Having a black background to your patients dental photos makes them look really professional, and helps to keep the focus on the aspects of the image that you want.
So, in this photo, I was only interested in the top teeth, and the bone/ soft tissue defect. The tongue and lower teeth were a distraction.
The best way to get this effect is to use a black contastor behind the teeth when you are taking the photo, but sometimes you may have taken the photo, and wished you had used a contrasor. This is how to put the contrastor in, using Adobe Photoshop.
Step 1 – Access Your Photo
I save all my photos in a cloud service: www.dentalnotebox.com, I used to use iPhoto, either way, you need to save the photo to your hard drive, as a JPG file. This technique cannot be done with a RAW file, you will need to convert this to JPG before doing this.
Now, open this photo in Adobe Photoshop. If you are working on the original photo, duplicate it. If you just downloaded it from Dental Notebox or iPhoto, then you don’t really need to worry, your original will still be safe.
Step 2 – Selecting the teeth
Before you make the selection, you need to make the working layer (background, lower right panel normally), to a normal layer. To do this, double click the layer named ‘background,’ then click ok when you get the following notification box.
Use the wand selection tool (Keyboard shortcut W), and set the tolerance to about 40. Click on the teeth, and you want the marching ants selection to be at the incisal edge of the teeth. You may need to hold shift and make more than one selection.
Now switch to the ‘Edit in Quick Mask’ mode (Q). In this view, everything that is not going to be selected will have a red overlay. You can add and remove the red by using the eraser and the brush tools. So use these tools to tidy up the edges. You will need to play with the brush options too, changing the brush density and size. You can use the [ and ] buttons to quickly change the brush size for both of these tools.
Now your screen should look something like this. Don’t worry if the incisal edges are not perfect, these can be refined later if needed.
So Everything which you want in black, right now is red.
Step 3 – Create a Mask
Switch back to the marching ants selection by clicking the same Quick Mask tool as in the previous step.
On the layers palate, click the add mask selection. Right now you should only have one layer, if you have more than one, make sure your main image is selected before making the mask.
Your screen should now look something like this.
The checked area is transparent. So all you need to do now is add a black layer below your main image.
You do this by clicking on the new layer icon, which will place the new layer above the main image layer. Just drag the layer below the image.
With this new layer selected, we are going to fill it in black. You can either use the shortcut Shift-F5 or go to Edit>Fill.
Select to fill with black, and it should now look like this.
Step 4 – Minor changes (optional)
For most, this should be fine, but lets say you want to tidy up the incisal edge on the canine tooth, you do this by editing the mask.
Click the mask (so the mask, and not the main image, has the selection corners around it).
Now you can edit this mask with the paint or eraser tool, just like you edited the red mask before. If you add black, then the detail in your main image will be hidden, (like the specs I have hidden), and if you delete the mask, then you will show the image hidden below the mask – useful if you add too much black!
Now, you need to save the file again. I will tend to just save it as a JPG file, so File>Save As… and select JPG.
I like to keep all these patient photos in one place, so I will re-upload it to Dental Notebox (www.dentalnotebox.com) and you need to be aware that this new file will have different date meta-data. so, to keep the files organised, you just need to edit the date, to the same date as the original.
Before & After
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