Dental Imaging Software and Photo Storage - the Hows & Whys?

OK, I lied......before I talk about patient expectations, since I already started on the subject of software, I shall continue in that vein for a bit, as it seems to be right near the top of the poll in terms of "need-to-know".

Use PMS (Eaglesoft, Dentrix, etc) or Not?

Personally, I do not use, nor do I recommend using, the Imaging modules of the dental PM software that is currently on the market.  Why not?

1. Cost: While some include the Imaging Modules, most charge a premium for the versions with all the bells-and-whistles, and quite simply, NONE of them are remotely as good as the most popular photography software available outside dentistry, and ALL of them are a LOT more expensive.
2. Lack of Keyword Capability: In just about every photography program available today, including Google's free Picasa, you have the ability to use Keywords, or Tags.  These are descriptive terms to used to identify what is in the picture.  For example, in dentistry you might want to have keywords related to what lab you used, which adhesive, which composite or amalgam used, type of isolation, reason for treatment, etc.  This allows you the option of tracking your work over time.
3. Harder to find images you want: in dental PM software, you have to generally keep your images in each person's file; if it's years down the road and you want the pictures you took of, "Hey......what was that guy's name about 5 years ago we did the single anterior crown for?????"  Ummmmmmmm, not too easy to do, is it?  This ties in with the lack of Keywords/Tags, too.
4. Harder to Group images for specific purposes: Let's say you want to put together a nice collection of pictures of veneer cases, or Six-Month Braces, or CEREC crowns, or implant overdenture cases, you have to go through all of the patients, in most cases export the images individually to another folder (and they don't make this really easy IMO), THEN you can start working with them.
5. Limited Editing Capabilities: Especially in comparison to programs like Photoshop, or even Photoshop Elements, most dental PM software has extremely limited editing capabilities.  Of the ones I know, the best is Apteryx.  However, it is again more expensive than just about any photo software currently available, and it has the same limitations regarding Keywords, image searching, and image grouping.

OK, so what software do I use/recommend? 

Personally, I like Adobe Photoshop Lightroom, which is currently in version 2, and version 3 will be released sometime in spring 2010.  Here are some other programs you can choose, though, and then I'll cover more of why these programs are IMO far superior to dental PM software imaging modules.

• Photoshop Elements 8
• Google Picasa
• Aperture 2

5 Reasons Photoshop Lightroom Rocks for Dentists

1. Easy Folder Hierarchy: It's basically just like Windows Explorer, in that you can set up a folder structure in any way that you want.  Here's the way I have it set up: My Pictures > Year > Procedure Type > Patient Name > Date of Service.  It's easy to keep track of all pictures by calendar year, and by having procedure types (such as Basic Restorative, Cosmetic, Periodontal, Implant, etc), you can put like types of procedures together.
2. Easy Keyword Tagging:  This is really one of THE most powerful tools available with LR or the other programs.  By using Keywords, you can easily label pictures with any descriptor you want.  As some examples, here are some I use: Decay, Recurrent Decay, Chipped Porcelain, Acid Erosion, Gingival hypertrophy, Posterior Composite, Anterior Composite, Veneer, Feldspathic, Empress, Surpass, Preop, Portrait, Amalgam, and you can probably think of a gazillion more.  And here's where it gets useful: Tracking your work over time!  Let's suppose that, after 5 years of using a particular lab, always using Captek crowns and cementing with zinc phosphate, you want to pull up ALL of the pictures of ALL patients in the last 5 years who got Captek crowns from that lab and which were cemented with zinc phosphate so you can see how they hold up........type the Keywords into the search field, and BAM!  There you go!  OR........say you know that there was an amazing veneer case you did 8 years ago, but you can't remember the patient's name, no problem!  Just select the year you want, perhaps choose keywords "Veneer, Maxillary, XYXYX Lab" and BAM!  There you go, all the maxillary veneer cases from the year 2002 that you did with XYXYX Lab are right there, and you can easily identify the case you want.  This is just an incredible feature.
3. Creating Customized Galleries and Slideshows:  This is another superb feature for anyone who wants to easily showcase their work.  Lightroom has several features that allow you to create highly customized Web Galleries, Slideshows with music, and more; with plug-ins (most are free, some have a small fee), you can upload galleries to sites such as Flickr, Smugmug, Zenfolio, and others.  Google's Picasa has a built-in tool to let you upload pictures to your online Picasa galleries, from which you can create links, Flash slideshows, and more.  The marketing potential of these customizable photo groupings is tremendous.  The slideshow seen on the right of my Blog is linked from my SmugMug photography site, and all those pictures were uploaded directly in a large batch.  EASY.  And the upcoming release of Lightroom 3 will have even more of these features built in!
4. Easy-to-Use Editing Features: with most of these programs, the controls to do a ot of basic editing are right at your fingertips, such as Cropping, Correcting Red-eye, Correcting overexposed or underexposed pictures, adding borders, etc.  Therefore, the learning curve to use them is much faster and shallower.
5. NON-DESTRUCTIVE editing!  This is a wonderful benefit like you wouldn't believe, especially when you're new.  Essentially, Lightroom does not actually edit the image file; instead it writes the edits "on-top-of" the file in a set of instructions that are rendered onscreen.  NOT UNTIL you export the image in some way (online, printing, slideshow) will those edits be permanently part of the new file.  Even then, though, the ORIGINAL file remains untouched, and you can revert back to it at any point.

Hence my recommendation to use a non-dental software for cataloging and editing your pictures. Please post comments and questions or send me an email for further clarification.