Digital Image Management on the Cheap

Figure 1. Windows XP displays folders with mini photos on the cover.

Figure 2. Windows XP film strip viewer.

Figure 3. Windows XP picture and fax viewer.

Figure 4. Ulead’s Photo Explorer Pro 7.0 desktop.
Figure 5. JASC’s After Shot printing module is very powerful.

Figure 6. JASC’s editing module functions intuitively.

Figure 7. ACDSee’s 4.0 desktop.
Figure 8. ACDSee possesses the most powerful editing package of the bunch.
Figure 9. ACDSee’s FotoAngelo module functions like an economy version of Microsoft’s PowerPoint.

If you’ve contemplated taking the digital dental photography plunge but have hesitated owing to a suspicion that the software end of the proposition is expensive, then I have good news for you. Fortunately, the universal aspects of the burgeoning digital photography industry have created for us something that we are quite unaccustomed to in dentistry: a bargain! Keeping in mind that dental digital images are no different than any other home brew digital photos, it makes sense to utilize the same software packages sold to the masses, off the shelves, at our local retail outlets. I’m referring specifically to packages ranging in price from $30 to $100 that will provide you with all the capability needed to catalog, edit, print, and even e-mail your images with a high degree of excellence.

Yes, there are ways to spend several thousand dollars on image management software that will directly link your patient photos to your patient records as part of your patient database, so long as your management package has this capability. Certainly, this is an elegant and useful path, but requires a more disciplined commitment to the concept of digital photography in your practice. There are many of us who will choose not to image every patient, but rather will limit imaging activities to cases that are perceived to warrant them; essentially prosthetic and cosmetic cases. To that end, so long as the user is content to allow the Windows operating system to store and alphabetize one’s images, a very tidy, “nonintegrated” database of patient images can be accumulated. What’s more, simply knowing the patient’s name will allow for easy retrieval without having to shut down your management package. After all, Windows has always been about multi-tasking.

If there was ever a reason to move from Windows 98 to Windows XP, it could be the way that XP handles images. Unlike 98, which would at best allow the user a thumbnail size preview when “clicking” on an image file, XP possesses a built-in series of utilities that provide a handy image viewer and manipulator.

The first different thing you’ll notice is that when examining your image folders, you have the capability of selecting the type of view that you’d prefer. If you choose “thumbnails” when folders are visually scanned, mini images of the folder’s contents appear on the familiar folder icon, making it a snap to choose the folder that you had in mind (Figure 1). Once you open the folder, you will view your images as either a series of detailed thumbnail images, or better yet, a filmstrip format that places the same thumbnails in a row at the bottom of the screen, with the highlighted image atop the row in enlarged form (Figure 2). Beneath the enlargement are a pair of arrows that allow you to advance the next thumbnail into the enlarged view, thus the filmstrip concept. It gets better.

The instant that you double click any of the thumbnails, the Windows picture and fax viewer is brought up, allowing the user to further enlarge and/or rotate the image. You can even generate a full-screen slide show from this utility (Figure 3). From this same utility, the image file can be saved, deleted, copied, or printed. Moreover, the default image editing program can be summoned by clicking on the appropriate icon. By default, Windows Paint program will appear, but this can be changed to the image editor of your choice. 

Did I mention that XP knows when you’ve plugged your USB camera into an empty port? XP will snatch your images effortlessly and deposit them into a “my pictures” folder. There is even a utility included to burn these images onto a CD without initiating another program, so long as your system has a CD burner installed. It’s not as sophisticated as a dedicated program like Roxio’s Easy CD Creator, but it works. Clearly, Windows XP has been designed to facilitate digital image handling, creating a natural environment with which to store and retrieve your dental images.

The three packages reviewed in this article are similar in many ways, yet each manages to do one thing or another better than its counterpart. Consider these software packages to be to the digital photographer what the Swiss knife is to the outdoorsman. They can perform many tasks admirably so long as you don’t ask too much of them. In essence, these photo managers allow the user to easily view, manipulate, and sort the images, and at the same time include a fair amount of editing capability. Such features handle cropping and color management as well as image annotation and text additions. These programs, like Windows XP, have the capability to scan for images from a connected digital camera or digital film source. Additionally, images can be printed in varying formats, e-mailed to whomever, and included in slide shows. All three programs also have built-in Explorer-type browsers that allow users to easily locate the folders they wish to view via familiar scrolling and clicking. Those operating Windows XP may indeed find considerable overlap, yet as might be expected, these dedicated applications exceed the capabilities of Windows XP’s built-in utilities. Users of Windows 98 have no choice but to go beyond Windows 98 for their photo management tasks, and will find that any one of the following programs will fill in the digital image management gaps found in 98. Let’s look more closely at them.

Weighing in at a low end $29.95 is Ulead’s Photo Explorer Pro 7.0 ( It was my first love with respect to off-the-shelf photo management programs. In many respects it remains one of my favorites, and is used heavily for patient demonstrations during a normal work day. It is the least powerful of the three, but is particularly good at producing a fast full- screen image upon clicking on the desired thumbnail. Thus, it’s great for show and tell. It has a simple layout, almost cartoonish in fact, which also makes it the least confusing to operate. It possesses a very functional editor that allows the user to crop images, adjust contrast and brightness, and adjust color hue, saturation, and balance as well as image sharpness, but lacks image annotation and text addition capabilities. Its printing module strays from being intuitive, so I use it sparingly.

Its standout feature is an item called SMART SEND. This feature will make e-mailing your images a breeze. Upon highlighting the images you wish to send from a displayed folder and clicking the mailbox icon atop the screen, your default mail program will be initiated. If you elected to use SMART SEND, the photos, no matter how large they were in KBs or MBs, will be downsized to sub 50 KB size, thus making them easily and quickly e-mailable. They will be automatically attached to your e-mail, waiting only for you to type in your recipient and message. Hit send as usual and a conveniently scrollable cavalcade of your images will be sent to the desired recipient. You can also send full-size images, but in most instances your recipients will appreciate the snapshot presentation that fits nicely into their viewing window. 

The low cost of Ulead’s PEP 7.0 makes it worth owning for the e-mail functionality alone. Because of this, PEP has a presence on all of my computer systems (Figure 4). Note that jpeg, tif, and BMP formats are all compatible with PEP 7.0.

Another budget-based standout is JASC’s After Shot ( Formerly titled Image Expert 2000, this smart title is typically found at $49.95 on most retail shelves. (Premium Edition). It can also be downloaded from the JASC website for $45. If you like, there is an online evaluation version available as well. There are several features that would endear this package to the digital dentist. First and foremost is its exceptional printing module. This is the program from which I print most of my dental images. The typical image layouts of 1, 2, or 4 to a page are easily attainable in addition to a myriad of other formats. Moreover, it’s possible to make adjustments on your previewed layout, such as zooming in on individual parts of an image or simply filling in a frame to fit the layout. Text is easily added to printed pages as headers or footers, and images can also be labeled with their file names. After Shot will automatically select your images or you can pick them manually and choose between a portrait or landscape printing mode. My only gripe about this wonderful printing module is the lack of a “save layout” feature. Once you exit the program, your layouts are history. Still, it’s so fast and easy to set up a printed page, you’ll quickly forgive JASC for the shortcoming (Figure 5).

After Shot also possesses a very slick editor that relies upon a generously sized split image and sliders to vary contrast, brightness, color characterization, and sharpness. The split screen image seems to fit dental use well (Figure 6), as compared with PEP’s editor, which produces multiple thumbnails, displaying variations that can be difficult to discern, particularly on a 15- or 17-inch display.

In this same vein, After Shot possesses a “quick fix” button for rapid-fire image corrections, as well as a “batch module” that allows the user to correct several images at the same time. While not allowing for precision corrections, this “once over” feature can prove useful when a set of images all appear to be too dark or too light. After Shot also allows the user to view multiple folders simultaneously by virtue of a clever “push pin” mechanism. Likewise, two or more enlarged images can be kept in view on the same screen, thus facilitating before and after displays without having to open up separate viewers as required by the other two programs reviewed. 

Finally, After Shot will also produce slide shows and even mini-movies from a series of related photos. Novelties to be sure, but some may find these features helpful. While an e-mail feature is also present, the SMART SIZE option of PEP is absent. Again, jpeg, tif, and BMP images are compatible. Consider this program a must for its printing capabilities alone.

ACD Systems ( claims that 24 million people use their popular image browser/editor, ACDSee 4.0. I own the Power Pack version that includes FotoCanvas, a pumped up photo editor, and FotoAngelo, a presentation package possessing some of the capabilities of Microsoft’s Power-Point. This particular package sells in the $90 to $100 range, but a stripped-down version of ACDSee is available for just under $50.

ACDSee does pretty much what the others do. I found it to be less intuitive than those described above, but once you are familiar with the various icons on its desktop, navigation is straightforward. The ACDSee desktop is adorned by large, easy-to-read thumbnails of your images that can be labeled with their file names, as well as pertinent facts about the image such as file size, name, and the date taken (Figure 7). By clicking on a thumbnail image, an instant enlargement becomes visible in a “viewer.”

So what does this Power Pack offer to the dentist? Certainly it’s a fine way to view, sort, and catalog your dental images. But ACDSee’s ability to view two images enlarged and side-by-side is less intuitive. Before-and-after comparisons can occur, but only when separate image viewers are opened and their size manipulated to allow both images to fit on the screen. This can be tricky. Comparison viewing is best carried out via ACDSee’s “slide show” capability. ACDSee will automate e-mails, and does possess a feature to downsize images prior to sending them, although this feature is somewhat buried in the menu hierarchy.

With respect to its printing capabilities, single images can be sized and printed as well as a series of thumbnail images. While these thumbnails can be manipulated as to position, size, and layout, the variety of printing layouts found in After Shot is missing in action. 

The ACDSee Power Pack FotoCanvas editor is the most robust of the three programs reviewed. It features photo touch-up capabilities including red-eye removal, airbrushing, cloning, and selective removal and editing of portions of your images. It falls short of enabling simulations, but allows the experienced user to clean up his portraits prior to submitting them for simulations to an outside lab such as Smile Vision ( (Figure 8). 

Additionally, the FotoAngelo presentation module referenced above makes it easy to piece together a nice restorative presentation, package it into an executable file, and whisk it off to wherever you desire. The recipient need only click on the file to see your presentation, which could include text, cool slide transitions, and sound, very much like the PowerPoint presentations that we are accustomed to seeing; a very attractive feature considering the price of the package (Figure 9).

So there you have it. It really is a low-budget affair to launch the software side of your digital experience. If at all possible, upgrade to Windows XP. It will make your computer life much easier in many respects. Image handling will become intuitive and your system lockups will become infrequent.

Don’t be afraid to try more than one of the programs reviewed. Even if you invested in all three programs, you’d still be spending less than $200 for some pretty awesome capabilities. My favorite? If I had to limit myself to one program, it would be After Shot because of the printing module and the ability to demo side-by-side images. But I’d miss SMART SEND and FotoAngelo. 

Two other postscripts: Microsoft’s Publisher, while not a browser/sorter, is excellent for developing printing layouts that are retrievable. If you already own it, your printing layout demands may already be met. And it is worth noting that both ACDSee and After Shot possess features for developing HTML content. Happy imaging!

Dr. Goldstein practices general dentistry in a group setting in Wolcott, Conn. He enjoys promoting the cosmetic side of his practice and has found it helpful to incorporate high-tech methodology into his daily routine to accomplish this. Dr. Goldstein serves on the staff of contributing editors at Dentistry Today and contributes regularly to multiple dental periodicals.He lectures on both digital imaging in dentistry and on the use of such high-tech methodology to further the cosmetic and restorative practice. He can be contacted at This e-mail address is being protected from spambots. You need JavaScript enabled to view it or (203) 879-4649.


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