Plaster casts of the jaws, clinical photos, one panoramic and one lateral X-ray image are traditionally taken before starting an orthodontic treatment. For us, the most important documents are at least eight before and after pictures of the patients. These include usually three portraits and five pictures of the mouth that are taken with a high-resolution digital camera. The intraoral shots give more information than the plaster models, showing inflammation, decalcification of the teeth, deficient fillings, and often also dysfunction of the tongue. Therefore they are very important for both treatment planning and patient consulting. At the end, we always show the patients the pictures taken before and after their treatment for comparison: there is nothing else that could show the success more clearly.
Dental impressions and plaster models of the teeth and jaw are still standards. This old technique is a little cumbersome for the patients and the thousands of models in the office need much space. In the long run the old dental impression technique may be replaced by digital impressions that are taken with an optical device or, alternatively, with a three dimensional x-ray machine (cone-beam tomogramme or CBT). Both techniques are not widely accepted yet, but we are following the development closely.
In order to diagnose caries, missing teeth, inflammation within the bone and other surprises before the treatment, a panoramic x-ray is essential. Usually, a second panoramic x-ray is taken during the treatment to check on the inclination of the tooth roots.