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Loupes:
Magnification and Illumination
M
ore and more dental professionals are adding
magnification and illumination as adjuncts to
their armamentarium of dental equipment. In
dental and dental hygiene schools, students are encour-
aged, if not required, to purchase magnification in the
form of dental loupes. However, the seasoned professional
may have multiple questions before deciding to make this
investment.
There are multiple benefits to magnification and illu-
mination. Improved ergonomics is the most important; a
compromised posture can lead to disability and a short-
ened professional career. Other benefits include reduced
eyestrain, work, time savings, and quality patient care.1
Before purchasing magnification, the clinician must
consider various factors: resolution, field width, field depth,
weight, magnification power, and angle of declination.
• Resolution is the capability to visualize small struc-
tures, and is set by the quality of the optical design and
one’s use of precision lenses.
• Field width is the range of focus delivered by the
loupe. Other considerations are diameter of the tele-
scope, optical design, distance from the lens to the eye
and magnification power.2
• Field depth is the range of focus delivered by the loupe.
• Weight is the comfort of the complete frame and loupe
system.
• Magnification power is the size of the image.
• Angle of declination is the correct working angle
(angle of declination) allowing the user to work in a
Susan P. Burzynski, RDH, MSEd
Vice President
Buffalo Dental Hygienists’ Association
Private Practice
Tonawanda, NY
E-mail: KleenTeeth@verizon.net
www.dentallearning.net
comfortable, ergonomically correct position, thus
helping prevent neck and back pain.2,3
In addition to the above factors, the clinician must de-
cide what types of loupes best fit their needs. Clinicians
have the choice of Single Lens Loupes (Class 1), Galilean
Loupe System (Class II), Prismatic Loupes System (Class
III), and Keplerian Prismatic Loupe System (Class IV)
(Figure 1).
In Class I loupes the refractive power is measured in
diopters (a measurement of refractive power and applies
only to single corrective lenses). Class II power is between
2.0 and 2.9 in magnification power; Class III is between
3.0 and 3.9; and Class IV is between 4.0 and 4.9.3
Class I loupes are the simplest form of magnification,
with the lens attached to a frame or headband. They have
limited magnification, a single working vision, and poor
peripheral vision. Class II loupes incorporate 2 or more
lenses that result in higher magnification, are usually tai-
lor made for individuals, and can accommodate illumi-
nation. Class III and IV loupes are similar to binoculars,
can be tailor made, are more expensive, and, because of
the higher power, can result in a smaller field of view.2
Loupes are also available as flip-up or through-the-
lens (TTL). Each has benefits and disadvantages. The flip-
up can be moved out of the way for an unmagnified as-
sessment of the field of view, though they can be bulkier
and heavier compared with TTLs. A change in an eyeglass
prescription can alter the working distance and result in
eyestrain. In addition, as lenses are moved up and down,
the telescopes tend to go out of alignment and the possi-
bility of cross-contamination is increased. TTL loupes are
lightweight, can allow the clinician to sit in an ergonom-
ically correct position, and the eyeglass prescription can
be added to the lenses. This can also be a disadvantage
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
their magnification in the form of a headlamp. Illumina-
tion will eliminate shoulder pain from reaching to adjust
the light, intensity can be controlled, and because the light
source is focused in one location, shadows are eliminated
from the operating field.4 Clinicians need to evaluate the il-
lumination for their personal needs. Considerations for il-
lumination are intensity of the light source, throughput of
the fiber-optic cable, performance of the optics, portability,
color temperature, and CRI (color rendering index), bat-
tery life (light-emitting diode only), and operator comfort.5
Without the use of magnification, loupes, and lights,
the clinician cannot see or diagnose what conditions are
present. Various resolutions in loupes aid in detection of
carious lesions, leakages around margins of restorations,
leakages around crown margins, as well as reading of the
periodontal probe in diagnosing periodontal conditions.
For dental hygienists, detection of supragingival and sub-
gingival calculus is easily detected. Additionally, magnifi-
cation, loupes, and lights aid in the dental professional
sitting in a more ergonomically correct posture eliminat-
2 Dental Learning / February 2011
ing work-related disabilities. Loupes and lights can be pur-
chased, from various dental supply companies, now of-
fering lighter weight units; some without cable and battery
packs, or others with laser eye protection that aids against
harmful radiation. When the dental environment is safer
and productive for both the professional and the patient,
it is a win/win situation for both parties.
References
1. Sheets CG, Paquette JM. Is magnification for you?
http://www.dentistryiq.com. Accessed: August 13, 2010.
2. Juggins KJ. Current products and practice, the bigger the
better: can magnification aid orthodontic clinical practice?
J Ortho. 2006;33:62-66.
3. A Dental Loupes Buyer’s Guide From Orascoptic. Ac-
cessed: August 13, 2010.
4. Cohen MD. Fiber-optic lighting: superior and cost-effec-
tive. http://www.dentistryiq.com. Accessed: August 14,
2010.
5. Dental Economics. Vision enhancement in the operatory.
http://www.dentistryiq.com. Accessed: August 21, 2010.
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