Using Mirrors in Intra-Oral Photography

For most intra-oral photography / dental photography, a specialised ring flash provides even lighting inside the mouth. It is best that the ring flash is attached firmly to the camera lens, providing ease of use and standardised illumination. The ring-flash must be capable of producing sufficient light for an aperture of at least f22 to maximise depth of field.

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Retractors are most commonly plastic. It is important that the design ensures excellent retraction of the lips and mucosa, pulling them away from the gums and teeth, to avoid the lips obscuring the teeth.

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Using Mirrors

Dental mirrors are available in either stainless steel or surface coated glass. Glass mirrors are preferable for higher reflectance and are available in a wide range of shapes. A standard set of mirrors should include sizes for both adults and children.

Palatal mirrors are necessary in intra-oral photography. They help capture the roof of the mouth and maxillary views of the dental arch. They are also used for photographing the Buccal view ( the teeth next to the cheek). Mirrors must be able to be autoclaved. A range of mirrors and retractors are required to cope with the variety of dentitions, patient’s age, size of mouth and shape of the lips.

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When using mirrors it is important to ensure the patient removes any orthodontic elastic bands or prosthetics (if they are not integral to the view) before taking occlusal views.

Warn the patient that the mirror is made of glass and that they should not bite it! Remind them they must keep their mouth open wide. The largest mirror that the patient can comfortably accommodate should be used. This helps to push the buccal mucosa away from the teeth.

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Intra-Oral Photography Top Tip. Gently heat the mirror by holding it under warm running water and then dry it carefully. Warming the mirror will prevent it from steaming up when it is placed in the patient’s mouth. If you do not have an assistant available, the patient is usually able to hold the mirror themselves. The mirror should be held by its edges or handle. Fingers and thumb should be as far from the mouth as possible.

Positioning

To place the mirror in the patient’s mouth, ask the patient to open wide, angle the mirror slightly to the horizontal and feed one corner in first, pushing this against the inside of the cheek, then straighten the mirror to feed in the other corner. Then turn the mirror so that it is horizontal and slide it slowly towards the back of the patient’s mouth. Take extra care if the patient has a gagging reflex. It may help to ask the patient to breathe slowly through their nose.

The result should be a perfect picture of the palate and occlusal (the biting surface) view of the teeth.

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