Dental Intraoral Cameras

Designed to allow clinicians to capture and display digital images from inside a patient’s mouth, intraoral cameras are a valuable tool for patient education and case documentation. Shaped like a small wand, many dental intraoral cameras are highly portable and easily connect to a computer wirelessly, via USB or via a docking station. Most commonly equipped with LEDs, these digital cameras can capture images without the need for external lighting. Patients do not always accept treatment they cannot understand, but an intraoral camera allows them to see what you see. A problem such as a fractured tooth can be easier to spot and impossible to ignore when it is magnified on a computer monitor or TV screen. While designed for intraoral imaging, some cameras also can capture extraoral full face images for patient records.

If your goal is to increase your case acceptance, and therefore profitability, showing patients really big pictures of their teeth beats showing patients unbelievably quick radiographs of those same teeth.

High-tech guru (and all-around good guy) Dr. John Jameson passes along this information to us:"For doctors who capture digital images of the patient, as well as 'befores and afters' of other cases for consultation purposes, we have seen an increase between 10 and 25 percent in case acceptance."

So, for those of you struggling to gain patient acceptance of high-quality comprehensive treatment, an intraoral camera is your best high-tech investment. That part is easy. Deciding which camera(s) to purchase, how to integrate them into your facility, and how to take full advantage of their wonderful attributes is a more of a challenge.

The "inside scoop"

• The optics distinguish a good intraoral camera from a not-so-good one. The best optic systems are created by placing the CCD chip at the end of the wand next to the lens. This is more expensive than placing the CCD chip in the middle of the wand. When the CCD chip is in the middle of the wand, an additional prism is used to direct the incoming image farther down the wand to the CCD chip. The addition of the prism degrades image quality.
• Why do inexpensive intraoral cameras at conventions or trade shows often appear to produce an equivalent — or even superior — image quality when compared to higher-end cameras that may cost two the three times as much? Artifacts

Internally, intraoral cameras have an adjustment for pre-shoot/over-shoot. This adjustment can electronically manipulate the video signal by boosting the peaks and valleys of the video signal wave pattern. These artificially manipulated images display whiter whites and blacker blacks and create an "illusion" of greater contrast, detail, and quality. White areas in the mouth that are wet will appear to have black or darkened areas surrounding them. These darkened areas are artifacts and do not exist. Fictitious black or darkened spots on white teeth can lead to misdiagnosis.

Analog intraoral cameras vs. "digital" intraoral cameras: If the word digital is anywhere near a product name or description it has to be better, right? If all other features are equal, the fact that an intraoral camera is "digital" has absolutely no advantage over an analog counterpart, with possibly one exception.

All intraoral cameras use incoming light to create an analog/video wave pattern signal through the CCD chip. There are no digital zeros and ones streaming through the air that you can intercept with your camera wand. What makes an intraoral camera digital is the location of the digitizing capture card. If it's in the camera rather than in the PCI or AGP slot in the back of your computer, it's digital.

If you compare pricing, digital intraoral cameras generally cost more than analog cameras plus capture card. The "digital" intraoral camera can connect to your computer through a USB port since the incoming data is already digitized. The USB connection would facilitate your intraoral camera's connection to a thin client that is, in turn, linked to an ASP (application service provider). If you are holding your breath waiting for all your dental software applications to be Internet-based, you better like the color blue.

Key features to consider when purchasing an intraoral camera

Quality of construction: How does the camera dock with the light source? Does it appear capable of withstanding 2,000 insertions and detachments a year? Does the wand cord have strain relief or will it ultimately fray and create "water spots" on image displays and printouts?

Depth of field: As you move the wand inside the mouth, how much of the viewing area is in focus? Do you have to continually adjust the focus ring? Superior intraoral cameras require little or no focusing inside the mouth.

Artifacts: How much of what you see is actually there? The best way to judge an intraoral camera image is to have an in-office demonstration. Only then can you compare what you see in the mouth (under typical operatory lighting conditions) with what appears on the monitor display. You have no frame of reference on the convention floor to judge image quality and the presence or absence of artifacts.