Comfort Zone: Shedding a little light on the subject!

April 1, 2001
In my perfect dental hygiene world, all mouth mirrors would be automatically replaced as soon as the scratches either distort the reflected images or limit the light-reflecting capability.

Those of us in the 40-plus crowd know how critical adequate lighting is to enable us to see clearly. Sometimes, I wish there was a rheostat on every light switch in the world so there would be more and brighter light every time I have difficulty seeing fine details! If you're only 20 or 30 something, you're probably thinking that you can skip this month's discussion. But, please read on because this information is for you, too! Remember, the work we do in the treatment room can only be as good as how well we can actually see what we are doing!

If you're driving down a narrow, winding country lane late on a cloudy night, you wouldn't use your low beams would you? Of course not! You'd switch on your high beams to see all of the obstacles and nuances in the road ahead. Now transfer this concept to the hygiene treatment room.

At a recent continuing-education program, a "dental hygiene comedienne" in the audience raised her hand and jokingly said, "Oh my, you mean number 15 has a distal?" All joking aside, seeing the posterior regions of the oral cavity clearly is often impossible because of inadequate lighting. So what can we do to gain more light on our subject?

First, let's examine some low tech, inexpensive solutions. Take a look at your overhead dental light. Are you losing valuable light because the cover is dusty, grimy, or scratched? Clean the covers and the light reflector with a very soft cloth or towel and an appropriate cleaning solution. Don't forget these components cannot tolerate harsher cleaning chemicals and can be scratched easily with abrasive materials. Replacement covers for most lights are readily available for a nominal fee. Your local dental supply company or catalogue has replacement covers for most lights.

Elementary as this may sound, mouth mirrors often are overlooked. Remember, you wouldn't drive your car with the windshield full of cracks, looking like a giant spider web, would you? In my perfect dental hygiene world, all mouth mirrors would be automatically replaced as soon as the scratches either distort the reflected images or limit the light- reflecting capability. Replacing worn-out mirrors is the least expensive way to improve our lighting other than cleaning the overhead operator light.

Defogging your mouth mirror is the ultimate low-tech problem! Conventional wisdom has us wiping the mirror surface on the inside of the buccal mucosa. A slightly higher-tech solution is to periodically dip the mirror into mouthwash or to wipe the surface with a mouthwash-dampened gauze. This changes the mirror's surface tension which causes water to slide off in a sheeting action, and keepsthe mirror surface clear for an extended length of time. Commercial products also are available that provide the same benefit.

The next tier of solutions involves the high-tech world: lighted mirrors and operator headlight systems. Imagine what you would really be able to see if your mouth mirror was lighted, allowing you to place the mirror where you really need it! Clinicians lucky enough to practice with lighted mirrors quickly become accustomed to working in a well-lit area. They even become acquainted with the distal of the upper-left third molar!

What would you think of a hands-free approach to seeing more clearly? If this concept appeals to you, then consider the ever-expanding world of operator headlights. These devices, long popular in surgical settings, are popping up more and more on the heads of dentists and hygienists. Clear vision and adequate illumination are just as important to the hygienist as they are to the dentist. Imagine how much easier your advanced periodontal debridement appointments would be if only you could see more clearly! Just think how many more fractured teeth could be detected with adequate light. Would periodontal probing be easier? Could you place a better sealant if you could see what you were doing? I think you know the answers!

A tiny, lightweight spotlight, attached to either your operator magnification system or an independent headgear apparatus, focuses a bright circular beam of light on the immediate working area. No more dark shadows, no more partially lit teeth, no more guessing! Suddenly, there is a mini-theater spotlight shedding light on your every move!

The original headlights were halogen and tended to be heavy. The early models did not produce a remarkable amount of additional light and required clinicians to be able to plug the unit into an electrical outlet. Newer halogen head lights produce a much cleaner and brighter light and weigh less than earlier models. Rechargeable lithium batteries power some models, giving the clinician more freedom of movement. This can be a significant benefit when treating patients outside of the traditional dental-office setting.

Fiber optic lights are the most sophisticated choice for operator headlight systems available today. The newest lights weigh about a half-ounce and attach to a generous length of fiber optic cable, which plugs into a light-source unit. It is important for clinicians to protect the fiber optic cable from undue stress and strain to prevent cable damage. Fiber optic light units allow the clinician to control the intensity and diameter of the light beam. These systems may appear cumbersome at first, but once you experience the sheer joy of doing all of your procedures in a well-lit environment, you'll never turn back! Clinicians who practice with headlights will tell you that they improve the quality of patient treatment as much as magnification. The combination is magnificent!

What does the future hold? Technology is moving faster than anyone could ever have imagined. Fiber optic lighting systems are an everyday occurrence for the high-speed dental drills. Imagine if this technology could be adapted to our ultrasonic scaler handpieces!

So, do you still think you're seeing well enough with an overhead light and the same old mirrors? Once you become accustomed to practicing with scratch-free mirrors and additional lighting, you'll wonder how you ever saw anything without them! Just remember to have replacement mirror heads and a spare bulb handy - you will become addicted to practicing in a well-lit comfort zone!

Anne Nugent Guignon, RDH, MPH, practices clinical dental hygiene in Houston, Texas. She writes, speaks, and presents continuing- education courses on ergonomics and advanced ultrasonic instrumentation through her company, ErgoSonics ( She can be reached by phone at (713) 974-4540 or by e-mail at [email protected].