Are loupes really necessary?

[bballrules]

I wanted to ask if loupes are necessary. It looks like most dentists don't use them. Maybe because they are old school and didn't use them earlier in their lives. Everytime I ask dentists about them, they say it's not necessary and it slows you down. I wanted to know if I should buy it or not because I want to get good without them. Money is not a concern, I just don't want to depend on them I guess. Right now I don't have a problem seeing the preps I cut. It seems like everyone in my class is buying them and I feel like I should too, just to hop on the band wagon. Is it really necessary? It seems like everyone is pushing for them in today's generation. Thanks for the input

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[Phlogicyde]

Most of the dentists I know wear loupes. I tend to think they're worth the investment. Not only do they help you see things, they'll force you to sit in such a position so that you aren't slowly killing your back and neck. I certainly wouldn't want to be a dentist with back problems that have developed because I had to slouch over patients.

 

[Synlar]

I just tried my loupes today for the first time in restorative, so great timing with this thread.
You're right at about every point I think. We were advised to get loupes at end of 1st year or start of 2nd year, so we'd have an idea of what we're looking at beforehand.

There are things to make dentistry possibly less stressful. For example, composite resins have just relatively recently become really useful, because before they didn't know how to make them bond to dentin, and now they do. Highspeed handpieces weren't used a long time ago either. You can do an entire prep by just using the slowspeed... it was possible then, and it's still possible now. Just highspeed's a lot faster that's why everyone uses highspeed.

Loupes give you a higher magnification. What's also important is the ergonomics; a professor told us how after so many years of practice, his cervical vertebrae have actually altered because of bending his neck. Loupes have a limited range that is in focus, so you're forced to keep that distance; if you start bending your neck too much, the view will get blurry. Also, you won't be needing to hunch over your maniken head as if you're making out with it, since you can see everything from a distance (because of the magnification).

So, are they necessary? No; as you said, there's many people who don't use loupes and can do perfect preps. Are they recommended? Yes. They probably slow you down because you can see more issues in your prep, so you'd spend more time finishing your prep probably. You could be worried of getting dependant on the loupes, but that's probably because with the loupes you'd realize you could possibly offer the patient a greater standard of care than without them, so wouldn't want to work without them.

What I would also recommend is the light. Yes your highspeed drill has a light... but only when drilling. What if you're using hand tools like a marginal trimmer, or an explorer to check for flash, for example. Also, for endo, crown preps, and extractions where the root tip breaks off, I'm sure the light would be really handy (those were the examples given to me by a demo who recommended I get the light)

You will probably have a loupes fair at your school, or have sales reps from different companies coming in... try out the loupes.

I got my loupes from Q-Optics, they have really great titanium sport frames (no other company has them like how Q-Optics does), and their quality seems great. Also they have lifetime warranties on a lot of the components. There's a lot of info on this forum on loupes, so check it out!

 

[bballrules]

Hi Synlar, thank you so much for the response. You make a very good case. My only question is that people recommend the 3.5s on here and when I tried them on, you can only see about half a quad. This concerns me because I can't see anything else. What if the patient is raising their hand or there's blood shooting out of the other side(haha, both of these examples are extremes). Since I'm only a D2, this might be a stupid question, but I'll ask anyway. I've heard that in the real world, no one ever goes by the ideal prep outline. Instead, they just go and remove the decay and their final preps look like giant craters and their box forms don't even look like anything at all. Dentists tell me that dentistry is mostly by feel. I don't get why it's so important to cut everything perfectly. Why do you need that magnification to see every little scratch for?

You make a great point about the ergonomics too. But I see people without loupes work well into their 60s and seem to have no trouble at all. I don't know why but I always think about whether if i should get them or not. Thanks again for the response

 

[dizzle23x]

I, like you, avoided buying loupes, not due to money, but because I didn't want to become dependent on them. I went in as a D1 and could see what I was cutting so I figured I'd spend the cash on a flat screen instead. Everything worked great, I passed all the preclinical stuff without a hitch and went up to clinic. As a D3, I could see still see fine on my patients. My preps were good but gradually my neck and back started bothering me. It wasn't a severe pain, but I could tell that if I continued doing dentistry the way I was currently doing it for the next x years, I would be in for a world of hurt.

I decided to pull the trigger and utilize my student discount for a pair of loupes because I wanted to improve my ergonomics. I went with the 3.5 expanded field (you can see the whole arch) and a light based on recommendations from dentists I know and reading info online.

The learning curve from no loupes to 3.5EF was probably about 2 clinic sessions. I can see everything MUCH clearer and since my working length is 21", I can't see anything if I'm hunched over so it forces me to sit straight AND use indirect vision (which I rarely used to do). This has just been my experience and as another SDNer wrote, loupes are recommended but not an absolute necessity.

 

[Synlar]

My Q-Optics ones are 3.5X TTL. I can see over them, and to the sides. Make a circle with your thumb and index finger of the same hand, and bring it 1-2 inches from your nose, that area within the 'ring' would be zoomed in, and around it you can still see if you need to. Though yes, sometimes you can be really focused into that field of view, so you have to be careful you're not squishing your patient's nose with your hand when fulcruming, for example. And when doing restorations, the main thing you want to see is the tooth you're working on, and one tooth behind and in front. You can still look over the loupes without much strain to do things like rubber dam.

And if money's not a concern, get the light. I love mine. I was just adjusting my loupes a bit (you can flex titanium a bit to make the nosepiece fit better for example) and looking in the mirror, then I decided to look at my own mouth through the loupes, with the light on; I knew I had a restoration on one of my molars, but wasn't sure how it looked exactly, but for the first time after many years, I was able to finally see it.

 

[omaralt]

Best investment i ever made was getting loupes with an led light. Dramatically improved my ergonomics and work. I wouldn't consider doing endo without loupes and would honestly consider it below the standard of care (most endodontists would say u need a microscope). I don't see why you guys are scared of becoming dependent on them?

 

[TJNova2011]

Hi Synlar, thank you so much for the response. You make a very good case. My only question is that people recommend the 3.5s on here and when I tried them on, you can only see about half a quad. This concerns me because I can't see anything else. What if the patient is raising their hand or there's blood shooting out of the other side(haha, both of these examples are extremes). Since I'm only a D2, this might be a stupid question, but I'll ask anyway. I've heard that in the real world, no one ever goes by the ideal prep outline. Instead, they just go and remove the decay and their final preps look like giant craters and their box forms don't even look like anything at all. Dentists tell me that dentistry is mostly by feel. I don't get why it's so important to cut everything perfectly. Why do you need that magnification to see every little scratch for?

You make a great point about the ergonomics too. But I see people without loupes work well into their 60s and seem to have no trouble at all. I don't know why but I always think about whether if i should get them or not. Thanks again for the response

You must not hear about those with neck/back/shoulder pain. Look into 3.5x expanded field. That'll let you see the entire arch (Design for Visions does, I have those).

 

[TJNova2011]

You must not hear about those with neck/back/shoulder pain. Look into 3.5x expanded field.

 

[Vicviper]

I did fantastic in both amalgam and composite classes without loupes, and I was one of the only people in my class without them - but now that I've got them, I realize how much better my back feels after a long time in the lab. They force me to sit up correctly, and I just love them now. I've got 3.5x regular field, and I can see more or less half an arch - which is all I really need to see. Anything larger, I can just look over the telescopes.

 

[La fea]

I did fantastic in both amalgam and composite classes without loupes, and I was one of the only people in my class without them - but now that I've got them, I realize how much better my back feels after a long time in the lab. They force me to sit up correctly, and I just love them now. I've got 3.5x regular field, and I can see more or less half an arch - which is all I really need to see. Anything larger, I can just look over the telescopes.

Yup.
And while doing restorative you will be using rubber dam. And in the real world you will have an assistant to help you out. And if the patient is in some real emergency, they WILL get your attention, believe you me. If patients are uncomfortable they will manage to get your attention too. Get 'em loupes, save your back.

 

[OG1]

Is it necessary to use a backhoe to dig a ditch? No, because I can use a butter knife to dig a ditch instead; I would prefer to not become dependent on a backhoe to dig ditches.

That's a huge exaggeration, but hopefully you catch my drift. Loupes are a tool that will enhance your ergonomics, your vision in the oral cavity, and the quality of your work. Why avoid a tool that will enhance your dentistry? You are already dependent on the handpiece, radiographs, and lighting.

In orthodontics I've noticed that a few of the older faculty tend to be resistant to advances in the field. One time I was told, "You can straighten teeth with a coat hanger!" Is that supposed to impress me? A surgeon could also do open-heart surgery with a pocket knife.

 

[LeoDDS]

This concerns me because I can't see anything else. What if the patient is raising their hand or there's blood shooting out of the other side(haha, both of these examples are extremes). Since I'm only a D2, this might be a stupid question, but I'll ask anyway. I've heard that in the real world, no one ever goes by the ideal prep outline. Instead, they just go and remove the decay and their final preps look like giant craters and their box forms don't even look like anything at all. Dentists tell me that dentistry is mostly by feel. I don't get why it's so important to cut everything perfectly. Why do you need that magnification to see every little scratch for?

Loupes are great for magnification and forcing a better sitting position on you. It should NOT be a concern that you might be "missing something on the other side"--trust me, if a patient wants your attention or even if something happens, you will see it with or without the loupes. Even though nothing in the real world is by the book (no straight lines, it is all about excavation) the magnification still really really really helps, especially with the finer works (ie, crown preps and root canals). If you're thinking of specializing in oral surgery or pedo then you won't need them, but everything else it will help. I've known new dentists who never picked up loupes in dental school, and now they are really regretting it. Me, it was by far the best investment I made in dental school. Fillings I might do without them, but I can't imagine doing crowns or root canals (especially the access) without my loupes.

The light is also GREAT. I would highly recommend it as well.

 

[3puttinHacker]

Loupes are great for magnification and forcing a better sitting position on you. It should NOT be a concern that you might be "missing something on the other side"--trust me, if a patient wants your attention or even if something happens, you will see it with or without the loupes. Even though nothing in the real world is by the book (no straight lines, it is all about excavation) the magnification still really really really helps, especially with the finer works (ie, crown preps and root canals). If you're thinking of specializing in oral surgery or pedo then you won't need them, but everything else it will help. I've known new dentists who never picked up loupes in dental school, and now they are really regretting it. Me, it was by far the best investment I made in dental school. Fillings I might do without them, but I can't imagine doing crowns or root canals (especially the access) without my loupes.

The light is also GREAT. I would highly recommend it as well.

So would you recommend 2.5x or 3.5x for us dental students?

 

[kitejunky27]

i went with 2.5

all the professors I talked to and my mentor said they use 2.5

The 2.5x are much lighter and more comfortable for me than the 3.5x which seemed off balance.

getting what is comfortable and ergonomic is key

 

[senpai]

So would you recommend 2.5x or 3.5x for us dental students?

Definitely 3.5x. Just learn to use them from the get go. 2.5x doesn't do anything for me. Even after using 3.5x I still feel like I could use more magnification. Most people in my class who got 2.5x were wanting to switch after a few months and most bought higher magnification once we got in the clinic. Don't waste your money on 2.5x. It'll take you just as long to get use to 3.5x as 2.5x if that's all you know...

 

[The Hammer]

Is it necessary to use a backhoe to dig a ditch? No, because I can use a butter knife to dig a ditch instead; I would prefer to not become dependent on a backhoe to dig ditches.

That's a huge exaggeration, but hopefully you catch my drift. Loupes are a tool that will enhance your ergonomics, your vision in the oral cavity, and the quality of your work. Why avoid a tool that will enhance your dentistry? You are already dependent on the handpiece, radiographs, and lighting.

In orthodontics I've noticed that a few of the older faculty tend to be resistant to advances in the field. One time I was told, "You can straighten teeth with a coat hanger!" Is that supposed to impress me? A surgeon could also do open-heart surgery with a pocket knife.

Exactly. I like the "most dentists don't use them" quote. Most dentists also don't make over $200K a year either, doesn't mean that I want to join them. I started on 2.5X Orascopics when I graduated from dental school and now I use 6X designs for vision and can't imagine practicing without them

 

[DrJeff]

I wanted to ask if loupes are necessary. It looks like most dentists don't use them. Maybe because they are old school and didn't use them earlier in their lives. Everytime I ask dentists about them, they say it's not necessary and it slows you down. I wanted to know if I should buy it or not because I want to get good without them. Money is not a concern, I just don't want to depend on them I guess. Right now I don't have a problem seeing the preps I cut. It seems like everyone in my class is buying them and I feel like I should too, just to hop on the band wagon. Is it really necessary? It seems like everyone is pushing for them in today's generation. Thanks for the input

Are they really necessary, absolutely not. For *MOST* folks that have them, do they help make it easier for you to do "better dentistry" - yes. That being said, there's plenty of dentists and dental students out there that went out and bought a pair, used them a few times, and found out that for them, it actually makes it tougher for them to work (for some folks it the weight of them, for some folks its the limited field of vision compared to what they're used to without their loupes on, and for others, its a personal thing)

If you choose to practice without loupes, will that necessarily equate to you being an inferior clinician?? Absolutely not!!

So, if YOU feel that they will allow YOU to do better dentistry, then great, take some time, try MULTIPLE models on (and not just because someone online told you that a certain pair is the greatest ever made 🙄 )

Personally I can say that the in the big scheme of things as I consider my personal experience with loupes (I bought a flip up pair in d-school that I absolutely hated) and now have 2 pairs - different magnification levels - of through the lense that I really like, the magnification I feel lets me see more detail and that's great, however in the big scheme of things, the focal length that FORCES me to maintain proper posture and how that translates into what my back/neck feel like at the end of the work day is the biggest plus! 😀

 

[jk5177]

No. Only air, water, food, and shelter are necessary. Seriously though, I love my loupes, and I use it for everything, even exos. Orascoptic ttl w/ light attachment - I'm in heave with that light. I'm attached to the light more than the loupe itself.

 

[cybermech]

I wanted to ask if loupes are necessary. It looks like most dentists don't use them. Maybe because they are old school and didn't use them earlier in their lives. Everytime I ask dentists about them, they say it's not necessary and it slows you down. I wanted to know if I should buy it or not because I want to get good without them. Money is not a concern, I just don't want to depend on them I guess. Right now I don't have a problem seeing the preps I cut. It seems like everyone in my class is buying them and I feel like I should too, just to hop on the band wagon. Is it really necessary? It seems like everyone is pushing for them in today's generation. Thanks for the input

I've used 2.5x and 3.8x EF in the pre-clinic and have found them to be worthwhile. Though, if I wasn't using a loupe light and expanded field, I'd probably stick with 2.5x.

You can just see so much more with the additional magnification. People say that you can do preps just fine without them. The thing is, because I can see more, I can learn to operative procedures faster than my peers who rely on "feel" to figure out what they're doing. When doing crown preps, I can even see my chamfer better, meaning I can do more conservative preps. It's just good dentistry, IMO.