Everything is illuminated

On various dental hygiene social media groups, questions about loupes are often posed. Who wears loupes? Which brands of loupes are best? What power is best? What headlamp is best?

I usually am one of the first to respond to these posts, as I am a firm believer in the use of loupes, illumination and the purchasing of your own equipment. I began my profession with no loupes, illumination, goggles, masks or gloves. How in the world I ever worked for 20+ years without protective wear is beyond my comprehension! This will not be an article of which brand is best (although I do have my favorite), or which power is best. The objective with this article is to make you an educated consumer.

Your own pair

My first suggestion to these posts is buy your own equipment. If and when you leave your current employer, this enables you to take your loupes with you to the next facility you work. I do volunteer work and take my loupes with me to the location in which I am volunteering. A few manufacturers sell directly to hygienists—seek them out. When attending either your local or national convention, go to the vendors. When reps come into your office, ask them questions. They want to talk to hygienists! Companies selling loupes may have a payment plan—ask!

Many factors are considered when purchasing loupes, including cost. Don’t let cost be the deciding factor. Remember, you get what you pay for! The other factors are: resolution, field width, field depth, weight, magnification power and the angle of declination. These are fancy terms, but they are terms you should make yourself familiar with:

• Resolution enables us to visualize small structures, and is set by the quality of the optical design and a clinician’s use of loupes.



• Field width and depth is the range of focus and allows for head movement.



• The weight of the loupe and magnification power are also important considerations. If the loupes are too heavy, they can put a terrific strain on the clinician’s neck. Most dental professionals I have spoken to prefer 2.5x magnification, yet others prefer 3.0. What you need to know is that the higher the magnification, the smaller the field of vision.



• Angle of Declination is extremely important. It is imperative to have the representative from the company to come to your office and measure your operating hand position (OHP), neutral posture, maximum rotation angle of the eyes, and the maximum downward rotation angle of the eyes.



• The working distance and the depth of field are important as this is part of the clinician maintaining the same focus.

As you can see, loupes are a very personal thing. Many dental professionals may find neck, back, and shoulder pain when they use loupes that have been handed down to them, or do not pay attention to these details. Some hygienists have stated that they find they become nauseated while wearing their loupes. My suggestion would be to “ease into them” by wearing them for short periods of time. I personally had no problems, but adaptation is different for everyone.

Different types of eyewear

Another question asked on social media is, “Will loupes hurt my eyes?” Again, each professional is different. I have used loupes since 2006, and my optometrist has seen very little change in my eye exam, year after year.

The different types of loupes available for the hygienist include:

• Fixed through the lens (TTL)



• Front lens mounted on the frame (FLM) without vertical adjustment



• FLM with vertical adjustment.

The TTL are mounted to the lens, and seem to be the most popular. Should you have prescription glasses, your script can be added to these lenses. These cannot be adjusted as the declination is fixed. However, they allow the clinician to sit in an ergonomic position.

Many factors are considered when purchasing loupes, including cost. Don’t let cost be the deciding factor. Remember, you get what you pay for!

The FLM without vertical adjustment have lenses attached to the frame that can be flipped up when inputting information in your patient’s chart or during the education portion of the visit. Again, the declination cannot be changed, but the distance is adjustable. The FLM loupes with vertical adjustment are also attached to the frame and can have the declination changed. Both FLM loupes can be shared between clinicians. With either the TTL or flip-up loupes, you need to remember infection control. As you remove them to speak to a patient or to enter patient information in the patient chart, you will need to disinfect the loupes.

Another question posed on social media is, “Why the need for loupes?” I have found the detection of supragingival and subgingival calculus is much easier. Other hygienists have found that, by wearing loupes, they are sitting more ergonomically correct.

Illumination

Along with magnification, illumination can be used. I am on my second headlamp—not because of dissatisfaction, but rather I wanted to upgrade to a headlamp without a cable. Again, I financed these through the company.

The many advantages to wearing illumination include:

• Intense focal illumination eliminates shadowing



• Little adjusting of light



• It does not shine into patients’ eyes

Some headlamps come with cables so that the clinician is tethered to the battery. Some have no cable and yet others come with adjustable light intensity (or lux level). It all depends on what the clinician prefers. Light intensity can also differ between products, so be sure to do your homework in choosing what is right for you.

Susan P. Burzynski, RDH, MSEd, received her associate’s degree from Erie Community College, her bachelor of science degree, as well as her master of general education, from Canisius College in Buffalo, N.Y. She was awarded the Sunstar/RDH Award of Distinction in 2010, a Fellowship from American Academy of Dental Hygiene (AADH) in 2011 and Excellence in Leadership in 2013 from the Dental Hygienists Association of State of New York (DHASNY). As a full-time clinical hygienist, Susan has written numerous articles for hygiene magazines, has worked as a key opinion leader for various dental companies, and volunteered her services to the veterans who have served our country.

References

1. Chang BJ. July 1, 2014, Declination Angle: The Key Factor for Custom Loupes, Acquired August 27, 2017.

2. Burzynski SP, February 2011, www.dentallearning.net, “Loupes: Magnification and Illumination” Acquired August 27, 2017.

3. Shah, MA, Pellegrini JM. November 2010, 8(11): 36-38, Dimensions of Dental Hygiene, Magnification Basics, Acquired August 28, 2017.

4. Cohn MD. June 1, 2005, Dentistry IQ, Fiberoptic lighting: Superior and cost effective, Acquired September 9, 2017