Photographs
Figure 1: Photographs help a patient understand the need for, and value of treatment: the upper left image shows a cavity that was not obvious to the patient. When the cavity was opened up with dental instrumentation, the underlying decay is obvious (upper right frame). Complete removal of the decay is shown in the lower left frame, and the tooth-colored composite resin filling is shown in the lower right frame.
Diagnostic photographs can clearly illustrate the need for, and value of treatment that may not be obvious to a patient (Figure 1).
As importantly, they can also rule out the immediate need for treatment, and spare a patient the time, money and potential discomfort of an unnecessary procedure. For example, if a dentist observes flat wear planes confined to the enamel layer of a patient’s teeth the first time he meets a patient, and the patient denies a tooth grinding (bruxing) habit, the dentist may choose to photograph the wear planes and compare the photographs to the teeth at future checkups.
If the patient does not have an ongoing habit, the wear would not be expected to increase, and treatment for the suspected bruxing habit may be avoided. In such a case, it may be reasonably concluded that the wear occurred in the past—possibly before the patient’s teeth were moved orthodontically, or during an especially stressful time of their life.
Whenever communication can be facilitated between a patient and their dentist, diagnostic photographs are a good idea. Another question worth considering is, “when should there be a charge for diagnostic photographs, and who should pay?” Although there is no one-size-fits-all answer to the question, if there is a diagnostically valid reason to take photographs, and the photographs become a part of the patient’s record, it may be valid to charge an appropriate fee for them.
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