, 3 March 2016

Ideal technique of shade matching, recording, processing and communicating in dentistry and dental photography

Ideal technique of shade matching, recording, processing and communicating in dentistry and dental photography

No matter how hard we try it is extremely difficult to capture the true colors of teeth as we see them ( as per the technology available today – NO CAMERA of the world is capable of recording true colors and that to consistently)

■Even the best cameras can go wrong
■Despite using fully manual settings colors might show some alterations in pictures taken at different times'

The way out? 

■The only way to record colors consistently or at least reduce the errors in recording colors is by
■DOING COLOR CORRECTION (in a software) to remove any faulty color casts that occur due to flash light, angle, exposure settings, white balance settings etc.

What is a Grey Card?

■Its is a simple card which is grey in color but manufactured using a very high Quality Control protocols and printed using the best technology available
■It is used by some of the best professional photographers of the world during commercial shoots where colors hold prime importance
■It is essentially 18 % GREY
■Dental Photography grey cards are usually credit card size and autoclaveable
■They last for a life time
■The almost never loose color if maintained and preserved cautiously

Logic behind a grey Card
■All cameras meter in a manner to achieve MID TONES
■This mid tone is essentially neither too white nor to black
■This is the aim of metering for every camera – to achieve a balance between not too white and not too black
■Now neither too white or neither too black is essentially GREY
■This means every camera sees in GREY during metering or aims at achieving a neutral 18 % grey 

How does a grey card fit in for shade match in dentistry?

■When we do shade matching we keep an 18 % grey card within the confines of the image we are composing
■Essentially what we are doing by this is that … we are ready to tell our image processing software that in the image we have an area which is 18 % grey

When we import this in image processing software like Adobe Camera RAW

This is how it works and removes any color cast
As you can appreciate in the after image … there is a HUGE difference in the tooth color after color correction
■This technique can be applied during lab communication by dentist or by lab as well
■During Composite buildups
■And other aesthetic procedures as well
■Note that the images which were opened in ACR (Adobe camera RAW) were RAW files which are way more accurate than a JGEG/ JPG file hence color corrections are more accurate
■Software like Picasa must be avoided

Can this technique be used for mobile phone images? mobile dental photography?

■Yes although mobile phone images are least accurate this technique still works …. All you need is an authentic 18% grey card (available with, )
■Jpeg/ jpg images can be corrected with this technique
■It is a very simple technique and can be done by labs , ceramists and assistants as well. 
CARE HAS TO BE TAKEN that light does not get reflected from the grey card back onto the camera … if this happens the card will appear silver and not grey. Keeping the card at an angle to the lens would be a good technique to avoid this mistake

Equipment used for this write up
Canon 6 D DSLR
100 mm 2.8 macro IS lens
67 – 58 step down adapter
MT 24 EX Twin Flash
Standard diffusers for flash
18 % Grey Card