Use of Magnifying Loupes among Dental Professionals.

AIM: The study aims to determine the perspective of dental professionals towards magnifying loupes and the selection criteria used while purchasing them. MATERIALS AND METHODS: In this regard, a close-ended questionnaire was structured and distributed among 111 dental professionals. The questionnaire was designed to obtain information regarding the usage of magnifying loupes in dental practices and procedures, limiting factors, and selection criteria for purchasing. The results obtained from this study were statistically analyzed with the help of SPSS. RESULTS: The findings illustrated that most respondents considered the use of magnifying loupes beneficial in dental practices. Also, 20.7% of them preferred "Through-the-Lens" magnifying loupes over "Flip-up" ones. Furthermore, many of the respondents considered that price, magnification, and resolution are the main factors in terms of selection criteria. CONCLUSION: Although, there is an immense growth seen in the usage of magnifying loupes in dentistry; still there is a need to increase the awareness of the dental professionals regarding the positive outcomes of magnification aids in dentistry. CLINICAL SIGNIFICANCE: The study will help enlightening clinicians regarding the selection criteria while purchasing magnifying loupes for dental practices.

Introducing loupes to clinical practice: dental hygienists experiences and opinions.

OBJECTIVES: Recent literature has identified a number of potential advantages in wearing loupes for dental hygienists, including improved quality of care and ergonomics. The aim of the study was to determine dental hygienists' opinions about wearing loupes. METHODS: A short online survey was distributed to all dental hygienists who had recently participated in a study investigating the efficacy of loupes on musculoskeletal disorders; all had only worn loupes for a 6-month period, and prior to the study had not worn loupes. All of those invited completed the survey (n = 12), achieving a 100% response rate. RESULTS: The majority of respondents noted that the loupes were adaptable to wear; however, only one-quarter of hygienists surveyed were wearing them often following the study. Respondents identified that the biggest advantage to loupes was calculus removal (91.7%), and most indicated that they felt the quality of their work increased when wearing loupes (75%). The biggest disadvantage to wearing loupes was the adjustment period (50%), with limited depth of vision, headache, vertigo and infection control noted by at least one-third of respondents. CONCLUSIONS: This study revealed that hygienists identify both benefits and limitations to wearing loupes, and therefore, ongoing support may be required for hygienists adopting their use in clinical practice.

Occupational ocular accidents amongst Greek endodontists: a national questionnaire survey.

AIM: To investigate amongst Greek endodontists, the incidence of ocular accidents during practice, the circumstances associated with them, the therapeutic measures taken after the accidents, their compliance with the use of eye protection and their eye care behaviour. METHODOLOGY: One hundred and forty-seven endodontists met the inclusion criteria and were invited to participate in the survey. Data were gathered through interviews based on a questionnaire. Participants were asked for personal/professional data, information on ocular accidents in the past 5 years, post-accident actions and the type of eye protection used. Their eyesight status and frequency of ocular examination were also recorded. Data were analysed using chi-square test, independent samples t-test and logistic regression. The level of significance was set at P = 0.05. RESULTS: The response rate was 84%. Ocular accidents were reported by 73% of the participants. Amalgam and NaOCl were the foreign bodies most frequently associated with ocular accidents. Medical assistance was sought in 16% of the most recent accidents. No permanent eye damage was reported. Regular use of magnification (OR:0.305, 95%CI:0.123-0.754) and years of clinical experience (OR:0.191, 95%CI:0.066-0.551) were significant predictors for the incidence of ocular accidents. Adequate eye protection was utilized by 82% of endodontists. Endodontists with eyesight deficiencies attended more frequently for ocular examination (P = 0.018). CONCLUSION: A high percentage of endodontists experienced ocular accidents. Regular use of magnification and increasing years in practice were associated with a reduced risk of ocular accidents. The majority of endodontists reported using adequate eye protection.

A critical evaluation of the evidence supporting the practice of behavioural vision therapy.

In 2000, the UK's College of Optometrists commissioned a report to critically evaluate the theory and practice of behavioural optometry. The report which followed Jennings (2000; Behavioural optometry--a critical review. Optom. Pract. 1: 67) concluded that there was a lack of controlled clinical trials to support behavioural management strategies. The purpose of this report was to evaluate the evidence in support of behavioural approaches as it stands in 2008. The available evidence was reviewed under 10 headings, selected because they represent patient groups/conditions that behavioural optometrists are treating, or because they represent approaches to treatment that have been advocated in the behavioural literature. The headings selected were: (1) vision therapy for accommodation/vergence disorders; (2) the underachieving child; (3) prisms for near binocular disorders and for producing postural change; (4) near point stress and low-plus prescriptions; (5) use of low-plus lenses at near to slow the progression of myopia; (6) therapy to reduce myopia; (7) behavioural approaches to the treatment of strabismus and amblyopia; (8) training central and peripheral awareness and syntonics; (9) sports vision therapy; (10) neurological disorders and neuro-rehabilitation after trauma/stroke. There is a continued paucity of controlled trials in the literature to support behavioural optometry approaches. Although there are areas where the available evidence is consistent with claims made by behavioural optometrists (most notably in relation to the treatment of convergence insufficiency, the use of yoked prisms in neurological patients, and in vision rehabilitation after brain disease/injury), a large majority of behavioural management approaches are not evidence-based, and thus cannot be advocated.

Magnification in dental practice and education: experience and attitudes of a dental school faculty.

The routine use of magnification and enhanced lighting by oral health care providers, educators, and students is growing, but there is little consensus regarding its implementation and use. Many students and faculty at the Temple University Kornberg School of Dentistry elect to use some form of magnification in their real and simulated patient care activities, even though the school does not mandate or suggest standards for its utilization. A questionnaire was administered to the clinical faculty to assess two parameters: experience with magnification, and attitudes concerning the value of enhanced vision. Eighty-two out of 124 eligible participants completed the questionnaire successfully for a 66 percent return rate. Sixty-one percent of respondents reported their primary practice or teaching activities as "general dentistry or restorative/prosthodontics." The remainder of the respondents represented a cross-section of other departments and specialists. All endodontists and periodontists who completed the survey and 56 percent of the general/restorative dentists indicated they use magnification. This group accounted for 91 percent of all magnification users. Thirty-nine percent in the magnification users group indicated that they avoid using magnification for some procedures. Faculty magnification users are not in full agreement about the value of enhanced vision in a dental education program. Nearly one-quarter of all magnification users indicated it is unlikely they would use magnification in the teaching environment, even though they may use it in private practice. Various explanations were given for this inconsistency. Only 61 percent of magnification users indicated they make a point to talk to students about the uses and benefits of magnification. While 91 percent of users said that magnification offers significant benefits, only 73 percent believe it should be a program requirement, and 61 percent think it should be required beginning in the first year of the curriculum. The findings of this survey suggest that educational institutions would be wise to address faculty concerns and reasons for resistance before moving to the mandated use of magnification.

Assessing the Use of Loupes and Lights in Dental Hygiene Educational Programs.

Purpose: The purpose of this study was to explore the use of loupes and lights in dental hygiene programs, to assess why they are being used, and to evaluate at what point in time they are introduced to students within the curriculum.Methods: A 20 question survey was developed and pilot tested. The survey was disseminated electronically to 335 dental hygiene program directors in the United States. Frequency distributions were analyzed to provide an overview of the data and Fisher's Exact Test was used to investigate differences between technical/community college programs and university-based programs.Results: Out of the 335 electronic surveys, 143 were completed for a response rate of 47%. Prevention of musculoskeletal disorders, ergonomics, and enhanced vision for instrumentation remain the top three advantages of using loupes. Ninety-six percent of respondents indicated students use loupes and over 50% of faculty use loupes. Fifty-seven percent of dental hygiene programs encourage students to purchase loupes with a light. Fifty percent of students pay $601-$900 for loupes and 47% pay $300-$600 for a light.Conclusion: Student and faculty use of loupes and lights are increasing in educational programs. Future research should focus on the longitudinal impact of using loupes/lights, the prevention of musculoskeletal disorders, and an investigation of the continued use of loupes in a professional setting post-graduation.

The Effect of Magnification Loupes on Dental Hygienists' Posture while Exploring.

Purpose: The purpose of this study was to determine the effects of dental magnification loupes on posture during instrumentation.Methods: A convenience sample of 27 right-handed dental hygienists, with no prior history of injuries or disabilities of the head, neck, or trunk region, enrolled in the study. Baseline posture calibration was taken and tri-axial accelerometers were placed on four locations of the head and trunk (occipital region of head; cervical vertebrae C5; thoracic vertebrae T5; lumbar vertebrae L1) to measure acceleration and the orientation of the body to gravity. Participants were randomly assigned to wear self-supplied magnification loupes during either the first or second half of the session. Dental chair mounted typodonts, prepared with artificial calculus, were used to represent a simulated oral environment. Participants were asked to explore all areas of the mouth using an ODU 11/12 explorer. Mean accelerations of the three axes were used to compute average forward/backward (AP) and side to side (ML) tilt of each accelerometer recorded during the instrumentation sessions. An end-user opinion survey was completed by each participant at the conclusion of the session.Results: No statistically significant differences in posture were revealed between the sessions with the participants wearing their loupes and not wearing loupes. However, data from the end-user survey indicate that 74% of all the participants strongly agreed that magnification loupes made exploring easier and 67% strongly agreed that they felt that magnification loupes improved their posture.Conclusion: While the majority of participants perceived that their magnification loupes enhanced their posture and made exploring easier, data from this study provided little evidence to suggest that wearing loupes leads to improved body orientation. Future research needs to examine the declination angle of ergonomic loupes and its relationship to neck and trunk flexion.

Contemporary dental practice in the UK: demographic data and practising arrangements.

OBJECTIVES: To investigate, by questionnaire, various aspects of primary dental care provision in the North West of England and Scotland. METHOD: A questionnaire containing 79 questions was sent to 1,000 practitioners, selected at random, in the North West of England and Scotland. Non-responders were sent another questionnaire after a period of 4 weeks had elapsed. RESULTS: Overall a response rate of 70% was achieved. The majority of practitioners were practice principals (65%), working in a group NHS practice (80%) located in a city or town centre (49%). On average 10-20 patients were treated each session with fewer patients treated per session under private arrangements. Many practitioners were found to lack hygienist support (44%) and to employ unqualified dental nurses (82%). Younger practitioners were more likely than senior colleagues to have access to up-to-date computers whilst 37% and 74% of respondents never used CAL programmes or magnification respectively. Contemporary cross-infection control standards were used by the majority of practitioners, although 3% of practitioners reported only autoclaving their handpiece once a day. CONCLUSIONS: The majority of practitioners, involved in this study, worked under National Health Service (NHS) regulations as principals in a group practice where the workload was greater than the private/independent sector. Contemporary cross-infection procedures were used routinely. In contrast computer-aided learning programmes and magnification were not used routinely. The practitioners in this study employed significant numbers of unqualified dental nurses.

Disposable optics for microscopy diagnostics.

The point-of-care testing (POCT) is having increasing role on modern health care systems due to a possibility to perform tests for patients conveniently and immediately. POCT includes lot of disposable devices because of the environment they are often used. For a disposable system to be reasonably utilized, it needs to be high in quality but low in price. Optics based POCT systems are interesting approach to be developed, and here we describe a low-cost fabrication process for microlens arrays for microscopy. Lens arrays having average lens diameter of 222 µm with 300 µm lens pitch were fabricated. The lenses were characterized to have standard deviation of 0.06 µm in height and 4.61 µm in diameter. The resolution limit of 3.9µm is demonstrated with real images, and the images were compared with ones made with glass and polycarbonate lens arrays. The image quality is at the same level than with the glass lenses and the manufacturing costs are very low, thus making them suitable for POCT applications.

The dental-operating microscope and its slow acceptance.

This article presents a review of the history of the dental-operating microscope and how it experienced slow acceptance. Following its introduction in 1982, it wasn't until 1997 that microscopy training became manditory for Advanced Specialty Education Programs in Endodontics. Undoubtedly, microscopic enhanced endodontics ultimately reshaped clinical practice and created a potential for a higher standard of care.

The use of magnification in general dental practice in Scotland--a survey report.

OBJECTIVES: This study had two aims, first, to quantify the level of the use of magnification in general dental practice in Scotland and second, to determine the current and potential areas of clinical use of magnification by general dental practitioners. METHODS: A questionnaire was sent to all general dental practitioners in Scotland with a Health Board list number (n = 1790). The questionnaire asked the practitioners about their experience of magnification and their opinions on possible areas for clinical use. An information sheet and a prepaid envelope were included with the questionnaire. RESULTS: One thousand two hundred and eighty (72%) of the dentists replied to the questionnaire. Nine percent of the respondents routinely used magnification. The level of routine use of magnification by practitioners increased with time since qualification. The suggested areas of clinical use of magnification by all the respondents were crown and bridge work, diagnosis and radiography. The routine users of magnification had a more positive view of magnification than non-users. CONCLUSIONS: Routine use of magnification was associated with the length of time the practitioner had been qualified and the attendance at a course at which magnification was discussed. The perceived uses of magnification depended on the experience of the practitioner with magnification. It was considered suitable for all clinical procedures except orthodontics and prosthodontics.

Microscope-assisted precision dentistry.

To enhance their vision for both clinical and laboratory procedures, an increasing number of dental practitioners are introducing magnification into their practices. Most are using either simple or compound loupes mounted on glasses frames. And although magnification is not new to dentistry, it is a trend that is gaining a broader acceptance among both seasoned practitioners and recent graduates. Many dental schools are allowing their students to use loupes on a discretionary basis, so the notion that magnification is reserved only to compensate for deteriorating vision is rapidly disappearing. Dental professionals have also begun to recognize that the quantity and quality of light in the working field is just as important as magnification. Headlamps with focused, color-correct light sources in combination with loupes are becoming popular. It is highly unlikely that a practitioner using loupes would relinquish them and return to practicing without magnification. The newest addition to the vision enhancement arena in dentistry is the operating microscope. In some medical subspecialties--such as otolaryngology, ophthalmology, plastic surgery, and neurosurgery--extensive microsurgical training is required to perform procedures at acceptable standards of precision. In 1998, the American Association of Endodontists (AAE) elected to mandate that all endodontic postgraduate students demonstrate proficiency using an operating microscope before they receive their certificates. Microscope use has also been reported in periodontics. For several decades, many dental laboratory technicians have used stereomicroscopes for trimming dies, refining castings, and performing other procedures that require a high degree of precision. However, according to microscope manufacturers, most current instrument sales are to general practitioners, who are not limiting the use of their microscopes to endodontic therapy--they are using them for a wide variety of procedures. Microscopes have the potential to enhance a dental practitioner's vision to unprecedented levels, but there are some practical questions that need to be addressed. What kind of visual acuity do dentists really need to perform high-quality dentistry? If a dentist wants to improve his or her vision, do loupes provide an adequate level of magnification? Is using a microscope too complicated for restorative and prosthodontic procedures, and how long does it take to become proficient with a microscope? These are some of the questions I posed to two outstanding dentists who have had extensive clinical experience using surgical microscopes. I also share my own experience with a microscope.

Current trends in endodontic treatment by general dental practitioners: report of a United States national survey.

INTRODUCTION: In the United States almost 70% of root canal treatment (RCT) is performed by general dentists (GPs), yet little is known about their treatment protocols. METHODS: A paper survey was mailed to 2000 United States GPs with questions about the types of endodontic cases treated, routine treatment protocols, use of newer technologies, and endodontic continuing education (CE). RESULTS: Completed surveys were returned by 479 respondents (24%). GPs who perform RCT (84%) reported providing anterior (99%), bicuspid (95%), and molar (62%) RCT and retreatment (18%). Rubber dam was used always (60%), usually (16%), sometimes (13%), and never (11%). Newer technologies used by GPs included digital radiography (72%), magnification (80%), electronic apex locator (70%), and nickel-titanium rotary instrumentation (74%). Compared with GPs with >20 years of experience, those in practice for ≤10 years were more likely to use rubber dam (P < .05), nickel-titanium rotary instrumentation (P < .001), apex locators (P < .001), and magnification (P < .01); in contradistinction, GPs in practice >20 years were more likely to perform retreatments (P < .05). Women were less likely to perform retreatment or molar RCT (both P < .05). GPs with >5 hours of CE were more likely to use rotary instrumentation (P < .001), irrigant activation devices (P < .01), and apex locators (P < .001) and perform molar RCT (P < .001) and retreatment (P < .05), but no more likely to use rubber dam. CONCLUSIONS: Recent GP graduates (≤10 years) were more likely to adopt new technologies and use rubber dam than those who practiced for >20 years. More experienced GPs were more likely to take on complicated cases than those with fewer years of practice. There was no association between hours of CE and compliance with rubber dam usage.

Use of dental loupes among dental trainers and trainees in the UK.

INTRODUCTION: Magnification loupes are used in dentistry where increased visual performance is needed. The interest and use of loupes among dental practitioners and students appears to be growing. Despite this little quantitative data regarding the use of loupes in clinical practice and factors governing their purchase among dental trainers and trainees is available. OBJECTIVE: To determine the extent of use of loupes among dental trainers and trainees in the UK and identify what factors influence their choice of selection. METHOD: A proforma questionnaire was designed to collect the information required and was handed out dental trainers and trainees. RESULTS: Use of loupes is more common among the dental trainers (44%) than trainees (28%). Of the nonusers, increased interest among the trainees (83.6%) and trainers (50%) in purchasing loupes was noted. Price was found to be the most important factor during purchase. The majority of users opted for 2.5×; and a light source was a popular choice. Both users and nonusers in the study group had an affinity towards "through-the-lens" type. No significant variation in back/neck discomfort between the users and nonusers was found. CONCLUSION: Use of loupes among dental trainers and trainees remains low. Reduction in price and provision of information could increase the number of loupe users.

Magnification loupes in U.S. entry-level dental hygiene programs--occupational health and safety.

PURPOSE: The purpose of this study was to determine policies and practices regarding magnification loupes among faculty and students in accredited dental hygiene programs as measured by a 31 item, self-designed questionnaire. In addition, the study compared policies among dental hygiene programs in 2 year versus 4 year programs in terms of requirements for the use of magnification loupes. METHODS: After institutional review board approval, a 31 item self-designed questionnaire was emailed via Survey Monkey to 303 entry-level dental hygiene programs. An overall response rate of 75% was obtained. Data were analyzed using descriptive statistics and chi-square test of independence. RESULTS: Results reveal the vast majority of programs do not require loupes for faculty or students, with only 23% of responding schools requiring students to purchase loupes and 8% requiring faculty to use loupes. More dental hygiene programs require students to wear loupes than require faculty to wear loupes. No statistically significant differences (p-value=0.54) in program policies were found requiring the purchase of magnifying loupes by students, based on 2 year and 4 year dental hygiene educational programs. Odds ratio (1.25) give the odds of students purchasing loupes in a 2 year program as 25% higher than a 4 year program. Almost two thirds of respondents reported loupes instruction as a curriculum component, although most respondents spent 2 or less hours teaching in this area. Most programs (90%) do not plan to require students to purchase loupes in the future, although the majority believes proper use of loupes should be integrated in the curriculum. CONCLUSION: Most respondents see advantages to loupes, but clinical policies on loupes do not appear to correlate with beliefs. Educational programs in dental hygiene seem slow to adopt and require the use of loupes. Current clinical polices on loupes should be reviewed to ensure graduates experience the potential ergonomic benefits magnification brings to clinical practice during their education.

Dental hygienists' opinions about loupes in education.

PURPOSE: The present study was conducted in order to explore dental Hygienists' perceptions of the advantages and disadvantages of loupes, and the extent to which dental hygienists believe loupes should be utilized in the educational setting. METHODS: Dental hygienists were contacted through a popular dental hygiene website and were asked to participate in a survey regarding the use of loupes. Eight hundred sixty-eight valid surveys were completed. Participants were asked to indicate the extent to which they use loupes, the environments in which they have used loupes, when they think loupes should be introduced to students in dental hygiene school, and the advantages and disadvantages of using loupes. RESULTS: Results indicated approximately 60.5% of practicing dental hygienists surveyed for the study always or sometimes use loupes, however only 21% had actually used loupes as a student. A number of differences were found between those respondents who use loupes and those who do not use loupes in regards to how they believe loupes should be used in education. Alleged advantages of using loupes received much greater support than alleged disadvantages. Members of the American Dental Hygienists' Association (ADHA) were much more likely to always use loupes than non-ADHA respondents. CONCLUSION: Dental hygienists participating in the survey believe that loupes should be introduced to dental hygiene students, although many believe using loupes should be an option while in school. Wide agreement exists among dental hygienists in regards to the advantages of using loupes. The authors contend that loupes are a vital tool that students should learn how to use, but the use of loupes should be optional once a student has learned how to use them properly.

Use of surgical telescopes by senior dental students: a survey.

This survey examined the use of surgical telescopes (STs) in a large senior dental student class. The percentage of students who purchased STs, factors that influenced those purchases, frequency/patterns of use, and purchase satisfaction were investigated. The survey return rate was 85.3% (128 of 150). Among the respondents, 86% had purchased STs and 14% had not. The most frequent motive for ST purchase was advice received from others (43%); ergonomic reasons were cited by 21% of users. Fixed-lens designs were selected more frequently (70%) than flip-down systems (30%). Nearly all ST purchases were made during the first year of dental school (95%), and low-power magnification (x 2-2.5) was chosen by 88% of purchasers. STs were used more often for operative dentistry, fixed prosthodontics, endodontics, and pediatric dentistry than for practice in other disciplines. ST users expressed a high level of satisfaction with their purchases (84%). The most common reason given for not purchasing STs was being able to see well enough without them (9 of 18; 50%).