More than meets the eye!

June 1, 2002
The use of magnification in dentistry has become an essential element of our treatment armamentarium. This improvement in vision allows for improved diagnosis and higher quality treatment.

By Jeffrey B. Dalin, DDS, FACD, FAGD, FICD

The use of magnification in dentistry has become an essential element of our treatment armamentarium. This improvement in vision allows for improved diagnosis and higher quality treatment. Eye strain and back strain can be reduced with the use of loupes and surgical microscopes.

Four features should be examined when making a decision on on magnification:

  1. Power of magnification - This is the ability of the lens to increase the visual size of what you are viewing.
  2. Working distance or focal length - The less the amount of space between the object and the lens, the higher the power.
  3. Field of view - This is the area that you are viewing through the lens; generally, as the power increases, the field of view decreases.
  4. Depth of field - This is the distance that the lens can be moved and still be in focus. Generally, the higher the power, the shorter the depth of field.

Loupes come in two forms: 1) through-the-lens and 2) flip-ups. With newer optics, the depth of field has improved as well as the field of vision. Loupes range in magnification power from 2.5 to 5.5. Through-the-lens types are usually a little lighter in weight and keep the optics closer to your eyes. They have the disadvantage of always being present and can get in the way when talking with patients or taking photographs. Flip-ups are heavier and can be knocked out of alignment. Their main advantage is that they can be easily flipped up out of your field of vision when not being used.

The major manufacturers of loupes are Orascoptic, SurgiTel, Designs for Vision, Keeler, and Zeiss. Each has its own distinct features. I suggest doing a model-to-model comparison and determine which one gives you the most comfort and best field of vision.

Now, surgical microscopes are beginning to get the attention of dentists. The added advantages of increased magnification and illumination from a microscope take diagnosis, treatment, and ergonomics to a higher level than with loupes. Most microscopes have multiple levels of magnification, ranging from 2.6 to 24 times. With a microscope, you can examine your patient's teeth and soft tissues at numerous focal lengths and levels of magnification.

This added level of visual acuity will help with:

•Diagnosis of decay and microfractures

•Locating and instrumenting canals during endodontic treatment

•Improving posture during treatment

•Lessening eye fatigue and muscle strain

•Patient education

High costs, space requirements in the operatory, and a steep learning curve are some disadvantages of working with a microscope.

Global Surgical, Zeiss, and Seiler are three excellent manufacturers of dental surgical microscopes.

As we continue to make every effort to achieve the highest quality in patient care, our standards rise as well. Precision and accuracy are something we are all striving for. Finding ways to improve our vision can only help us accomplish our goals.

Jeffrey B. Dalin, DDS, FACD, FAGD, FICD, practices general dentistry in St. Louis. He also is the editor of St. Louis Dentistry Magazine and spokesman and critical-issue-response-team chairman for the Greater St. Louis Dental Society. His address on the Internet is Contact him by email at [email protected], by phone at (314) 567-5612, or by fax at (314) 567-9047.

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