A digital mouth tour!

Oct. 1, 2003
"Hold still ... wait ... OK, smile! Wow! Come over here and look at the picture I just took of you. You look so good!" It seems everywhere I go somebody is using a digital camera.

"Hold still ... wait ... OK, smile! Wow! Come over here and look at the picture I just took of you. You look so good!" It seems everywhere I go somebody is using a digital camera. What's that all about anyway? Do you own one? I do, and I absolutely love the instant gratification it gives me. I love the fact that I can just about take the perfect picture — after deleting all of the ones that didn't come out!

My desire for instant gratification doesn't stop there. I now use an intraoral digital video camera inside my operatory. And guess what? It is truly fun! With increasing frequency, I hear of health-care professionals buying this imaging technology in both the medical and dental fields. In the future, consumers will come to expect this imaging technology at their health-care appointments.

So, as a bona fide digital dental hygienist, what can I expect from such a device? How will this intraoral digital video camera affect the way dental hygienists give daily patient care? What kind of influence will using the intraoral digital video camera have on patient education, treatment planning, and case acceptance? And, most important, when during our patients' hygiene appointments do we schedule time to use it?

I like using the "look-check-record" method. Using an intraoral digital video camera is just like using a digital video camera at a family event. "Look" for the occasion to use it. "Check" for anything unusual happening. And "record" that Kodak moment in time with a still photo or video clip.

Let's explore together a digital dental hygiene day!


• Focusing — Like a learned skill such as using a mouth mirror, an intraoral digital video camera takes practice. Intraoral digital video cameras offer different depths-of-field. A quality camera should have a great depth-of-field, on the order of about five inches. This means that as you "tour" the mouth, you can get as close as one inch, and as far away as five inches, and still stay in focus.

Your ease of focus inside the mouth will depend on which camera you purchase.

• Movie clips — The most important thing for movie-clip purposes is the depth-of-field focus response. With a lesser quality camera, a great portion of the movie could be out of focus. So, to make this work, you will need an add-on imaging software feature that can capture the movie.

As a side note, the captured movie takes up an incredible amount of hard drive space. However, once captured, you can move back and forth in the movie (in motion, or frame by frame). You can stop on the desired shots and simply "drag" them off to the side to be saved. So once you have selected the desired shots, you discard the movie to free up hard drive space and keep the chosen still photo images.

• Still photos — The "tour the mouth" concept is like using a digital camera. When you see the desired photo, click to take. The image is captured as a still photo on the computer screen. If your office purchased a separate imaging software application, the still photo image appears inside the patient's digital chart. This feature allows you to take several still photos and store them all in one place.

• Foot pedal — One feature I really like is the foot pedal. Once you like what you see on the screen, simply step on the pedal and freeze the image you are viewing on screen. It will be captured as a still photo.

• Printing — With that still photo just captured, you are now able to print the captured image onto photographic paper. It's very cool to send your patient home with a mouth picture.

• Size/weight — There are several different types of intraoral digital video cameras. They basically have a similar function — a camera lens inside what looks like an electric toothbrush design located at the tip of the neck. The lens of the camera transmits the digital image from inside the mouth to the computer monitor.

The weight of an intraoral digital video camera tends to be very light. You can even mount them on your tray delivery system for easy access.

• Imaging software module — Seamless integration between screen modules is a key feature for intraoral digital video cameras.

In an image program, you can place pointers, words, annotations, etc. and keep them as part of that image, and print them out. Also, with some imaging programs you can export that image to a common Windows format (such as JPEG), and use a patient education module to draw anything, or to make that photo part of a slide show, plus print it out of that application.


• Patient co-diagnosing — The primary advantage is to possess a tool that makes me look smart in front of patients. I love to hear my patients shriek when I show a huge computer image of their mouths with leaky amalgam, fillings with cracks and lots of black and grey stuff. Or, I show images of red swollen gums and tartar. I usually hear "OK, OK, I believe!" Really, seeing is believing!

• Data collection — Record keeping has never been so easy. With a click of a mouse, an intraoral digital video camera with imaging software allows you to store and retrieve visual patient information inside their digital chart.

• Insurance proof — We have all heard about insurance companies that hire employees unfamiliar with dentistry to look at our documentation. Imaging technology reinforces that "seeing means believing" mentality and can facilitate reimbursement for dental treatment.

You can help your patients by using the intraoral digital video for still photos. The front office can email the photos along with insurance claims to insurance companies as JPEG images — all thanks to your help!

I once worked in an office in Illinois many years ago where the office used a 35mm camera to document patient cases for veneers. They would submit the insurance claim with photographs. I will never forget the doctor's remarks, "Never had a veneer case turned down with photos." And that was several years ago! He was way ahead of his time! But my point is true, "seeing will mean believing" especially for insurance companies today!


• Sometimes patients do not want to look at their mouths on a computer screen.
• Using hygiene time to hunt for the only intraoral digital video camera in the office.• Off line from the local office network.
• Piecing together technologies that do not integrate smoothly require more operator workload! Yuck!


• Excellent communication tool!
• Creates baseline data measurement for future comparison.
• Builds patient trust and confidence.
• Increases perceived value of what your service is.
• Effective and easier patient case acceptance.
• Increases diagnosis with greater magnification.
• Helps facilitate patient education.
• Easy access to stored information inside a patient digital chart.

Hy-Tech user tips for ...
intraoral digital video camera

• Mount the intraoral digital video camera in an easy access area.
• Use the intraoral digital video camera to "look-check-record."
• Set up the still photos on the computer screen before the dentist's exams.
• Make sure the intraoral digital video camera network is working before your day begins.
• Decide where and when you would like to use the intraoral digital video camera in your daily routine.
• Use the intraoral digital video camera to check and document oral pathology.
• Practice on your co-workers with focusing the intraoral digital video camera — angles and images appear opposite.
• Receive proper training with imaging software.
• For OSHA compliance considerations, use the recommended customized covers that fit over the intraoral camera. If the covers are too baggy and there's no clear spot for the lens, then the image can easily be distorted. Navigation with a loose fitting cover can influence your dexterity.

Victoria DaCosta, RDH, BS, is founder and president of GumAerobics, Inc. A practicing dental hygienist for 17 years, DaCosta is a speaker, author, consultant, and an expert in the design of medical/dental software. She is also on the new technologies committee for the California Dental Hygienists' Association. DaCosta can be contacted at [email protected].