749 QUINTESSENCE INTERNATIONAL | volume 52 • number 9 • October 2021
Dental magnification technology evolves to become an industry icon
The past four decades have produced technological advances in dental magnification that have broadened the horizons of con- temporary dentistry.1 Dental magnifying loupes have become the most identifiable tool being donned by dental students and professional dental practitioners alike. It stands to reason that loupe magnification has evolved from a simple tool of the trade to become the recognizable icon of the dental industry, similar to how the stethoscope evolved to become the symbol for the application of medicine and research worldwide.2
The operational field for dental practitioners is confined and cramped, with many other drawbacks. Direct sight lines are often limited, which creates awkward adjustments to contort the clinician’s body, making it deviate severely from an ideal posture.3 Over the course of days and weeks, these ill-advised habits can take a heavy toll on the body; the conditions associ- ated with musculoskeletal disorders (MSD) and optic strain are compounded within an even shorter time span.
It stands to reason that first-year dental students become increasingly aware of utilizing dental magnifying loupes for the following reasons:
■ enhancing procedural quality of work to improve patient care
■ protecting against chronic bodily and optical fatigue made worse by inapt posture and prolonged demands on the eyes
■ increasing the dental practitioner’s ability to function and perform
■ promoting career longevity for the dental professional
■ allowing for proper ergonomics to avert long-term bodily afflictions such as MSD.4
For dental professionals, eye strain is the most common occu- pational hazard. Tension and demand on the retina and optic nerves, combined with varying degrees of shaded and lit areas in the workspace, make it increasingly difficult to direct sight and then focus on either near or extremely close objects quickly.
Studies show that 87% of dental practitioners will suffer from
some type of eye strain and 90% will require some type of visual assistance at some point during their professional tenures.5
The naked eye can distinguish between two distinct lines separated by a distance of 0.2 mm (200 μm). Lines closer to- gether than 0.2 mm are indistinguishable and seen as a single line.1 With loupe magnification set at 2.5×, the resolution in- creases for the human eye from 200 μm to 80 μm, whereas 4.5× magnifying loupes can improve the resolution to 44 μm (0.044 mm).1 Early clinical research confirmed that magnifica- tion allows the dental practitioner to perform procedures more conservatively by reducing the number of invasive operations.6 Despite this, visual enhancement has been met with oppo- sition relative to loupe eyewear, and its repeated use was said to cause adverse effects on the eyes. This controversy appears to be unfounded. Loupes have been shown to safeguard against eye strain and chronic back and bodily strain for first- year students and practicing dental professionals, for the bet- terment of quality work and the benefits of enhanced patient care.6 The routine use of loupes in dental practice will likely continue to grow in the years to come, as evidenced by a sur- vey that stated over 94% of dental practitioners consider loupe magnification technology beneficial.1,5,6
The following six features should be considered regarding opti- mal benefits of dental magnifying loupes:1,5,6
■ working distance and depth of field
■ declination angle and working angle
■ field of view
■ convergence angle
■ magnification
■ illumination.
The selection of the loupes should be made at the discretion of the student or professional based on clarity and optical com- fort. The loupes visual aid was designed to assist with the pro- duction of high-caliber craftsmanship for excellent care and service for the patient.
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In summary, the use of dental magnifying loupes promotes excellence of patient care and prolongs the career of a dental practitioner, with improved ergonomics and decreased eye strain and chronic MSD. Today, dental magnifying loupe tech- nology has evolved into an icon and hallmark of the dental pro- fession, recognized all over the world.
Esteban D. Bonilla, DDS
Health Science Lecturer/Researcher, Section of Restorative Dentistry, UCLA School of Dentistry, Los Angeles, CA, USA
Marc Hayashi, DMD, MBA
Assistant Clinical Professor and Vice Chair of Section of Restorative Dentistry, UCLA, Los Angeles, CA, USA
Walker R. Johnson
UCLA Business School, Los Angeles, CA, USA Cornelis Pameijer, DMD, MScD, DSc, PhD
Professor Emeritus, University of Connecticut, CT, USA; and DLC International, Palm City, FL, USA
Correspondence: Dr Marc Hayashi. Email: mhayashi@dentistry.ucla.edu
References
1. Carr GB, Murgel AFC. The use of the operating microscope in endodontics. Dent Clin N Am 2010;54:191–214.
2. Rice T. “The hallmark of a doctor”: the stethoscope and the making of medical identity. J Material Cult 2010;15:287–301.
3. Maggio MP, Villegas H, Blatz MB. The effect of magnification loupes on the performance of preclinical dental students.
Quintessence Int 2011;42:45–55.
4. Valachi B, Valachi K Mechanisms leading to musculoskeletal disorders in dentistry. JADA 2003;134:1344–1350.
5. Burton JF, Bridgeman GF. Presbyopia and the dentist: the effect of age on clinical vision. Int Dent J 1990;40:303–311.
6. Chou TM, Pameijer CH. The application of microdentistry in fixed prosthodontics. J Prosthet Dent 1985;54:36–42.
Esteban D. Bonilla
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