Charlie Ward, DDS

In this article, I’ll share how I save my Dental DSLR photos and choose between the file formats of RAW versus JPEG. There are specific reasons why we might need one format or the other, or perhaps both. I’ll also share how I store and protect my ever-growing collection of images. 

The Difference Between RAW and JPEG Format 

We have a choice when we’re shooting with our DSLR about how we want to save our files. On the menu of our camera, we see that we can choose between RAW and JPEG, and the quality of JPEG. When RAW is selected, all data that hits the camera sensor is saved. A JPEG is a processed image resulting in a compressed (smaller) file size.  

The data stored in RAW images can be 3 to 4 times more than in JPEG images, depending on the quality of JPEG you select on the camera menu. The processor in your DSLR camera will remove data from a JPEG image that it perceives to be imperceptible to the human eye. The greatly smaller size of JPEGS makes them universally preferred, not only for storage but for quick upload, download, and opening for viewing online. I routinely shoot high-quality JPEGs for diagnostics and routine lab communication.  

(If you are wondering what JPEG stands for, it’s for Joint Photographic Experts Group. Once JPEG images are in your computer, they can be saved as different file formats ending in different extensions such as .eps, .pdf, .jpg, .jpeg, .bmp, .tif, and .tiff.) 

If I take an image in both RAW and JPEG format, at first glance, the JPEG and RAW images may look the same, but on closer inspection, I may see that the stain on a tooth’s enamel or surrounding skin tones appear lighter in the RAW image. The camera itself has processed the image and determined that some of that data is unnecessary.  

When to Shoot RAW Images 

For most of what dentists do with our DSLR cameras, JPEGS are fine. There are three situations when we should choose to shoot RAW images. 

1. When we want to edit images like a professional photographer. 

1. When we shoot images for accreditation for the American Academy of Cosmetic Dentistry. The Academy requires images in raw format so they can tell that the images have not been edited.  

1. When we are using a digital shade matching system like eLab or Matisse that requires RAW input. 

Why Shoot Both Versions When You Want RAW 

If you are storing CBCT and RAW images on your server, a lot of data can accumulate quickly. I shoot JPEG versions of the images I shoot in RAW format so I can delete the RAW files from my server when they are no longer needed and still have a case record with the JPEG files. 

Storage Tip: In my practice, we download the patient’s or the day’s images from the SD card on to our server in a patient folder. We have one main folder and within it a subfolder for each letter of the alphabet. Inside each alphabet letter’s folder is another subfolder labeled with the patient’s name for each patient whose last name begins with that alphabet letter. Inside each patient’s folder are appropriate subfolders, labeled for example, “Name-Prep-Date.” 

It can be very frustrating to take a series of dental photos only to realize there were scratches or watermarks on the mirrors when you review the images later on a computer. Cleaning mirrors without damaging them can be a challenge.

I happen to like the [chromium or titanium] coated buccal, lingual, occlusal and anterior contact Intraoral Handle Mirrors from PhotoMed®. These feature a stainless steel handle that keeps fingertips out of the photograph. And, if your patient is cooperative, they can hold the mirror to free up your assistant. All of the handle mirrors from PhotoMed are single-sided, autoclavable, and can be cold sterilized.

In my practice, we try to protect our mirrors as much as possible from scratches, because once they happen, there is nothing you can do about it. Watermarks, on the other hand, can be eliminated and also cleaned away.

To avoid watermarks, we always wrap our mirrors in a paper towel before putting them in the autoclave bag. To clean away fingerprints and water spots, we use premoistened lens cleaning wipes that are designed for cleaning eyeglasses. They can be purchased in bulk, and we find them economical, efficient, and effective in cleaning our intraoral mirrors for crisp intraoral photo images. We keep a box in every operatory, where they do double duty in cleaning our eyeglasses and loupes.

In my last blog, I discussed the possible scenarios that could occur when your patient answers their phone during an appointment. Now, I’ll explore how you can leverage smartphones to your advantage in your dental practice.

Leveraging Smartphones in the Dental Practice

Which scenario would you hope might happen with you the most? Are these all valuable experiences? Do you KNOW YOUR PATIENT more by observing each behavior? Do you KNOW YOURSELF more from your level of engagement and influence on the outcome? How will you modify your future interactions for each patient from what you have learned?

Let’s face it, for the past couple of decades we’ve had it easy. If we chose, a whole wall could be filled with charts of Baby Boomer patients. Boomers are everywhere in great numbers, most have comprehensive needs, most have the means to care for themselves, most have a high level of trust. It was an ideal patient population and still is.

Now we have Millennials. Frankly, they are initially a tough personality for more seasoned practitioners to relate with (we look at them like spoiled kids). The stark reality is that they outnumber Boomers and have plenty of dental needs. They are the future of our workload.

To relate with Millennials, they need information fast. They need to see to believe and establish trust. Fortunately, they have a camera in their pocket. Sure, I still take my full photo series and we keep the intra-oral cameras in our rooms, but when I see the slightest glimmer of doubt in a Millennial, I ask if they can open the camera on their phone. Then I pull out a photo mirror.

It’s almost as if saving the image in their device’s storage is connecting to their memory bank. They look at it several times. They text the picture to friends and post on social media. They seek validation. From cracked teeth to gingival needs to caries – for my millennials, seeing is believing. (Now if I can keep them off social media while I’m prepping their teeth.)

Here are two photos of a tooth that a skeptical patient refused to crown because there were no symptoms. The “just fill it Doc” attitude changed with two simple snaps on their phone using a mouth mirror.

To be continued …