My recent post on colour management in clinical photography mentioned that Adobe Camera Raw (ACR) could not flip images vertically or horizontally, which is needed for mirror images in Dental photography. This has been possible in Photoshop but the feature has now been introduced with a new version of ACR, in February 2018. 

Many dental images are taken with mirrors; the occlusal surfaces of the upper arch, for example, is taken with a the patient tilting his or her head back a little, a palatal mirror is gently put into the mouth to the back molars and the photographer can then see – and photograph – the upper arch reflected in the mirror. However, as it is literally a mirror image, the resultant picture needs to be returned to an anatomically-correct orientation and this is done by flipping the image vertically, i.e. along the horizontal axis. Usually this is done in Photoshop: Image menu, Image Rotation -> Flip Canvas Horizontal or Flip Canvas Vertical.

I put in a Feature Request to the Adobe Camera Raw team back in October 2017 for this to be introduced in ACR and was really pleased to see this happen so quickly, so for those photographers following my colour-managed work flow, the ability to do this in Camera Raw and then exporting straight to the chosen format is a welcome addition. But you need to know the secret key combination to access it…

Firstly, make sure that your Adobe Creative Cloud app (ACC) has delivered the update to ACR. You should have version or later. To check, open any raw-format image in ACR and then use Ctrl-K or click the Preferences icon at the top. The version number will be shown at the top of the Preferences screen, as seen here.

ACR version Feb 2018

If you have an earlier version, you will need to get the update through the ACC application (Check for App Updates) and ensure that you have this version or later.

With an image open in ACR, you will that the usual set of icons across the top looks like this, with the Rotate Left and Rotate Right icons at the far right.

ACR menu bar - rotate

Press the Alt key (Windows) or the Opt key (Mac) and they change…

ACR menu bar - flip

…into the Flip on Vertical Axis (i.e. flip left-to-right horizontally) and Flip on Horizontal Axis (i.e. flip top-to-bottom vertically) icons.

So now, you can take your mirror views of the upper arch, or mirrored lateral buccal views and re-orientate them using the Flip keys in ACR without having to take them into Photoshop.

Composite views: mirror images in dental photography

Big thanks to the Camera Raw team at Adobe for this feature and to colleagues at Birmingham Dental Hospital for the mirror views above.

Anyone interested in clinical or dental photography should visit the IMI site for more information on this specialist work.