October 6, 2017
With all of the technologies at the fingertips of dentists in the contemporary practice, the unsung hero of imaging over the years may be the intra-oral (IO) camera. As a clinical aid, patient education tool, and insurance documentation method, this imaging device has evolved into an important part of the diagnostic imaging armamentarium.
Intra-oral cameras have advanced in many ways over the years, with size being one of the most essential progressions. Dr. Gordon Christensen in an article for Journal of the American Dental Association noted that he was one of the “first to investigate the potential viability of intra-oral cameras as a tool for patient education and archival documentation of clinical procedures.” He explained that the original intra-oral television cameras were “basically endoscopes” adapted from other areas of medicine for use in dentistry and in their early days were mostly used by “academic dentists” rather than those in routine practice. Besides being expensive, these cameras were so large that they needed to be positioned on a mobile cart and were fairly difficult to operate.1
Even in their first generation of manufacture, intra-oral cameras were perceived as beneficial by practitioners because the image quality was generally good and intra-oral pictures could be archived. But despite that, some hygienists were reluctant to work IO cameras into the appointment protocol. Hygienist Tricia Osuna, in an article called Intraoral Cameras2 recalled, “The IO camera did not receive as warm a welcome from hygienists as it did from dentists because it was time consuming to use and bulky to move from operatory to operatory. I resisted it myself when I was first asked to implement it into my appointments in the late 1980s.” She added that although the practice in which she worked was considered progressive, “it was not as open to cha
nging the length of patient care appointments so we could adequately use that technology.” As a result, she only used the camera on patients if time allowed. Despite the size and difficulty of using these early units, she did acknowledge that the images helped to improve patient communication. She said, “I have realized over time that using it would have made my time talking with the patients much easier, and they would have accepted many more of my suggested treatments.”
As years passed, intra-oral cameras have become smaller, lighter weight, and more ergonomic. Image quality continues to improve because of technological developments and innovations. For example, the DEXIS™ DEXcam™ 4 HD provides highest definition available on the current market because of its 1.3 million pixel CMOS sensor. Image quality is also enhanced and distortion reduced by a precision 7-element glass optical lens. These cutting-edge technologies result in high definition images that are extremely crisp and true-to-color, and remain clear even when enlarged.3 For patient education, crisp and clear images can offer patients a realistic look at their dental condition, resulting in their realization that treatment is necessary. Osuna noted that verbally telling a patient about periodontal disease has far less impact than viewing a large image of “red, swollen, bleeding gums.”
Cathy, a Certified Dental Assistant, offered her experience with intra-oral images in an article by Dr. Ken Neuman of Vancouver, BC. She said, “From the patients’ perspective, for the first time they see what we see. It opens the door for better levels of understanding and education about their mouths. It creates instant trust, and communication flows along with questions, all-important in establishing a relationship. It creates a ‘wow’ effect in viewing problem areas and healthy ones. Many times, patients will tell us what they need. The camera is fun to use, comfortable, and painless.”4
Dr. Randy Shoup recognizes that getting patients to “take ownership” of their dental health involves helping them to understand the scope of their dental issues. He says, “No tool is more effective in creating the appropriate ownership attitude than an intra-oral camera. Every office should have and use one … When a patient sees the image of his or her own teeth on the screen, the ownership issue is 95 percent resolved.”5
Besides the positive clinical and patient education aspects, an intra-oral camera also can help with documentation by creating a clear history of improvement or decline of the patient’s oral health for the office records as well as image documentation for insurance carriers.
From the bulky equipment of yesteryear to today’s compact and portable devices that can fit in the palm of your hand, intra-oral cameras are a must-have for the patient-focused dental practice.