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Medical Forum / General / Dentistry / July 2005Loupes or no loupes?
In a book by Mac Lee, I read a while back that one of the defining characteristics (for consumers) of a good dentist is the use of loupes. I'd forgotten all about it, until I came across the following thread on www.dentistry.com today: -------------------- Darius posted 07-25-2005 01:04 AM Hello, I need a few cavities filled. I have seen some doctors who use magnifiers/microscopes for all dental procedures. I am embarrassed to insist that my doctor should use them if he is going to fill my cavities--I would feel much better if he did. Is this reasonable? Thanks ---------- Jeffrey L. Wissot, DDS posted 07-25-2005 07:21 PM Interesting question. I practiced 30 years without using loops. Some dentists prefer them. I think it's really a matter of personal preference. ------------------- What is your take on this topic? What percentage of dentists use loupes for all procedures? Is it one of the surefire characteristics of a good dentist? How necessary are loupes? And for what procedures? Any comments would be appreciated - cheers :-) ! > In a book by Mac Lee, I read a while back that one of the defining > characteristics (for consumers) of a good dentist is the use of loupes. [quoted text clipped - 28 lines] > dentist? How necessary are loupes? And for what procedures? Any > comments would be appreciated - cheers :-) ! This is definitely procedure-specific. A dentist with normal corrected vision hardly needs magnification for denture procedures. However, for most operative procedures they are a definite advantage. For some procedures operating microscopes are becoming the standard of care. Steve  SignatureCut the nonsense to reply > This is definitely procedure-specific. A dentist with normal corrected > vision hardly needs magnification for denture procedures. However, for > most operative procedures they are a definite advantage. For some > procedures operating microscopes are becoming the standard of care. > > Steve Thanks for this :-) (did you mean "dental" rather than "denture" procedures? and how are "operative" as opposed to non-operative procedures defined in dentistry?). I actually found the extract from the book I mentioned above: "Here are a few guidelines to follow and questions to ask when you are looking for the right dental professional for you and/or your family: Does the dentist wear special magnification lenses? This is essential for doing quality work because dental procedures are precise and the dentist is working in a small, dark area on a small object. Most up-to-date dentists will tell you that they would not want to get their dental work done by a dentist who is not using high-tech, high-powered lenses." Now, you should know that a "Steve" rarely makes mistakes <G>. "Denture" procedures refer to constructing dentures (false teeth). Impression taking, tooth selection, try-ins, etc. Not very much in the way of minute detail to be seen. "Operative" is a term we use refering to treating cavities by removing the decay and placing a restoration (filling, inlay, etc.) Magnification helps to ensure complete decay removal as well as restoration placement and finishing. I worked for quite a few years with no magnification (heck, when I started practice, dentists didn't even wear gloves!). I still see a lot of my old work that is doing quite well, so I would say magnification might not always be mandatory. As I've gotten older, I can't get a 'better look' by getting closer to an object. It just gets blurry. So, magnification is an absolute necessity for me so that I can see what I'm doing. If a dentist is careful and skilled, magnification will make treatment easier and it will help ensure that nothing goes unseen. If the dentist is sloppy or less skilled, magnification isn't going to have much of an impact. JME, Fawks > Thanks for this :-) (did you mean "dental" rather than "denture" > procedures? and how are "operative" as opposed to non-operative [quoted text clipped - 11 lines] > dental work done by a dentist who is not using high-tech, high-powered > lenses." I will add that I initially went with loupes to increase the focal distance so I could sit with my back and neck straight. I was starting to get some significant neck pains. Signature~+--~+--~+--~+--~+-- Stephen [What's a Temporary?], D.D.S. Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > > Now, you should know that a "Steve" rarely makes mistakes <G>. [quoted text clipped - 40 lines] >> dental work done by a dentist who is not using high-tech, high-powered >> lenses." > Now, you should know that a "Steve" rarely makes mistakes <G>. > [quoted text clipped - 20 lines] > unseen. If the dentist is sloppy or less skilled, magnification > isn't going to have much of an impact. Word! Steve > JME, > Fawks [quoted text clipped - 14 lines] >> dental work done by a dentist who is not using high-tech, high-powered >> lenses." SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > Now, you should know that a "Steve" rarely makes mistakes <G>. *grin* - of course not :-) (it seems to be quite a popular name around here...) Thanks for the detailed explanation! > "Denture" procedures refer to constructing dentures (false teeth). > Impression taking, tooth selection, try-ins, etc. Not very much [quoted text clipped - 37 lines] > > dental work done by a dentist who is not using high-tech, high-powered > > lenses." Absolutely right, Nobody touches my teeth without loupes on. Signature~+--~+--~+--~+--~+-- Stephen [What's a Temporary?], D.D.S. Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >> This is definitely procedure-specific. A dentist with normal corrected [quoted text clipped - 19 lines] > dental work done by a dentist who is not using high-tech, high-powered > lenses." >> This is definitely procedure-specific. A dentist with normal corrected >>vision hardly needs magnification for denture procedures. However, for [quoted text clipped - 6 lines] > procedures? and how are "operative" as opposed to non-operative > procedures defined in dentistry?). I meant denture procedures. IMO while I suppose magnification could possibly see minute voids in impressions, defects in partial frames etc. generally I don't see much utility. It is also useful to do try-ins and other procedures involving esthetics using wide unobstructed vision--seeing things as others would. OTOH, most operative (drilling, restoring), endodontic, and periodontal procedures benefit from magnification. I'm a relatively recent convert to using loupes. First I tried the Oroscoptic 2.5X, but found them very difficult to use mounted on a bifocal lens (in my civilian life I use progressive bifocals). They were also rather uncomfortable on my nose due to their weight. I now use Designs for Vision 2X, which are less uncomfortable. They are mounted on a monovision lens halfway between the upper and lower of my bifocal prescription. My brother who started with the Designs for Vision 2X has moved onto these ridiculous-looking 4.5X, which in order to have a usable depth of field are very, very long. It took him a while, but he has gotten used to them. Most endodontists around here are now using operating microscopes, which have adjustable magnifications usually in the 6-30X range. These have helped detect small canals which previously might have been missed. A few years ago there was a dentist whose name (IIRC) was Glen Van As, from Vancouver. He was advocating operating microscopes for all operative dental procedures. Personally I think this is overkill, but I'm sure there are times when it would be very nice to have. Steve > I actually found the extract from the book I mentioned above: > [quoted text clipped - 7 lines] > dental work done by a dentist who is not using high-tech, high-powered > lenses." SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > I meant denture procedures. Thanks for clarifying - I wasn't quite sure (you must forgive me - but after reading all about "loops" ;-) - see my first post - I thought it might have been a typo). Obviously, I should have known better (with the answer coming from a "Steve" :-)). And thanks for the explanation below! > IMO while I suppose magnification could > possibly see minute voids in impressions, defects in partial frames etc. [quoted text clipped - 40 lines] > Brooklyn, NY > 718-258-5001 I still remember the first week I used loupes and I thought to myself, "Wow, I have not been as accurate as I could have been!" Loupes makes the dentist much more accurate. Signature~+--~+--~+--~+--~+-- Stephen [What's a Temporary?], D.D.S. Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >> In a book by Mac Lee, I read a while back that one of the defining [quoted text clipped - 36 lines] > > Steve After using them (Designs for Vision 3.5X - super nerd frames) for 11 years, it would be tough to do dentistry without them. I'm definitely hooked! > In a book by Mac Lee, I read a while back that one of the defining > characteristics (for consumers) of a good dentist is the use of loupes. [quoted text clipped - 28 lines] > dentist? How necessary are loupes? And for what procedures? Any > comments would be appreciated - cheers :-) ! I like Orascoptics' TTL (through the lens) loupes. They're very light, and unlike the Designs for Vision ones, they're fully submersible in water for cleaning. > After using them (Designs for Vision 3.5X - super nerd frames) for 11 > years, [quoted text clipped - 32 lines] >> dentist? How necessary are loupes? And for what procedures? Any >> comments would be appreciated - cheers :-) ! > After using them (Designs for Vision 3.5X - super nerd frames) for 11 years, > it would be tough to do dentistry without them. I'm definitely hooked! I agree. I bought a second pair just in case I broke my main ones. I am so dependent upon them that I wouldn't practice without them. Fawks >> After using them (Designs for Vision 3.5X - super nerd frames) for 11 years, >> it would be tough to do dentistry without them. I'm definitely hooked! [quoted text clipped - 5 lines] > >Fawks That's a good idea, a back-up pair. I wouldn't practice without magnification either. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com Each time I upgrade to higher magnification, I keep the last pair as a "spare". The first pair I bought are now in the garage-shop for when I need to work on something tiny at home. Signature~+--~+--~+--~+--~+-- Stephen [What's a Temporary?], D.D.S. Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >>> After using them (Designs for Vision 3.5X - super nerd frames) for 11 [quoted text clipped - 15 lines] > Take out the G'RBAGE > wubbabubbazG@RBAGEyahoo.com >Each time I upgrade to higher magnification, I keep the last pair as a >"spare". The first pair I bought are now in the garage-shop for when I need >to work on something tiny at home. "Ten-Foot Pole" Alert... <G> -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >>Each time I upgrade to higher magnification, I keep the last pair as a >>"spare". The first pair I bought are now in the garage-shop for when I need >>to work on something tiny at home. > > "Ten-Foot Pole" Alert... <G> That's just WRONG!! (tee hee) Steve > -- > > W_B > Take out the G'RBAGE > wubbabubbazG@RBAGEyahoo.com SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 Too funny! Fawks The first pair I bought are now in the garage-shop for when I need >>to work on something tiny at home. >>Stephen [What's a Temporary?], D.D.S. > > "Ten-Foot Pole" Alert... <G> > -- > > W_B Hey,,,,,,, quit picking on me! Signature~+--~+--~+--~+--~+-- Stephen [What's a Temporary?], D.D.S. Michigan, USA .................................................... ...................... > > Too funny! [quoted text clipped - 10 lines] >> >> W_B OK, I guess you have enough troubles already. Before W_B chimed in, I was going to agree that working with magnification at the office, led me to occasionally use them at home for certain projects. His comment just kind of changed the whole thread. Sorry. <G> Fawks > Hey,,,,,,, quit picking on me! <vbg> Signature~+--~+--~+--~+--~+-- Stephen [What's a Temporary?], D.D.S. Michigan, USA .................................................... ...................... > > OK, I guess you have enough troubles already. [quoted text clipped - 11 lines] > >> Hey,,,,,,, quit picking on me! >OK, I guess you have enough troubles already. >Before W_B chimed in, I was going to agree that [quoted text clipped - 10 lines] > >> Hey,,,,,,, quit picking on me! I use them for working on computers, on the hardware that is. Sometimes hard to read those litte letters on the jumper settings. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com
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