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Magnification and Illumination
ore and more dental professionals are adding comfortable, ergonomically correct position, thus
magnification and illumination as adjuncts to helping prevent neck and back pain.2,3
their armamentarium of dental equipment. In In addition to the above factors, the clinician must de-
dental and dental hygiene schools, students are encour- cide what types of loupes best fit their needs. Clinicians
aged, if not required, to purchase magnification in the have the choice of Single Lens Loupes (Class 1), Galilean
form of dental loupes. However, the seasoned professional Loupe System (Class II), Prismatic Loupes System (Class
may have multiple questions before deciding to make this III), and Keplerian Prismatic Loupe System (Class IV)
investment. (Figure 1).
There are multiple benefits to magnification and illu- In Class I loupes the refractive power is measured in
mination. Improved ergonomics is the most important; a diopters (a measurement of refractive power and applies
compromised posture can lead to disability and a short- only to single corrective lenses). Class II power is between
ened professional career. Other benefits include reduced 2.0 and 2.9 in magnification power; Class III is between
eyestrain, work, time savings, and quality patient care.1 3.0 and 3.9; and Class IV is between 4.0 and 4.9.3
Before purchasing magnification, the clinician must Class I loupes are the simplest form of magnification,
consider various factors: resolution, field width, field depth, with the lens attached to a frame or headband. They have
weight, magnification power, and angle of declination. limited magnification, a single working vision, and poor
• Resolution is the capability to visualize small struc- peripheral vision. Class II loupes incorporate 2 or more
tures, and is set by the quality of the optical design and lenses that result in higher magnification, are usually tai-
one’s use of precision lenses. lor made for individuals, and can accommodate illumi-
• Field width is the range of focus delivered by the nation. Class III and IV loupes are similar to binoculars,
loupe. Other considerations are diameter of the tele- can be tailor made, are more expensive, and, because of
scope, optical design, distance from the lens to the eye the higher power, can result in a smaller field of view.2
and magnification power.2 Loupes are also available as flip-up or through-the-
• Field depth is the range of focus delivered by the loupe. lens (TTL). Each has benefits and disadvantages. The flip-
• Weight is the comfort of the complete frame and loupe up can be moved out of the way for an unmagnified as-
system. sessment of the field of view, though they can be bulkier
• Magnification power is the size of the image. and heavier compared with TTLs. A change in an eyeglass
• Angle of declination is the correct working angle prescription can alter the working distance and result in
(angle of declination) allowing the user to work in a eyestrain. In addition, as lenses are moved up and down,
the telescopes tend to go out of alignment and the possi-
Susan P. Burzynski, RDH, MSEd bility of cross-contamination is increased. TTL loupes are
Vice President lightweight, can allow the clinician to sit in an ergonom-
Buffalo Dental Hygienists’ Association
ically correct position, and the eyeglass prescription can
Private Practice be added to the lenses. This can also be a disadvantage
Tonawanda, NY because clinicians may need to be without their loupes
while their script is being changed.2 Dental Learning / February 2011 1

Figure 1—Magnification loupes terminology.

Some dental clinicians decide to add illumination to ing work-related disabilities. Loupes and lights can be pur-
their magnification in the form of a headlamp. Illumina- chased, from various dental supply companies, now of-
tion will eliminate shoulder pain from reaching to adjust fering lighter weight units; some without cable and battery
the light, intensity can be controlled, and because the light packs, or others with laser eye protection that aids against
source is focused in one location, shadows are eliminated harmful radiation. When the dental environment is safer
from the operating field.4 Clinicians need to evaluate the il- and productive for both the professional and the patient,
lumination for their personal needs. Considerations for il- it is a win/win situation for both parties.
lumination are intensity of the light source, throughput of
the fiber-optic cable, performance of the optics, portability, References
color temperature, and CRI (color rendering index), bat- 1. Sheets CG, Paquette JM. Is magnification for you?
tery life (light-emitting diode only), and operator comfort.5 Accessed: August 13, 2010.
Without the use of magnification, loupes, and lights, 2. Juggins KJ. Current products and practice, the bigger the
the clinician cannot see or diagnose what conditions are better: can magnification aid orthodontic clinical practice?
present. Various resolutions in loupes aid in detection of J Ortho. 2006;33:62-66.
carious lesions, leakages around margins of restorations, 3. A Dental Loupes Buyer’s Guide From Orascoptic. Ac-
leakages around crown margins, as well as reading of the cessed: August 13, 2010.
periodontal probe in diagnosing periodontal conditions. 4. Cohen MD. Fiber-optic lighting: superior and cost-effec-
For dental hygienists, detection of supragingival and sub- tive. Accessed: August 14,
gingival calculus is easily detected. Additionally, magnifi- 2010.
cation, loupes, and lights aid in the dental professional 5. Dental Economics. Vision enhancement in the operatory.
sitting in a more ergonomically correct posture eliminat- Accessed: August 21, 2010.

2 Dental Learning / February 2011