What photographs and X-rays are needed for an online assessment?

Almost every Istanbul clinic offers a free online assessment, and almost all of them ask for the same thing: send us some photos and we will send you a plan.

That is a reasonable place to start and a dangerous place to finish. What a dentist can tell from photographs is genuinely useful. What they cannot tell from photographs is most of what determines your treatment.

Knowing which is which puts you in a much better position — both to send images that are actually worth looking at, and to recognise a plan that has been built on more confidence than the evidence supports.

What photographs can show

• The shade and general appearance of your teeth
• Spacing, crowding, obvious rotations
• Missing teeth that are visible
• Broken, worn or chipped edges
• Gum colour, visible swelling, visible recession
• How much gum shows when you smile
• Existing crowns or fillings on show, and how well they match

That is a real basis for a conversation. It is enough for a dentist to say which directions are worth discussing.

What photographs cannot show

• Decay between teeth or under existing fillings and crowns
• Bone levels — the single most important factor in whether implants are possible
• Gum pocket depths, which are measured with a probe, tooth by tooth
• Root condition, including previous root canal treatment and any infection at the root tip
• Cracks in teeth
• The position of the sinus and the nerve canal
• How your teeth meet — your bite, which a photograph flattens
• Whether a tooth is loose
• Bone density and volume at a proposed implant site

This is not a small list. It contains most of what a treatment plan actually depends on.

What the X-rays are for

A panoramic X-ray (OPG) is a single wide image of both jaws. It shows bone levels, root shapes, previous root treatments, unerupted teeth, and gives a first look at the sinuses and the nerve canal. Most clinics will ask for one, and if you have had one in the last year or two your own dentist can usually supply it.

Small individual X-rays (periapicals and bitewings) show detail on specific teeth — decay between teeth, the state of a root, bone around one implant site.

A CBCT scan is a three-dimensional scan. This is what implant planning genuinely requires: it shows bone volume in three dimensions, bone density, and the exact position of the sinus floor and inferior alveolar nerve.

The distinction matters. A panoramic X-ray is not sufficient for implant planning. It is a two-dimensional projection, so it cannot show how wide your bone is — and width is what determines whether an implant fits without grafting.

Most Istanbul clinics take a CBCT on arrival, which is normal and reasonable. What is not reasonable is a fixed, final, priced implant plan issued before anybody has seen one.

How to take photographs that are actually useful

Most sets sent to clinics are unusable. Five minutes of care makes a real difference.

Light. Daylight from a window, facing towards it. Not the bathroom ceiling light, which throws shadows straight down into your mouth.

Focus. Tap the screen on your teeth so the camera focuses there rather than on your face.

Retraction. Pull your cheeks back with clean fingers, or use two clean plastic spoons. Lips over teeth is the most common reason a photo shows nothing.

Dry. Wipe your teeth first. Saliva reflects the flash and hides surface detail.

The set worth sending:

1. Full face, relaxed, lips together
2. Full face, big natural smile
3. Teeth together, front on, cheeks retracted
4. Teeth together, from the right, retracted
5. Teeth together, from the left, retracted
6. Upper arch from above — head back, camera looking down at the biting surfaces
7. Lower arch from below
8. Close-up of anything specific that concerns you

Take several of each and send the sharpest. A blurred photograph is worse than none, because it can be misread.

What a good response looks like

A useful reply to an online assessment sounds like a range of possibilities and a list of what is still unknown.

A reply that arrives as a single fixed plan with a firm total price, a tooth count and a schedule, based on nothing but your photographs, is telling you something about the clinic. Not necessarily that they are dishonest — but that the plan was produced by a process that did not require a dentist to look at bone.

Watch for a specific pattern: the plan quotes for a number of units, the price is attractive, and the number changes upward after your scan on arrival. Establishing in advance what happens if the scan changes the plan — who decides, what it costs, and whether you can decline — is worth more than any amount of pre-arrival price comparison.

Getting your records from your own dentist

You are generally entitled to copies of your dental records, including X-rays. In the UK and the EU this sits under data protection law rather than under any dental rule, and a practice should not charge for a straightforward electronic copy.

Ask for them as image files rather than photographs of a screen, and ask for the date each was taken. An X-ray more than about two years old is a historical record rather than a current picture, and should be described as such when you send it.

Doing this before you contact any clinic puts you in a stronger position: the same records go to everyone, so the quotes you get back are actually comparable.

Sending your records safely

X-rays and clinical photographs are health data. A few sensible precautions:

• Prefer a clinic's own secure upload form over a messaging app
• Send the images and nothing else — no passport scans, no card details, no address, no date of birth beyond what is asked
• Ask what happens to your images if you do not proceed, and how long they are kept
• Türkiye is outside the UK and EU adequacy arrangements, so a clinic there should be able to tell you what safeguards apply to data you send them

If a clinic cannot answer that last question at all, that is information too.

Questions worth asking any Istanbul clinic

1. What can you tell from these photographs, and what can you not?
2. What is your plan based on — and what would change it?
3. Do you need a CBCT before this plan is final?
4. When will that scan happen, and is it included?
5. What happens if the scan shows something that changes the number of implants or crowns?
6. Can I decline the revised plan after arriving, and what would I have paid by then?
7. How is my data stored, and what happens to it if I do not proceed?

The short version

Photographs are for conversation. Scans are for planning.

A clinic that gives you a considered range from your photographs and tells you plainly what still needs to be seen is doing the assessment properly. One that gives you a final price and a fixed tooth count from a phone snap has produced a quotation, not an assessment — and the two are easy to confuse until the day you arrive.