The Definitive Guide to Dental Loupes

Dental loupes. A minefield of different brands, types, and specifications - coupled with a lack of information available to determine the right loupes for you. It's no wonder that choosing a pair can be a daunting prospect for both students and dentists alike.

In the US, the majority of dental students use loupes - and the UK is slowly catching up.

This article has been written by dental students to give you an unbiased overview of dental loupes.
It has been divided into the following sections:

1. Why you should consider dental loupes
2. What types of loupes are available
3. What to look for when buying loupes

Why Dental Loupes?

Dental loupes are one of the most valuable tools to the practising dentist:

Improved Vision

Dentistry involves operating in small dark areas, performing procedures that require extreme precision. Dental loupes allow you to see a more detailed working site, at an increased magnification. This improved visibility allows you to identify critical details such as root canals, fractures or open crown margins - thus allowing you to diagnose and treat to a higher standard. Attach a light to the loupes, and you'll no longer suffer from shadowing in the mouth.

Superior Ergonomics

Dentists experience a greater amount of neck and back pain than any other profession - with around 70% reporting musculoskeletal pain. This can develop even as a dental student.

Poor vision and insufficient lighting when performing dental treatment often results in poor operator posture. Loupes force you to maintain a healthier posture, thus reducing this problem.

Before loupes

After loupes

Types of Loupes

There are two types of loupes available, and are classified based on the positioning of the optics:

Flip Up Loupes

Flip up loupes have the optics attached to a moveable arm, and can be manually adjusted to suit anyone.

Advantages

• Much cheaper (£100-500+)
• Easily flipped up when not required (good for communicating with the patient)
• Better resale value
• Easier to add prescription

Disadvantages

• Heavier
• Smaller field of view

Through The Lens (TTL) Loupes

TTL loupes have the optics built into the glasses, with the specifications (such as inter-pupillary distance) customised to your eyes.

Advantages

• Lighter weight
• Wider field of view (as the optics are closer to the eyes)
• Optics will always be in the right position

Disadvantages

• Much more expensive (£1000s)
• Cannot be moved from the view, so more difficult to communicate with the patient
• Poor resale value (as only suited to the clinician they are set to)

What to Look for When Buying Loupes

1. Magnification

A range of magnifications are available, with the most common being 2.5x and 3.5x.

Increased magnification provides a more detailed working site. However, there are some downsides:

• Smaller field of view
• Darker field of view (decreased light enters the lens)
• Steeper learning curve for new users

You may come across the terms Galilean (lower magnification) and Prismatic (high magnification, more expensive) loupes.

Image courtesy of Orascoptic

Ideal magnification: For general dental and hygiene work, 2.5x magnification is universally recommended. For more detailed work (eg endodontics), a higher magnification such as 3.5x and beyond is advised.

2. Resolution

Resolution is the ability of loupes to distinguish between two closely spaced objects.

In other words, it refers to the clarity of the image, which is in turn determined by the quality of the optics. For example, think about the quality of a projected image vs the quality of your mobile phone screen.

Image courtesy of Orascoptic

Ideal resolution: unfortunately, the only way you can determine resolution is by trying the loupes on yourself

3. Depth of field

The depth of field refers to the range of distances in which the object remains in focus. It determines how much you can lean into or away from the object (eg if your depth of field is 20cm, you can move 10cm closer to and 10cm away from the object and it will remain in focus). It is important to have a generous depth of field to reduce fatigue.

Image courtesy of Orascoptic

Ideal depth of field: around 10cm should be sufficient

4. Field of view

This term simply refers to the area visible through the loupes. Is the view zoomed in on one tooth, or can you see an entire quadrant?

A larger field of view is preferred as it allows more to be seen, easier introduction of instruments into the operating area, and reduces eye strain.

Image courtesy of Orascoptic

Ideal field of view: for a pair of 3.5x mag, a field view of around 7cm (although remember this will decrease with increasing magnification). Choose a pair that allows you to see everything you need to see for your day to day procedures

As you have seen, there is far more to purchasing loupes than just the magnification. Other factors to consider are the weight of the loupes (remember that you will be wearing them for the majority of the day), and the availability of a light. When purchasing your own pair, remember to ask about all of the above criteria.

Questions to Ask Yourself

1. What magnification and field of view are suitable for my daily procedures?
2. Is the depth of field sufficient in that the loupe will allow me to comfortably practice dentistry?
3. Do I need flip up or TTL loupes?
4. Is a light available to me? Can other lights be used with these loupes?
5. Do these loupes feel comfortable on me?