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Smartphone Vs DSLR Dental Photography among Orthodontists

Article  in  Indian Journal of Public Health Research and Development · June 2020

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Arya S Prasad Arvind Sivakumar

Saveetha University Bhagwan Mahaveer Jain Hospital
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 118 Indian Journal of Public Health Research & Development, June 2020, Vol. 11, No. 6

Smartphone Vs DSLR Dental Photography among

Orthodontists

Arya S Prasad1, Arvind Sivakumar2

1
Postgraduate Student, 2Senior Lecturer, Department of Orthodontics and Dentofacial Orthopaedics, Saveetha
Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences,, Saveetha University

Abstract
Introduction: Smartphone photography has come a long way in terms of technological advances in sensor
quality, resolution, and lens sophistication, giving much improved image quality over the last few years.
Smartphones being relatively compact and lighter than a Digital SLR camera hence the younger generation
dentists prefer it over the conventional cameras. We did a survey to assess the perception of quality of
images taken using smartphone and DSLR (Digital Single Lens Reflex) intra oral cameras. The aim of this
study is to compare the quality of intraoral images taken using mobile phones with DSLR cameras.

Materials and Methods: 20 intra oral images of subjects were taken using DSLR (Canon 700D) and 2
renowned smartphones (iPhone 7 plus and Oppo R7 plus). A questionnaire was prepared and sent through
social sources to general dentists and specialists. The questions included in the survey are based on the
knowledge, attitude and practice in the usefulness of mobile phones compared to DSLRs for taking intra
oral images.

Results: The primary outcome measure of this study was to assess the orthodontist’s perception towards the
various image characteristics of intra oral photographs taken using digital SLR camera, iPhone 7 plus and
Oppo R7 plus.

Conclusion: So, from this study we can conclude that there were no statistically significant results found.
In the coming years smartphone cameras can really give a tough challenge to bulky cumbersome DSLRs.

Keywords: Mobile dental photography, smartphone dental photography, DSLR (Digital Single Lens Reflex),
iPhone 7 plus, Oppo R7 plus.

Introduction monitoring of treatment progress etc. (1) (2) (3) A Digital

Clinical photography in dentistry is mainly used
for documentation, evaluation of craniofacial and
dental relationship, assessment of soft tissue profile,
smile analysis, medicolegal purposes, evaluation and
Corresponding Author:
Arvind Sivakumar
Senior Lecturer, Department of Orthodontics and
Dentofacial Orthopaedics, Saveetha Dental College
Saveetha Institute of Medical and Technical Sciences,
Saveetha University, 162, Poonamallee High Road ,
Chennai-600077, Tamil Nadu,India
Email : arvind.sivakumar@gmail.com
Telephone Number: +91 8220552400
Single Lens Reflex, or DSLR is necessary for high-quality
images of both extraoral and intraoral structures. (4) The
DSLR camera with a high-quality lens is considered
to be the ideal choice for dental photography, as it is
capable of taking portraits as well as close up or macro
images of the dentition, by through-the-lens viewing
and metering, precise focusing and accurate framing (5)
A full set of clinical photographs must be taken before
any treatment is started as it is an invaluable record
detailing the original clinical situation. These should be
a mandatory record for each and every patient before
we diagnose and design the treatment plan, even if the
treatment is only extraction of teeth to intercept the
developing malocclusion. Clinical photographs allow us
to record the relationship of the teeth and jaws to the
 Indian Journal of Public Health Research & Development, June 2020, Vol. 11, No. 6 119

facial structures.(5) bias. The operator had good experience with the usage
of all three cameras and had undergone specific training
Digital photography can have several influences and standardisation for using all the three cameras for
on dental practice: Photos can educate patients and taking the intra oral pictures on ten patients before the
improve patient acceptance and improve patients’ study was started.
confidence following treatment. The dental treatment is
subject to change, can be recorded in detail by means
of photography. Intraoral pictures can provide improved
documentation and the option of checking particular
conditions over longer periods of time. 

In today’s smartphone generation, mobile dental

photography has become one of the fastest and easy
ways to record or document cases. Smartphones, as
it is very aptly named in the way that it can turn an
amateur into a professional photographer. Nowadays
many professional photographers are ditching their
heavy, sophisticated DSLRs in favour of more compact,
lightweight, handy smartphones. (6) (7) It is quite common
nowadays to see people clicking pictures using their
phones to take photos, leaving their expensive DSLRs at
home. (8) A DSLR has a camera body with some fantastic
technology but nowadays cell phone photography has
raised its standards to a considerable extent to compete
with a DSLR setup, and yet is light and easy to operate.
The image sensors have come a long way & are capable
of capturing pictures of more than 10 MP (megapixel).

Nowadays its quite common to take portrait shots

and other face photographs with smartphone camera
which produces good quality photographs with adequate
recording of the details. Smartphone cameras are viable
alternative to heavy DSLR cameras in taking intraoral
and extraoral photographs.(9) Hence in this study, we
wanted to compare the quality of photographs obtained
with smartphones and compare them with gold standard
DSLR. Figure 1: Intraoral images taken using iPhone , DSLR, and
Oppo R7
Materials and Method The photos with Canon 700D DSLR were taken
This cross sectional questionnaire study was with following settings: ISO between 400-600, shutter
conducted by using intraoral pictures of 20 random speed of 30-40, f 20-22 at 30 mm zoom used with ring
subjects who reported to our hospital for treatment flash (Meike FC-100). While using iPhone 7 and Oppo
were taken using Canon 700D (Canon India Pvt. Ltd., R7 the photos were taken using auto mode with flash
Gurgaon, India) and two renowned mobile phones iPhone kept on.
7 plus and Oppo R7 plus which has got a good camera.
The intraoral images taken in each subject includes
Intraoral photos of each subjects were taken thrice using
the frontal intraoral image in centric occlusion with all
three cameras and were sorted into three groups: in
the teeth focused from incisor to molars, right side in
group 1 – photos were taken using DSLR (Canon 700D),
occlusion and left side in occlusion. The right and left
in group 2 – photos were taken using iPhone 7 plus, in
side occlusion was taken with the camera pointing
group 3 – photos were taken using Oppo R7 plus. All the
almost perpendicular to the buccal surface of molars &
photos were taken by one author to avoid inter operator
 120 Indian Journal of Public Health Research & Development, June 2020, Vol. 11, No. 6
premolars. Three intra oral images were taken for the
twenty subjects using three different cameras to obtain
a total of 180 images. This resulted in sixty images per
group. All the images taken were cropped in uniformity
by using Adobe photoshop software (CS6) to the size
of 4 X 6 inches (Figure 1). All the patient images
which lacked in clarity, improper lighting and camera
positioning & any form of distortion were removed from
the study. Finally, the best set of ten photographs out
of frontal, right and left occlusion were chosen for the
questionnaire survey.
The questionnaires were created using google
survey. Each set of the selected photographs, were
arranged in individual slides containing 3 photos (same
photo taken using the three different cameras) & the
examiners were asked to choose the best photograph
based on the image quality. These questionnaires were
mailed to 80 orthodontists through google survey link.
Results
Out of the 80 google survey links sent to
orthodontists, 55 orthodontists responded to the survey.
The survey results of the 55 orthodontists was as follows:
38% orthodontists liked photos taken using DSLR
photography, 34% liked photos taken using iPhone 7
plus and 28% liked photos taken using Oppo r7 plus
(Table 1) (Figure 2).
Table 1: Results of the Survey
Intra oral images taken
S.No. Response (n=55)
using
1 DSLR (Canon 700 D) 38%
2 iPhone 7 plus 34%
3 Oppo R7 plus 28%
Figure 2: Overall results of survey
Discussion
The purpose of this study was to assess the perception
of orthodontists towards intraoral pictures taken using
DSLR and two popular phones in the market which have
good cameras. In this study we have taken one high end
smartphone and a midrange smartphone to assess the
quality of images produced with both the phones and
compare them with the SLR cameras which are currently
the gold standard in intra oral photography. Also, we
have evaluated whether the quality of images produced
using these smart phone cameras were adequate enough
for using it to take pictures in intraoral photography.
The characteristics of the photographs are affected
by many factors including different operators, camera
settings, room lightings and various other factors. As the
image characteristics varies according to the operators,
the present study used a single operator. The settings were
standardised among all the photographs. The operator
had already undergone a phase of standardisation were
the settings of the camera were altered to find the best
settings for each camera.
In a DSLR camera the inbuilt flash of the DSLR
camera is placed away from the lens (on top of the lens)
and hence the light from the flash gets obstructed from
the presence of the protruding lens and the flash does not
light up the area covered up by the lower part of the lens.
This is the reason why ring flash is used for intra oral
photography to produce light which is unobstructed by
the lens and adequately lights up all parts of the images.
(10) The characteristic of the light produced by a ring flash
is precise and therefore shadow-free illumination of the
object without shadowing effect of the lens, whereas in
a smartphone camera the lens is not protruding outside
and the flash is right next to the lens and hence there is
almost zero obstruction of the light from the flash.
Smartphone cameras has really come of age from
less than 1 MP to more than 20 MP , from simple CCD
(charged couple device) to latest CMOS (Complementary
metal–oxide–semiconductor) sensors which are far more
accurate and more sensitive.(11)
Smartphones has evolved rapidly in terms of
advancement and technology.(12) (13) (14) Smartphones
are a part of our day to day life and because of their
compactness, ease of carrying around , requires less
expertise and versatility of use. They are always present
within our arms reach, whereas DSLRs are cumbersome
to carry, bulky, technique sensitive and requires a
 Indian Journal of Public Health Research & Development, June 2020, Vol. 11, No. 6
lot of training. Till now there is no doubt that DSLR
cameras is the gold standard in dental photography.
(15)
A smartphone camera is very simple to use and
even an amateur photographer can produce excellent
photographs due to the smartness of the phone. Other
advantage is its instant access of digital images to the
operator, optimal choice of illuminating the object
of interest which spares us from costly accessory
equipment for like ring flashes; technical data of each
photograph are automatically recorded, which makes its
adequate reproduction possible; possibility of copying,
fast printing, and sending by electronic mail to any part
of the world; possibility of fast reviewing and removing
of spotted errors as well as the possibility of instant
deleting and repeating shooting procedures until till
desired results are obtained .
iPhone 7 plus photographs have really given a
tough competition to DSLR photographs in intraoral
dental photography. Smartphone cameras can be
used alternatively for intra oral dental photography.
Utilization of mobile dental photography can help in
the treatment planning and patient consultation that is
organized and more user friendly for both the dentist and
easily understandable by the patients.
Conclusion
The application of smart phone photography in dental
practice is simple, fast and very useful in documentation
of clinical procedures, help in education of patients
and for clinical investigations, thus enhancing many
benefits to dentists and as well as patients. To overcome
the bad reputation of smartphones in producing low
quality pictures mobile phone manufacturers try to
counteract these shortcomings mainly through clever
programming of the camera software parameters, as
they cannot overcome such physical limitations. So
many smartphone companies have started creating add
on flash lights attachments and Macro lenses for mobile
phones and making it much lighter, easier and quicker to
use setup for dental photography. Mobile Photography
is certainly here to stay and will advance further in the
future and digital dental photography is an exceptional
tool for communication and documentation. Many
shortcomings will be overcome in coming years. And
so mobile phone manufacturers try to counteract these
shortcomings mainly through clever programming of
the camera software parameters. Smartphone dental
photography will advance further in the future.
121
Ethical Clearance - Taken from scientific review
board, Saveetha Dental College and Hospital, Chennai,
Tamil Nadu
Source of Funding - Self
Conflict of Interest - Nil
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