Patient photos in a lecture or congress: precautions

Lectures, courses, congresses, and live clinical case sessions always ask for the same thing: the patient's image. It is a legitimate and important use for training in orofacial harmonization. But it is also where the photo leaves the control of whoever took it for good: the audience photographs the slide, the file goes to the organizer, the video is recorded and goes to the event platform.

This page covers what to do before projecting a patient's photo, not after. It does not replace legal advice or your professional board's rules, which should be consulted; it organizes the reasoning.

Why is a lecture a different use from the medical record?

A photo in the medical record is stored, with restricted access, by the professional and the clinic. A photo in a lecture is shown to people the patient does not know, often in a place they do not frequent, for a length of time no one controls. The LGPD (Brazil's General Data Protection Law) treats a face image as personal data, and health-related data as sensitive personal data, which calls for a clear legal basis and a specific purpose. The reasoning is: each new purpose needs a new authorization. See the full picture in consent and LGPD for photos.

What authorization to ask for?

The document should be separate, short, and clear. For lectures and congresses, the form usually spells out:

• which photo or photos will be used (or the type of image);
• where they will be presented (internal lecture, course, congress, scientific publication);
• whether the face appears whole, cropped, or with a bar;
• whether the patient's name or any data about them will be mentioned;
• how long it is valid and how to revoke it;
• that refusing changes nothing about their care.

The page separate consent for image publication shows why each use needs its own acceptance. As supporting text, the consent form should be explained in plain language and without pressure, on the day of the visit or before.

Anonymizing is more than a bar over the eyes

A bar over the eyes is an old and fragile habit. A face is recognized as a whole, not just by the gaze. Before projecting, go over the image looking for what identifies:

Real anonymization removes from the image everything that lets someone trace it to the person. In small-area cases (lip, tear trough, glabella), cropping only the treated area, without the whole face, is the safest way to illustrate the case and is usually just as instructive as the full image. If a tattoo or mark identifies the patient, see photo with a tattoo or mark that identifies the patient.

The file travels with you

A good part of the risk is in the file, not the slide. Some practical rules:

• Export the slides as a PDF and send the PDF to the organizer, never the editable file with the original images embedded.
• Remove metadata and location from the images, as in metadata and location in patient photos.
• Avoid using the presentation on a third party's computer with automatic cloud sync.
• Do not leave the photo on the event computer's desktop after the talk.
• If the lecture is recorded or streamed, tell the patient and the organizer that there will be a recording, and confirm that the authorization covers it.

Whoever presents must also accept that the audience photographs the screen. The authorization should be honest about this: once projected, the image can be captured by others.

What about the "advertising" clinical case?

A lecture is not an advertising piece. Showing a real patient's before and after to sell the clinic, under the label of "clinical case," mixes a teaching purpose with a promotional one and violates the rules on publication. Anyone publishing result images must follow what is in what you can publish (CFO and CONAR) (in Brazil, the dental board and the advertising self-regulation body), according to your professional board's rules, and with specific authorization for publication. If the patient authorized only the lecture, it does not apply to social media.

One more point: never use a simulation image as if it were a real result. An illustrative simulation must be presented as a simulation.

If the patient changes their mind

The patient can revoke the authorization. The organization needs a simple procedure: where the patient gives notice, who receives it, which future uses are canceled, and how files are withdrawn. For what has already been presented, the form should warn in advance that there is no way to take back what was seen. Record the revocation in the medical record, as in the case of deleting a patient photo on request.

Which mistakes to avoid

• Projecting a patient's photo without authorization for that use.
• Relying on a bar over the eyes as anonymization.
• Leaving the patient's name in the file name or caption.
• Sending the editable slide deck with original images to the organizer.
• Mixing a clinical case with clinic promotion.
• Using a simulation as if it were a result.

Whoever prepares a lecture thinking of the patient first rarely needs to worry about the rest. The question that settles almost everything: if this person were in the audience, would they agree with what is on the screen?