Dr. Mills: Hi. I’m Dr. Brian Mills from Mountain View, California. Today, I want to be talking to you about taking the basic bioesthetic photographic series. I hope what I have to show you today is helpful.
First, I’d like to start off with what we use. I happen to use two different cameras. The first one is a Canon Rebel. It’s a nice camera. I use this for the intraoral pictures. It has an intraoral lens and a ring flash. This particular setup can … you can get it from Photomed.net.
The second camera I use is also a Canon Rebel. This one is set up for portraits. If you notice, I have a diffuser up on top here. The diffuser you can get from GaryFong.com. He also has a complete portrait kit for doing nice portrait photography. It’s well worth getting. I think you’ll appreciate having that in your office.
Also, we’re going to be using retractors. There are basically two types. There are metal retractors, and we have plastic retractors. I prefer the plastic ones, but I’ve seen plenty of nice photography using metal retractors. Again, that’s a personal choice.
Last, we have a little black background here. This is by Smileline.com. It’s an excellent little tool if you want to just feature a particular area in the mouth. You’ll be seeing that, too. I’ll demonstrate that later.
Okay. Thank you very much.
Let’s start with what not to do. First, you don’t want your patient seated in a dental chair. Let me just go over why. When you’re taking portrait shots, you won’t be able to have the patient in a natural head posture. The headrest is going to interfere with how she positions her head and her neck and her back.
Secondly is that, when you’re taking your facial shots, if I have Julia turn towards me so I can actually see her face straight on, you notice that completely changes the musculature here, here and over here, so we’re not going to get a true representation of her head, neck and facial musculature.
Also, when we’re doing the retracted photographs for the intraoral, I’m going to have to have her turn towards me again, and it is almost impossible not to skew your pictures somehow. I’ve never seen a straight picture taken from a dental chair with it not being skewed to the side. The first thing you want to do is have the patient get out of the dental chair.
Let’s go ahead and start this way. Here we have our patient, Julia, seated. A couple of things that we want to notice is when you’re seating your patient. These are going to be diagnostic photographs, so, first of all, the hair. We have to be careful that we have the hair off the ears, so we will be able to see in here.
We don’t want sunglasses on or any kind of glasses. A lot of times, people just flip them up like that. You don’t want to do that either because it will interfere with your diagnostic photographs and, also, if you’d want to feature any of these photographs in a presentation, it just looks bad.
Let’s have Julia take the glasses off. The other thing, you don’t want them to be hunching. You want them in a natural head posture. How do you do that? Some people have them stand. I prefer them seated. It’s easier for me. You want them to just sit up nice and straight, and the eyes need to be level with the horizon. Okay?
Tip your chin up like you’re looking up.
This you don’t want to have as you can’t really see the profile properly.
Now, tip your chin way in.
It changes also her facial profile. You want her head up and looking straight into the horizon.
Just take it off your ears, thank you, and on the other side also. Okay.
The other thing you’ll notice is she has some small earrings, that’s perfectly fine. If they’re large earrings that have weight on them, they’ll distort this part of the face when you’re trying to take your pictures. So no earrings, no heavy jewelry, and no glasses.
Okay, so now we have Julia seated. We’re going to be doing our portrait shots. Just a couple of things as an overview, you want a nice background. Okay? Another thing, when you’re in the dental chair, you don’t have a good background for your portraits. I happen to be using a black felt background that you can purchase at most camera stores. This is one of the parts that come with the portrait kit from GaryFong.com. You can also use a blue background. That actually gives a nice look also. It’s a personal preference. Okay? So we’ll be starting our portraits now.
The first series of shots we’re just going to have Julia sit up nice and straight. When you’re framing your shot, you don’t want to have it too wide. You almost want to have it framed into your … how your final cut is going to be. The first shot, we’re just going to ask Julia …
Give me a big smile. Great. Now, gently, bite down. Don’t clench, but teeth together, lips together. Look straight. Thank you. Give me one more big smile. Great. Now, all you’re going to do, Julia, is you’re going to turn your chair 45 degrees. Look right into that corner. Turn your chair, and I want you to look straight into that corner. Sit up nice and straight, chin down slightly, lips together, teeth together. Give me a big smile.
Now, you’re just going to turn your chair 90 degrees. Look out the window for me. Sit up nice and straight, lips together, teeth together. Give me a big smile. Great. Now, you’re going to come back at 45.
This next shot, a lot of times you’ll want to feature a nice portrait shot, just not more like a mugshot. I found that, if you just have the patients sit at 45 degrees, have them turn their head towards me and then say something silly like, “I’m going to Disneyland,” and give me a nice, big smile. You’re going to find that it creates a really nice portrait for a final picture and also a before picture. I want to thank my friend Tim Leary for showing me that trick.
Now, let’s do the other side. Come forward. Now, you’re going to turn 45 this way. Look straight into the corner, 45 degrees right into this corner. Sit up nice and straight. Tip your chin down slightly, lips together, teeth together. Give me a big smile. Now, you’re going to turn 90 degrees. Look straight. Sit up nice and straight, lips together, teeth together. Give me a big smile.
Now, you’re going to come back at 45 degrees for me, Julia, and stay seated like that and turn your head towards me and, “I’m going to Disneyland.” There we go. Oh, nice. One more. Okay, and that pretty much completes our portrait photographs.
We’re going to start our closeup photography. We’ve changed cameras. The first series is without retractors. We’re trying to get a pretty good idea of the structure of the lips and the cheeks and this area of her face.
Julia, what I want you to do is just slightly just … I’ll sneak in here a little bit … Lightly touch your teeth together. That’s good. Tip your head up a little bit. Now, lips together, teeth together very lightly, no clenching. Now, lips together, teeth apart. Okay. Now, I want you … Next, you’re going to go, “Emma.”
Dr. Mills: Yeah, just go, “Emma,” and let your lips relax. The “Emma” is a great way, or you can go, “Duh,” but you want a reposed … the lips relaxed and reposed. You’re looking at the incised ledges here.
Dr. Mills: Good. Next, you’re going to go, “E.” Put your-
Dr. Mills: Big E, like cheese.
Dr. Mills: This will help to show teeth and if there’s any gingival issues.
Next, I want you to … the largest smile you can. Okay. Now, you’re going to turn 45 degrees, and we’re going to do the same thing.
Now, normally, you’re just doing the 90-degree picture, but, 45, we’re going to do the same sequence. Even though you might not need them, it’s better to have and not need than need not have. A lot of times, when you’re setting up to do your photographs, you don’t know how the case is going to turn out, you don’t know what photos you’re going to want to use to feature certain parts of the case, so it’s better to take extras. You can always take extras.
Okay, so same thing, you’re just going to go lips together, teeth together. Slight smile for me. Big, big smile. Say, “Emma.”
Dr. Mills: Say, “E.”
Dr. Mills: Now, you’re going to go 90 degrees for me. Okay? We’re going to do the same thing. Come back just a little bit. There we go.
By the way, when you’re doing your 90 degrees, and this is for that setup mainly for the portrait, but also to make sure they’re not overturned, you should be able to just see a bit of the far eyebrow. That means that’s a good position for them.
Okay, so same thing, lips together, teeth together. Tip your chin up ever so slightly. A slight smile. Big smile. Say, “Emma.”
Dr. Mills: Say, “E.”
Dr. Mills: Okay, so that’s pretty much our series. We can do the other side, too.
All right, now we’ll be placing retractors and doing the retracted series. One hint, for patient comfort, I’d wet these with some warm water. I have the patients go ahead and place those for me – if they’ve already placed them one time, they’re experts – and bite down. Then the other thing, I like them to hold it. First, it’s easier – it frees your hands up and frees your assistant. But also for comfort – they know how hard they want to pull.
Real simple, we’re going to be doing our intraorals here. One hint, you don’t want her tipped down too much because, if you’re shooting down on the teeth, you won’t be able to see the proper cusp form.
Tip slightly up. Good. Teeth slightly apart. Bite down again. Now, don’t take these out, but take tension off of this one and pull that one for me real … as hard as you can, and tip a little towards me so I can see.
Now, we’re going to be just doing a buccal corridor shot. Teeth slightly apart. Bite down. Now, tension off of this one. Pull that one. Bite down. Teeth slightly apart. Bite down.
Now, we’re going to be doing our functional positions. Again, I always just cue it up with “teeth together.”
Now, bring your teeth out edge to edge for me.
On this one, if you want to, you can go ahead and have them tension off of this one, pull this one so you can look.
Pull a little harder. Okay? Thank you. Tension off of that one. Pull that one. Bite down.
You have the patient reset before you do your lateral movements.
Now, go ahead and grind to the right slightly. A little bit more, and hold. Make your canines go all the way to the edge. Tip your head up ever so slightly. Bring your canines all the way so they’re tip to tip. Keep going. Keep going. Stop. Tension off of this one. Pull that one. Bite down. Grind to your left again and hold. Tension off of that one. Pull that one. Good job. It’s a very unnatural position, I know, Julia. You’re doing great.
Okay, bite down, and we’re going to do the other side, so grind this way. Perfect. Hold. Tip your chin up ever so slightly. Relax your tongue. Tension off of that one side and pull. Good. Tension off of the other side. Okay, and take a break.
Okay, we’ve given Julia a little break. Again, you want to consider patient comfort when you’re doing these.
Julia, if you could please put those back in, the retractors?
Our next shot is going to be the sagittal occlusal view, which shows us cusp form. How we set that up is you have your patient turn at 45 degrees.
Tip your head up.
For me, I found it easier if I come down a little bit and kneel because you’re going to be shooting up at the teeth at this angle.
Open as wide as you can, as comfortable. That’s about it.
Our next shots are going to be the occlusal shots. On this, you want the patient to slightly roll the retractors down when you’re doing your bottom, and you’re going to be coming in at a little bit of an angle like this.
Open just a bit. Okay, and now tip your head up and roll those slightly up. Thank you.
Our last series will be the mirror shots for the maxillary occlusal and mandibular occlusal.
Julia, if you can put the retractors back in?
Now, what I’ve done is I’ve put … warmed the mirror with some warm water and dried it. It’ll help from having it fog.
Instructions for Julia, roll the retractors up. One, two, three, hold your breath. Take a rest. Now, we’re going to do the bottom ones. Same thing. Ready? One, two, three, hold your breath. Okay. We’re all done. Nice job, Julia. Thank you very much.
This isn’t part of your bioesthetic photographic series, but we talked about if you want to feature a particular area of the mouth, having a black background can give a very aesthetic photograph. This is that Smileline.
Julia, if you put the retractors back in?
We’re going to feature the lower anterior teeth. Here’s all what you’re going to be doing.
Roll those slightly down.
Just place this in the area you want.
Roll them down just a little bit more. There we go. Perfect. Okay.
You just place it like that. You want to take a couple from a few different angles. Just one more, and we are done. I want to thank Julia for being such an excellent patient this morning, helping us with this.
I hope that what you’ve seen today will help you with your level 3 photographic assignment, and I want to thank you very much. Take care.