Guidelines For Updating Your Magnification

While many oral health professionals have embraced magnification and illumination as tools to enhance visual acuity in clinical practice, some may find the loupes that once served them well no longer provide peak performance. Although evidence-based literature on when loupes should be replaced is not available, clinicians may experience symptoms indicating it’s time for an upgrade. According to dental ergonomics researcher Claudia Turcotte, CDA, RDH, MSDH, MSOSH, a professor of dental hygiene at Tunxis Community College in Farmington, Connecticut, vision changes are inevitable, and may dictate the need for new magnification setups. This is especially true for operators who are experiencing headaches, increased neck strain, or a reduction in image clarity.¹ Because visual acuity decreases with age, eye examinations are recommended every two years, she notes.

Offering magnification ranging from 2.0x to 3.5x, Galilean loupes contain both concave and convex lenses to produce a clearer image than single-lens setups. They typically provide a sufficient width and depth of field for many procedures. Prismatic, or Keplerian, loupes tend to be heavier, and offer a magnification range of 3.5x to 8.0x, which may be adjustable in some models.² Generally speaking, many dentists will find magnification in the 2.5x to 5.0x range accommodates their clinical needs, as this provides sufficient detail of the operating site while still keeping clinicians attuned to adjacent structures. It is important to know that as magnification increases, the field of vision narrows.

Loupes are available in through-the-lens (TTL), flip-up, or interchangeable-magnification models. Turcotte notes that while TTL loupes do not need optical adjustment, operators should factor in additional fees if prescription lenses are needed. She also advises clinicians to have their interpupillary distance measured when choosing TTL models, as the optics are fixed. Additionally, the fit, weight, declination angle, magnification, depth of field (or working distance), optics and image clarity are key considerations. Providers may also wish to weigh the benefits of antireflective coatings and ease of cleansability in their purchase decisions, and determine whether the loupes will function properly if using a full face shield.

Turcotte points to an additional ergonomic benefit of upgrading, as the overall weight of loupes has decreased over the years, with frames now produced in materials such as plastic, nylon, titanium and carbon composite. At the same time, the ability to personalize loupes has increased, as clinicians can choose from a wide selection of frame designs and colors, including wraparound models that help improve protection. With an eye on the demands of daily use, she advises operators to select a frame that fits best while still ensuring optimal eye protection.

Illumination is another important consideration when upgrading loupes, Turcotte notes. Whether wireless or corded, lights help eliminate shadows and the need to reach up to adjust the operatory lighting. Like loupes, illumination systems are now lighter than previous technology. When selecting wireless lights, clinicians should consider how long it takes for the battery to charge, how long it lasts, and the weight and location of the battery pack. Illumination systems that use LED technology yield a cool, white light and last much longer than halogen lights, she observes. Turcotte suggests that clinicians try various light options to evaluate the clarity and weight of the combined setup.

Ultimately, loupe upgrades should be based on vision changes and clinical demands. An informed decision will be predicated on the operator’s magnification and illumination preferences, and supported by the additional considerations of cost, clarity and warranty coverage. When it all comes together, dentists can render treatment in an efficient and ergonomic fashion that supports not only musculoskeletal health, but also optimal care.

REFERENCES

1. Auger A. When It’s Time to Update Your Magnification. Available at:  https://www.orascoptic.com/en-us/blog/when-it-s-time-to-update-your-magnification. Accessed October 17, 2022.
2. Marsh L, Rivera M. Clinical value of visual acuity. Decisions in Dentistry. 2021;7(1):18,21.

From Decisions in Dentistry. November 2022;8(11)46.