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Loupes: making a wise long-term investment

Hygienist Angie Stone purchased her loupes many years ago, proving that making a choice for quality pays off in the long run.
Ellen Slattery & Lynn Pencek, USA

Ellen Slattery & Lynn Pencek, USA

Thu. 19. March 2009


The television shows Grey’s Anatomy, ER, House M.D. and, in the late ’80s, Chicago Hope have used the image of a surgeon wearing loupes. What point are the producers of these shows trying to make? Most likely it is an attempt to make the show technically accurate. It may also be an effort to depict the doctor as a highly regarded professional, making use of the best equipment available in order to provide excellent care to the patient. Isn’t that what each hygienist strives for every day in the practice of dental hygiene? Some hygienists may worry about what patients will think when they begin to wear loupes. Those worries need to be put aside. Patients are very accepting of loupes, maybe because of the popularity of medical shows.

When it is time to buy loupes, as tempting as it may be, the investment should not be based upon how cute the frame looks. With the cost of loupes ranging between US$200 and US$1,800, it is imperative the purchaser understands the quality of the equipment in order to make an intelligent long-term investment. The major consideration is how the optical equipment will perform and how will it stand up to everyday use.

Loupe review

The two most common types of loupe configurations available are flip-up and through the lens, or TTL. Through the lens optics are custom drilled to meet the clinician’s individual needs and are permanently glued in place. The advantages of TTL loupes over flip-ups are:

1. The optics will not go out of alignment.
2. They are better balanced.
3. They are lightweight.
4. They give a wider field of vision because the optic is closer to the eye.

The TTL setup is similar to top-lined reading glasses where the wearer looks over the optic to view the room using distance vision and though the optic when viewing the patient’s mouth at close range. There is now a hybrid TTL loupe on a flip-up hinge similar to the sunglasses being worn by baseball players. Flip-up telescopes are adjustable. Some clinicians with strong prescriptions or bifocals prefer flip-up telescopes because the optic can be flipped up and out of the way. Flip-up loupes have the weight of the optic balanced forward and they can be knocked out of alignment. An important tip for wearers of flip-up telescopes is that the head strap needs to be fastened securely while they are worn. If the strap is not tight around the clinician’s head, the loupes may feel heavy, uncomfortable and they may slide down the nose. Flip-up telescopes are adjustable and can be changed to different frames if needed. It is easy to change a prescription in a flip-up loupe if the vision of the clinician changes. Recently, a hybrid TTL that flips up with a removable prescription insert for additional flexibility has become popular.

Magnification power

Choosing a lower magnification level (class II power, i.e., 2.5x) offers a wider field of vision and a more forgiving depth of field when looking through the optic area than higher magnification. Stronger telescopes zoom in to a narrow field and are difficult to work with independently.

Optic qualities

A good optic should have the following qualities: be lightweight, have a wide field of vision, have three-dimensional image qualities and a very sharp high-resolution image. Low end, less expensive loupes are heavy and have lower resolution image quality. Some loupes have narrow fields that show less than the full mouth, sometimes just a few teeth. Also, some loupes have no depth, which requires the operator to hold a static posture or dictates the operator’s posture.

Product considerations

It is true that consumers get what they pay for. Less expensive loupes may not be made out of high quality materials. Good frames are made of titanium and carbon fiber. If the frame is plastic or aluminum, it may not pass the test of time and may need to be repaired and/or replaced due to daily use.

Ask if the loupes are water sealed. Will it fog when being washed under running water?

If a prescription is involved, ask to have it installed during manufacturing, the better quality loupe companies will install custom prescriptions if needed.

Inquire about the warranty. A good loupe company will have a lifetime warranty on the optic and an extended warranty on the frame.

Before buying

The purchase of a loupe is a long-term investment. It is important to buy a quality product that will stand up to daily use to prevent the need to repurchase in a short period of time. When purchasing loupes, inquire about the following items:

• What are the terms of the trial period?
• What happens if the loupe does not fit or perform as promised at the time of purchase?
• Is the company well established and is it readily available for follow up if needed?
• Is the company a start-up that only sells at the larger trade shows?
• Ask other clinicians about their experience when buying loupes and find out about the companies’ customer service reputation.

Cost is often the main reason clinicians hold off on purchasing loupes. The more established loupe companies will offer extended payment plans, from three to 12 months to spread out the payments of the investment. Also, remember to save the receipt; this investment can be tax deductable!

Hygienists need to keep up with advances in the practice of dental hygiene. Wearing loupes is state of the art and allows the clinician to deliver services of the highest quality to patients while keeping themselves free of back, head and neck problems. How can a price be put on this? It is the responsibility of the buyer to make an informed decision. Do the necessary homework prior to making a purchase so the needs of patients and the clinician are met for the long haul.

Editorial note: This article was originally published in Hygiene Tribune US, Vol. 2, Issue 1, 2009.

Contact info

Contact Ellen Slattery at Contact Lynn Pencek at lynn.pencek@sybronden

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