To Loupe or Not to Loupe
Written by Gurleen Dhaliwal and Sharon Yoon, University of Toronto DDS Candidates
Visuals by Varsha Balaji, University of Western Ontario BSc Candidate
Introduction
Dentistry is a detail-oriented profession where small delicate movements are made in areas of the mouth that are often hard to visualize. Arguably, many dental students and dental professionals struggle to see their work while maintaining proper ergonomics. For this reason, loupes have been introduced as an aid to the dental practitioner. Loupes work to magnify the workspace of the mouth while assisting the maintenance of proper ergonomic form.
However, for newly accepted and incoming dental students loupes can be a confusing, intimidating and unfamiliar purchase. While students may be advised to consider the purchase of loupes for their dental career, they may feel discouraged and overwhelmed by the amount of information available - in addition to the high prices.
In light of this issue, we hope to offer an informative and relatively objective answer to the question every dental student has asked at one point of their career: To loupe or not to loupe?
What are loupes?
So…what exactly are loupes, and why should dental students consider buying them in the first place?
Loupes are magnifying glasses that are used by many professionals such as dentists and dental students in order to improve diagnosis and treatment. Loupes are also beneficial in improving comfort and lowering musculoskeletal discomfort.
For the purposes of this article, we will be discussing two of the most important considerations: Magnification and Illumination.
Magnification
Dental loupes can be purchased in a variety of magnifications from 2.5 x to 5.0x, 6.0x and even 6.5x. Although loupes were initially developed for endodontic procedures, in which very high magnifications tend to be used (e.g. 6.0x), dental students tend to purchase loupes at a magnification around 2.5-3.5x to improve vision while still being able to see the entire dental arch for learning purposes. General dentists also often use a similar magnification and may purchase an additional set of higher magnification loupes for specific procedures such as root canals.
Illumination
Lighting is often overlooked, however it can make a “night and day” difference in a student’s learning and clinical experience. The loupes light is an externally wired or wireless attachment that allows for improved diagnosis and treatment through a better lit field of view. Lights can be purchased with different settings and battery life can extend up to 48 hours. Although the loupes light may add weight to the frames, overall, they are a useful addition.
In addition to the considerations mentioned above, there are also other factors to consider when making this purchase. While we have curated an informative graphic, displaying common benefits and disadvantages, we advise readers to inquire into the features specific to different different manufacturers for purchase.
What are students and practitioners saying about loupes?
To gain better insight into loupe usage and user opinions among dental students and dental professionals we sent out a Google survey form across social media platforms. After closing the survey, we received submissions from a total of 171 respondents.
In the responses, approximately 6% (11) of respondents identified themselves as first year dental students, 21% (35) respondents identified as second year dental students, 9% (16) respondents identified as third year dental students and 11% (18) respondents identified fourth year dental students. Moreover, 2% (4) of respondents identified IDAPP (aka International Dentist Advanced Placement Program) students, 28% (48) respondents identified as general dentists, 16% respondents (28) identified as graduate students, 6% (10) identified as specialists and 1% (1) identified as a data analyst.
Across the 171 respondents, an overwhelming majority 96% (165) responded "yes" to the question of whether they had loupes.
When inquiring further into the magnification utilized by respondents, 33.9% of participants identified having loupes with 3.5X, while 23% and 19% of respondents identified having 3x and 4x magnification respectively. A deeper look into the data showed on average, all cohorts of respondents used loupes of 3-4.5x magnification and 3 general dentists wore loupes of greater magnification (6x, 7.5x and 10x). Overall, it seems that a 3-4.5x magnification is used by the majority of dentists and dental students.
Moreover, nearly 100% of the respondents recommended loupes for students and clinicians. It is also important to note that a recurring comment received was that although loupes are recommended, individuals also suggested practicing without loupes to learn basic manual dexterity skills and to get a better sense of spatial orientation. At the same time, this isn't a set requirement for students as a McGill dental student noted in their response "[a]t McGill Dentistry loupes are part of the tuition and are used day 1 in preclinical training." Many general dentists that responded to our survey also noted that loupes may be beneficial for students in assisting their learning.
Critical comments to note in loupe usage were as stated below:
DDS1
"May strain the eyes a lot at the beginning, but will eventually get used to them."
"I would say first learn how to do resto without loupes to get the basic manual dexterity skills down. Then get loupes to enhance those skills even further."
DDS2
"Finding the right balance is key - I find I forget about important basics (ex bur angulation, monitoring patient comfort) when I rely on my loupes too much."
"I would recommend working without loupes for a while and seeing how a full field of view can help you at times. Even with loupes, for some procedures I prefer to get a good look without loupes because I can get a better sense of spatial orientation. I got loupes in mid second year and it took almost no time at all to adjust to them."
Conclusion
Through this survey we obtained a quick, preliminary look into the opinions and reviews regarding loupe usage amongst dental students and/or professionals. All in all, we found that an overwhelming majority of users utilized loupes that were bought with 3-4X magnification range, and many recommended its purchase to fellow dental students and clinicians. Lastly, commonly brought up points on recommended loupe features included the weight of loupes, magnification, ease of contact with the sales representative, and customer service. Students further elaborated upon these points mentioning a purchase of a cordless light to ease comfort, as well as considering different brands when shopping for comfort and convenience. In conclusion, with the information provided, we hope that readers can look critically at the options available to them and ultimately make a decision best suited for their own learning and dental career.
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REFERENCES:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7414349/
https://www.professionaldentistry.co.uk/news/2019/what-to-look-for-when-buying-dental-loupes