Thursday, July 16, 2009

Dental Loupe is a tool

Few months ago, I met an instructor of a dental hygiene program. Her school is known and popular amongst students. The school is often referred to as a futuristic playground for dental hygiene students, and the instructor understandably is very proud of the reputation.

It was a social gathering; the discussion took a turn on to the need of binocular loupes for dental hygiene students. It is always interesting to hear the point of view of those involved in formal academic settings, as magnification loupes is considered controversial by many in the academic setting.

While she acknowledged that dental loupes might be beneficial at the older age, she really argued aggressively that her students did not need these expensive devices since they did not need visual enhancement.

Loupes do enhance the clinical image, but this is not the only reason why dental hygiene students wear the loupes was my argument.

I asked her to explain; why is that studies show recurring evidence of dental hygienists complaining about neck and shoulder pain and why one out of five dental hygienists give up their career early.

The answer is clear.

Dental hygienists also put long hours performing their procedures. Each sitting with a patient is ½ hour to 1 hour long. This certainly puts strain on shoulders, neck, back and eye nerves. At the young age we do not feel this strain as our body is strong and can easily withstand it. Constant strain on these parts gradually takes its toll and symptoms become visible at the later part of one’s career. As bodies get weaker and capability of sitting for long hours gets reduced, dental hygienists are forced to give up their career.

Visual enhancement does help during assessments in probe reading, tissue characteristics, etc; but the most important reason to wear a loupe is to reduce the risk of developing musculoskeletal problems.

Does having loupes solve musculoskeletal problems for every dental hygienist, she immediately argued.

No they will not, was my reply, and then I further explained, dental loupes are simply a tool and as with every tool, dental loupes can only help you if

  • You are using it on regular basis
  • You selected a quality loupe correctly matching to your needs.

A loupe does not directly reduce the risk of musculoskeletal problems, it is your correct posture which reduces the strain on your back, neck and shoulder nerves and thereby reduces the risk of developing musculoskeletal problems at later stage. Loupes can help you maintain your correct posture.

What about exercises, they can also reduce the risk of such physical pain, she asked.

No one can deny the significance of exercises, but one has to understand that exercises are reducing the effects of strain on your body, whereas correct posture reduces the strain itself. They both are complementary and should be part of every dental professional practice. We, as part of STAC Education Series developed special yoga exercises for dental hygienists but the exercises do not reduce the importance of having correct posture.

How can loupes help maintain the correct posture, was her next question.

The key is working distance and depth of view. Every loupe has a fixed working distance and a small range within which image remains focused and this range is called depth of view.

Let’s take an example. Hygienist A has the habit of leaning over the patients while performing a procedure. The distance between her eyes and the mouth of the patient is generally 325-350mm. With the correct posture of her body, the ideal distance is 420mm. She buys a binocular loupe with 420 working distance and let’s further assume the depth of view for that loupe is 50mm. As it happens with every dental professional, when you are cautious you try to maintain your correct posture but as you get absorbed into your procedure, you unconsciously form the posture what you are habitual off. Hygienist A, who has the habit of leaning closer to patient, when starts wearing a loupe with a working distance of 420. As she bends her image will become blurry when her distance reduces to lower than 370mm. She will immediately lean backward to her correct posture. This will gradually change her habit.

Therefore a correctly chosen loupe not only maintains your posture it can change your incorrect posture habit.

There is another aspect one has to understand. Any damage on the body parts is irreversible. Therefore, it is equally important to create and maintain the habit of correct posture and the habit of doing the right kind of exercises regularly at the young age itself. Therefore it is our responsibility to explain and provide dental students the appropriate set of tools.

After much encouragement she agreed to wear the loupe for a month to feel the effect.

I visited her school the next day and helped her too find her correct working distance. I gave her STAC 3.0x Flip Up Loupe with 420mm working distance. After a month she met me with a changed opinion. As she promised, she used her STAC Loupe every day during last month. She feels comfortable and less strained; she admitted that she does not feel any heaviness in her back, shoulder or neck area and her frequency of headaches also was reduced. She feels she cannot live without her STAC Loupe.

I asked to convey her first hand experience to her class also. It is critical that every profession begin to take responsibility for their physical well-being. The leadership has to come from you as an instructor.

The rest is simply a story of her arranging the presentation in the class, students followed her as an example and today every student in her class got their own loupe. She encourages them every day to make it a habit of wearing the loupe in every practice session.

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