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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-
“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 email@example.com.
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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