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A Student’s Guide to Dental Loupes- Part 1: The Basics

A Student’s Guide to Dental Loupes- Part 1: The Basics

Loupes. It’s something we hear a lot around our dental school, but a month or so back, if you’d asked me anything about what loupes are on the market or how they work, I’d have absolutely no idea…There’s a distinct lack of information available to help dental students make a decision on whether or not to get loupes, and if they decide yes, there are a dozen different specifications to work your head around…

I recently became the owner of a pair of Heine 2.5x flip-up loupes, and I’m here to share as much information as I can to help you come to an informed decision about dental loupes…

This article is split into 2 parts. The first part addresses the basics of loupes, and the second part looks into brands and specifications.

Please note…I’m definitely not an experienced clinician or loupes user, so the information I’ve written below is based purely upon the questions I asked and the answers I found whilst researching loupes.


Part 1 : The Basics

 

  • Why should I get Loupes?
  • When Should I Get Loupes?
  • Gross Anatomy of Loupes:
    • Through-The-Lens vs Flip-Up
    • Magnification (2.5x or 3.5x)

Why should I get loupes?

There are ergonomic and optical benefits to wearing loupes.

Ergonomics

60-80% of dentists experience chronic back and neck pain1 ,with a contributing factor being poor posture2. In order to keep the patients mouth in focus, you must be at your loupes configured working distance (distance between eyes and working site), which will be set to an ‘ideal posture’:

 

Image courtesy of Schultz Optical

Optical

As shown below, a magnification of 2.5x shows a clear improvement in vision of the working site. The improvements in diagnosis and operative treatment are well documented3.

When should I get loupes?

Now this is the tricky part… research shows that undergraduate students tend not to show an improvement in clinical performance when using loupes4 …Therefore, it would seem that the only clear benefit of dental students using loupes would be from an ergonomic stand point i.e improved posture.

However, from what I’ve gathered talking to clinicians and other students, there are no real disadvantages to using loupes. Therefore you should see benefits (ergonomically at first, then in clinical performance as you gain experience), no matter how early in your dental career you start using a pair of loupes.

Conclusion:

There is no harm in getting them early on in dental school. I found the learning curve very easy and I’m now learning all my clinical skills with loupes on.

N.B. No research has been done to show the impact of starting to use loupes from a pre-clinical stage.

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Gross Anatomy of Loupes:

-Through-the-lens vs Flip-Up

There are two designs for the positioning of the optics:

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TTL-  Have optics that are set in the lens of the frame. The loupes are individually customised for your working distance and inter-pupillary distance (distance between your eyes).

+ Larger field of view (optics close to eye)
+ Lighter
- Expensive

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Flip-Up- Have optics that are attached to a mechanism that allows them to ‘flip-up’ out of the way.

+ Can be flipped out of the way when not needed (e.g whilst talking to the patient)
+ Cheaper
+ Easier to add prescription to frame
+ Adjustable angle of declination
-  Heavier
- Narrower field of view

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Conclusion:

In my opinion I felt that TTL loupes were better, purely because of the lighter weight (more on this in Part 2). However at low magnification (i.e 2.5x), the weight of the optics is light enough that I didn’t feel the extra cost of TTL would be worth it (approx. TTL=£1000, Flip-up=£500).

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-Magnification

The standard for general dental procedures is stated as being 2.5x magnification. However as you can see from a quick search below, there are people mentioning that higher magnification may be a better starting point (as you are likely to eventually move up in magnification).

http://forums.studentdoctor.net/showthread.php?t=486925

As you increase magnification, the learning curve becomes steeper, and the field of view (how much of the working site you can see through the loupes) decreases.

After trying out a few pairs of loupes for a couple of weeks, I found 2.5x was a much more comfortable starting level for me.

Conclusion:

If you can handle 3.5x, it sounds like a good idea to get them and save yourself some money in the long run.  It seems many dentists move up in magnification as they become more experienced using loupes. (often going to 4.5x and more). However 2.5x works great for me, is light, and is easy to use.

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Sadhvik Vijay
2nd Year Dental Student- GKT- KCL

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