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Those troublesome occlusal shots

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         ‘Those troublesome occlusal shots’
         26        Industry Clinical                                                                        IMPLANT TRIBUNE | October 2008




                By Martin B. Goldstein DMD                                                                                             taken like this will need to be “mir-
                                                                                                                                       ror-flipped” vertically with image
            The following e-mail is typical of                                                                                         editing software to properly orient
         the trials and tribulations that doc-                                                                                         the arch prior to presentation.
         tors and staff encounter when                                                                                                    I hope these tips are helpful. Prac-
         attempting to add digital occlusal                                                                                            tice makes perfect.
         shots to their new patient exam pro-

                                                                                                                                         IT
         tocols.
            “My staff and I are still having                                                                                                   About the author
         problems with getting decent occlusal
         pictures. We even bought the newer
         occlusal mirror with an attached han-
         dle and the lip lifter. We already had
         mirrors, both large and small, with-
         out handles. It seems to be a problem
         with getting a good clear picture back
         to the second molars, and of course,
         the lower is even harder than the
         upper. We blow air on the mirror to
         clear the fog. Perhaps the problem is
         that the patient is not reclined back in
         the chair enough, or is not opening         Example of an occlusal mirror view.
         wide enough. Should we be taking the
         picture from in front of the patient, or   rors can slide through them rather      often helps to clear the field.               Dr. Martin Goldstein, a member of the
         from behind? We take it from the           than bump into them as they do with         Air is essential to defog the mirror      International Academy of Dento-Facial
         front. Gagging is a problem all the        the solid plastic retractors            and a bit of indirect lighting from the       Esthetics, practices general dentistry
         time. I need some advice.”                    It helps to pull the retractors up   overhead light will help the camera           in Wolcott, Conn. Noted as a Dentistry
            Occlusal images may indeed be           and out when shooting the maxilla       to lock in focus.                             Today C.E. Leader for the last five
         tough to get. Assuming your camera         and down and out when shooting the          Sounds crazy, but the wide end of         years, he lectures and writes exten-
         is properly set up, the following tips     mandible. This 45 degree tug will       the occlusal mirror goes in first, not        sively concerning cosmetics and the
         might help regardless of whether           expose the second molars.               the small end. (You’d be surprised at         integration of digital photography into
         you are using auto or manual focus            The patient is usually reclined to   what I see at my hands-on seminars.)          the general practice. A regular con-
         to take your occlusal shots. (Note:        about 30 degrees with the photogra-         Attempt to get the image as close         tributing editor for Dentistry Today, he
         manual focus might be more pre-            pher shooting from the front of the     to a perpendicular to the occlusal            has also authored numerous articles
         dictable with respect to magnifica-        patient. (If you are shooting with      plane as possible; the bigger the             for multiple dental periodicals both in
         tion and illumination, but auto-focus      manual focus, use 1:3 magnifica-        mouth, the easier it is.                      the United States and abroad. He can
         will certainly speed up the process).      tion.)                                      If I can’t get a good occlusal shot,      be contacted at martyg924@cox.net.
            It’s important to retract the cheeks       We often ask the patient to move     I’ll take quadrant shots to make up           His current speaking schedule can be
         when taking occlusal shots. Wire           his or her tongue behind the mirror     for this using a smaller mirror               found at www.drgoldsteinspeaks.com.
         retractors may aid the cause as mir-       when taking the occlusal shots. This        Finally, realize that mirrored shots




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