Clear Aligner Records: How to Take Clinical Photos & Scans
Every aligner plan is built from your records. Why photos matter when you already have a scan, the short kit, the six photos every case needs — the full face smiling, three intraoral views with the teeth together, and the upper and lower occlusal views in the mirror — how to take each one, how to capture a complete scan, and the records check before the patient leaves the chair.
Every plan is built from your records. The Virtual Setup comes from your scan, and your photos tell the design team what the scan cannot. When the records are complete and clean, the plan starts right; when they are not, the case waits — or it is planned on a guess. The start-a-case lesson named the three records: the scan, the photos and the radiographs. This lesson is how to take the first two well — the six photos, how to take each one, and the scan — and the check before the patient leaves the chair.
Why photos, when there is a scan?
The scan — the teeth
every tooth, every surface — the Virtual Setup is built from it
The photos — the patient
smile line · midline against the face · gum display · how the lips sit
How the team understands the chief complaint — and reads your instructions
Can be uploaded later on the case page — but the case can't move until every record is there
Two records, two jobs: the Virtual Setup is built from the scan, and the photos show the smile, the midline and the lips that the plan is judged against.
The scan is the teeth. The photos are the patient: the smile line, the midline against the face, how much gum shows, and how the lips sit over the teeth. They are how the design team understands the chief complaint — and how they read your instructions.
Photos can be uploaded later on the case page, but the case cannot move until every record is there. So take them at the records visit, not after it.
The kit
Digital cameraideally a macro lens + ring flash
Cheek retractorspulled outward and slightly forward, off the teeth
Intraoral mirrorsan occlusal mirror for the arches · warmed or anti-fog
White backgrounda plain wall for the face photo
An assistant holds the mirror and retractors — every intraoral photo gets easier
Four things — and an assistant. A digital camera, cheek retractors, intraoral mirrors, and a plain white background for the face.
The kit is short:
A digital camera — ideally with a macro lens and a ring flash.
Cheek retractors.
Intraoral mirrors — an occlusal mirror for the arches, warmed or treated so it does not fog.
A plain white wall or background for the face.
An assistant to hold the mirror and the retractors makes every intraoral photo easier.
Six photos, every case
Full face, smiling
Anterior · occluded
Right buccal · occluded
Left buccal · occluded
Upper occlusal · mirror
Lower occlusal · mirror
The same six, the same way — start · correction or refinement · end
One extraoral, three intraoral with the teeth together, and two occlusal views in the mirror — the same six, taken the same way, every time.
One extraoral — the full face, smiling.
Three intraoral, with the teeth together — the anterior view, the right buccal view, and the left buccal view.
Two occlusal views in the mirror — the upper arch and the lower arch.
The same six, taken the same way, every time — at the start, at a mid-course correction or a refinement, and at the end — so any two sets can be compared side by side.
The full face, smiling
Head level — the dashed line between the pupils parallel to the floor — then framed from the top of the head to just below the chin, with the face centred on the vertical centre line.
A plain white background, the patient upright and looking straight into the lens.
The head level — the line between the pupils parallel to the floor — and the camera at the height of the eyes.
Hair off the face and ears, glasses off.
Frame it from the top of the head to just below the chin, with the face centred.
Then ask for a natural, full smile — the one the patient really has, because that smile line is what the plan is judged against.
The intraoral views — teeth together
Anterior
Right buccal
Left buccal
Anterior: straight in front, centred on the midline, the occlusal plane level in the frame. Buccal: square to the canine and premolars, so the bite reads from the canine back to the first molar.
Three of the five intraoral views are taken with the teeth together. Retractors in, pulled outward and slightly forward, off the teeth, and the patient biting fully together on the back teeth.
Anterior. Stand straight in front: the camera at the level of the bite, centred on the midline, and the occlusal plane level in the frame.
Right and left buccal. For each side, pull that side’s retractor further back and shoot straight onto the canine and premolars, with the camera square to the teeth — not angled in from the front — so the bite reads from the canine back to the first molar: the same canine and molar relationships you read in the Class II & Class III lesson.
The occlusal views — in the mirror
Upper — head tilted back
Lower — chin down
The mirror seated deep, the camera square to the arch in its reflection — every tooth, last molar to last molar, with nothing in the way. The upper arch is shown as it reads once the image is flipped.
Position the patient — head tilted back for the upper arch, chin down for the lower, and the mouth wide open.
Seat the mirror deep, at the last molars, angled about 45° to the occlusal plane, so the whole arch fills it.
Photograph the reflection, with the camera square to the arch in the mirror — not to the mirror itself.
Every tooth in the frame, from the last molar on one side to the last molar on the other, with no lip or retractor in the way.
For the lower arch, ask the patient to lift the tongue behind the mirror.
Dry the teeth, keep the mirror clear of fog, and flip the image afterwards, so the upper incisors sit at the top and the lower incisors at the bottom.
The scan
Capture both arches completely — every tooth, all the way to the distal of the last molar, with the gingival margins and a band of gum around them.
The scan is the foundation, so give it the same discipline.
Finish any fillings or crowns before you scan. A tooth that changes shape after the scan will not fit its aligner — and it needs a rescan.
Dry as you go, and keep the cheeks and tongue out of the way.
Capture both arches completely — every tooth, all the way to the distal of the last molar, with the gingival margins and a band of gum around them.
Then the bite, on both sides, with the patient fully closed in their usual bite, not posturing forward.
Before the patient leaves, review it: no holes on any tooth, no blurred or doubled areas, the last molars complete, and a bite that matches the mouth. A tooth the scan missed is a tooth that cannot be planned.
The check — before the patient leaves the chair
Six photos — sharp, evenly lit, the right views, nothing cut off
A complete scan of both arches and the bite
A recent panoramic · a cephalometric where indicated — always in a growing Class II
Upload everything together — one submission
A missing photo or a scan with a hole holds the case until you fix it — and the patient waits
Four checks, chairside — then one submission.
Run the four checks before the patient leaves the chair, then upload everything together, in one submission. A missing photo or a scan with a hole holds the case until you fix it — and the patient waits.
The takeaway
The scan is the teeth, and the photos are the patient. Six photos, every case — the face smiling, three intraoral views with the teeth together, and the upper and lower arches in the mirror. Retractors in, teeth together, the camera square to what you photograph. A complete scan with the bite on both sides, checked before the patient leaves. And one complete submission.
Six, every case. One extraoral: the full face, smiling. Three intraoral, with the teeth together: the anterior view, the right buccal view and the left buccal view. And two occlusal views in the mirror: the upper arch and the lower arch. Take the same six, the same way, every time — at the start, at a mid-course correction or a refinement, and at the end — so any two sets can be compared side by side.
Why take photos when you already have an intraoral scan?
Because the scan is the teeth and the photos are the patient. The photos show the smile line, the midline against the face, how much gum shows and how the lips sit over the teeth — what the scan cannot. They are how the design team understands the chief complaint and how they read your instructions. Photos can be uploaded later on the case page, but the case cannot move until every record is there, so take them at the records visit, not after it.
What equipment do you need for orthodontic photos?
The kit is short: a digital camera — ideally with a macro lens and a ring flash — cheek retractors, intraoral mirrors (an occlusal mirror for the arches, warmed or treated so it does not fog) and a plain white wall or background for the face photo. An assistant to hold the mirror and the retractors makes every intraoral photo easier.
How do you take occlusal photos with a mirror?
Tilt the head back for the upper arch and the chin down for the lower, with the mouth wide open. Seat the mirror deep, at the last molars, angled about 45 degrees to the occlusal plane so the whole arch fills it. Then photograph the reflection, with the camera square to the arch in the mirror — not to the mirror itself. Every tooth must be in the frame, from the last molar on one side to the last molar on the other, with no lip or retractor in the way; for the lower arch, ask the patient to lift the tongue behind the mirror. Dry the teeth, keep the mirror clear of fog, and flip the image afterwards so the upper incisors sit at the top and the lower incisors at the bottom.
What makes a good intraoral scan for clear aligners?
Finish any fillings or crowns before you scan: a tooth that changes shape after the scan will not fit its aligner, and it needs a rescan. Dry as you go and keep the cheeks and tongue out of the way. Capture both arches completely — every tooth, all the way to the distal of the last molar, with the gingival margins and a band of gum around them — then the bite on both sides, with the patient fully closed in their usual bite, not posturing forward. Before the patient leaves, review it: no holes on any tooth, no blurred or doubled areas, the last molars complete, and a bite that matches the mouth. A tooth the scan missed is a tooth that cannot be planned.
What should you check before the patient leaves the chair?
Six photos — sharp, evenly lit, the right views, nothing cut off. A complete scan of both arches and the bite. A recent panoramic, and a cephalometric where indicated — always in a growing Class II. Then upload everything together, in one submission. A missing photo or a scan with a hole holds the case until you fix it, and the patient waits.
