We began our consult appointment by asking Sharon what questions she had from her previous visit with us. Without hesitation she said that she was excited to see her photographs, the first of which was already on our consult room computer screen. Sharon said she anticipated that she would get a “better perspective” of her current condition. Before we began to look at her photographs and the models that I had prepared, I shared with Sharon my feelings of nervousness. I shared with her that I was fearful that the best opportunity that I saw for her might be more than she anticipated. I wanted permission to share a plan with her, but I didn’t want her to be overwhelmed, never to return. Sharon chuckled with glee at my honest concern. She knew that extensive measures were necessary to get what she wanted. I could immediately feel my own tension disappear as we looked at her first photograph together.

 

I have discovered that I am most successful in helping patients move from a crisis orientation to a health orientation when they have ownership in their current condition. Although it sometimes takes many “touches” in order to earn the right to care for people, the tools that I use to develop this ownership can influence this timeline. In my career, I have found the use of clinical intraoral photography to be my most powerful tool to increase awareness and develop this ownership. While my learning of appropriate skill sets in these areas have certainly taken separate paths, I have noticed that as my photography has improved so, too, has my skill at helping patients move toward health.

 

With correct technique, nearly every area of the mouth can be clearly viewed. I still remember trying to show a patient a shadow of decay under a silver filling of a posterior tooth with a hand held mirror. The patient obviously could not see what I was trying to describe. Not only was the patient frustrated that they couldn’t see it; I was frustrated that I couldn’t show it to him better. Of course, with excellent photographic images, this experience is now infrequent. Additionally, an image helps people see things in the way that I see them. During our clinical exam I will intentionally describe to my assistant, Vicki, what I am seeing in words that my patients can understand.

 

Although Vicki may record what I describe as a fracture at the mesial marginal ridge, I describe that I see a dark line that moves away from the front edge of an existing silver filling. When the patient sees a photograph of this area in our follow-up consult appointment, my description will have been consistent with what they see. It has also become clear that people can more easily accept themselves in a photograph as opposed to a mirror.

 

Some dentists believe that they can get engagement with a still image from an intraoral video camera. My challenge to them is to recognize the phenomenon that an image from an intraoral camera shows detail of usually one tooth. If your goal is to move from single-tooth dentistry to a more comprehensive approach of the total masticatory system, an image that moves towards visualizing a quadrant, or better yet an entire arch, is more helpful in this regard. Our patients can more easily see how different areas of their mouths relate to each other if we help them see a “bigger picture” perspective.

 

 

As you take a photographic tour, I do not suggest that your focus be narrowed to only pathology; the opportunity exists to compare areas of health with areas of concern. If you are concerned about a patient’s periodontal situation, for example, show him/her an area that they are maintaining well and compare it to an area that could be improved. Help the patient understand that your intention is to partner with them so that all areas of their mouth will have the opportunity to be just as healthy.

 

Considerable emphasis in dental marketing is based upon using the right scripts to “sell” dentistry. I realized early that this mentality did not fit with my temperament or my values. I do not want to be a salesman. I do not want to be guilty of being one of those people that tells patients what they “need.” My role as a dentist has become clearer because I want to be a partner with my patients, a facilitator. I want to hold out possibilities for them and sit side by side as we put together a plan that meets their wants, desires, and values. With photographic images in a digital forum, we can easily take a tour together that meets their objectives. (The old ways of teach and tell versus new models of partnership, engagement, and empowerment)

 

I find that a majority of my patients are engaged at a high level with the use of photography. I have also learned to not be discouraged when I have someone who communicates through words or body language that they have little interest. It’s important to recognize that the patients in our practices have different learning styles and will therefore desire information in different ways. When Vicki and I prepare for a co-discovery appointment, we have available the models, radiographs, clinical charting and the photographs. Sometimes, with permission, we use all of these tools during our time together. Sometimes we use them sparingly or not at all. I believe it is important to let our patients guide their own discovery process in a way that honors their learning style.

 

Sharon guided the rest of our time together as she used the mouse herself to scan through the photographs that we had prepared for her. We paid attention to the photographs that she thought best showed her current condition while talking about the opportunities that I thought were possible. Our plan developed during our conversation to include a multi-disciplinary approach to her care with orthodontics, perio-esthetics, and implant and restorative dentistry. At no time did I feel like a salesman “selling” dentistry. My feelings were more about pride in my team’s ability to partner with Sharon. From our first contact with Sharon over four years ago to the present, our team has helped her create ownership for herself, and she has now truly developed an appreciation for what is possible.

 

If you would like to learn more about how to use digital photography in this way, please consider enrolling in The Pankey Institute’s digital dental photography course. You will gain the confidence and skills to step up your practice effectiveness through imagery.