Seeing is believing

July 1, 2000
`I`m not old enough to need magnification.` Age has nothing to do with it. Being able to see better helps you do better clinical and diagnostic work. You don`t know what you`re missing.

Anne Nugent Guignon, RDH, MPH

`I`m not old enough to need magnification.` Age has nothing to do with it. Being able to see better helps you do better clinical and diagnostic work. You don`t know what you`re missing.

At the beginning of a recent course on ergonomics, I asked dental hygienists to complete a short survey prior to the presentation. More than a third of the participants responded that they were currently experiencing pain, discomfort, or soreness because of the way they practice hygiene. Of these respondents, more than one third listed back, neck, or shoulder problems.

Statistical gurus may challenge this poll because it was not a random sample, or they could point out that the audience might have attended simply because of the topic. However, through the years I have come to realize that most hygienists have experienced some type of discomfort, if they practiced long enough.

Often, hygienists reduce their work schedules, retire prematurely, get totally burned out, or suffer permanent disabilities. Practicing today`s dental hygiene - frequently in a 30-year-old delivery model using outdated and worn equipment - can accelerate or accentuate these problems. Recent graduates are suffering work-related injuries in addition to those of us who have practiced for decades. From a public health perspective, this is an epidemic.

One of my favorite questions to ask a hygienist experiencing burnout or work-related pain is, "Would you be happy with dental hygiene again if you could practice in comfort and be rid of the physical aches and pains?" A look of wonderment often fills their faces. The resounding "yes`s" are overwhelming. My answer is simple. You can practice in comfort and fall in love with your profession all over again.

Sitting up straight to see

Correct posture is the foundation for solving the comfort puzzle. A fast track to good posture begins with wearing high-quality magnification, not drug store "cheaters." Quite simply, if you are wearing loupes, you are forced to sit up straight. If you try to lean in too closely, everything gets blurry and you can`t see what you are doing. Unless you are one of the very fortunate (and very rare), you were not trained to use magnification when you began your education. Thankfully, dental hygiene educators are now encouraging students to consider magnification, and, in some programs, loupes are mandatory.

When you are fitted for high-quality magnification, measurements are taken which determine factors such as working distance, frame size, and color. Loupes can be fabricated to incorporate the requirements of your prescription eyewear. Magnification lenses can be fabricated in either a flip-up binocular style mounted on the frames of glasses, or in a fixed, through-the-lens system. Loupes magnify at a minimum of 2x but can range upwards. My first pair of loupes was the 2x flip-up style. Now I use a 2.6x through-the-lens system and am considering an increase to 3.25x. Each magnification configuration offers a difference in width of visual field, working distance, amount of light through the lens, and weight.

As with any serious purchase, it is important to consider different designs and models offered by the various manufacturers to get the perfect fit. Some companies offer a grace period after the initial purchase. What is the return policy? Are there any payment plans to cushion the budget? How is the company`s customer service? Serious companies want satisfied hygienists. Ask your hygiene colleagues about their experiences. Gather information from journal articles, ads, the Web, and professional meetings.

Now for the test - wear the loupes! Expect a learning curve. Remember quality magnification must be custom-fitted. You will need an ounce or two of patience to get your bearings. Learning to practice dental hygiene with loupes is not a point-and-shoot experience. Each one of us has a different break-in period. But if you`re willing to give it a serious try for a week or two, you will reap the rewards. Your clinical skills and observations will improve. You will be amazed at what you`re now seeing. Soon your sore neck, shoulders, and back will be a thing of the past. Your dental hygiene focus will change dramatically.

If you are not convinced that magnification is for you or you can only focus on the barriers, then take the time to consider the top 10 reasons hygienists resist magnification:

1. I`m not old enough to need magnification. Age has nothing to do with it. Being able to see better helps you do better clinical and diagnostic work. You don`t know what you`re missing.

2. I only work in pedo. Pedo deserves the same careful quality. Wait until you do a sealant with magnification!

3. My patients won`t accept or understand magnification. Patients are smart, and we are the educators. Help them understand how it makes you a better clinician and more comfortable physically. No one wants a worn-out hygienist in pain.

4. My doctor won`t let me. Consider whether you really want to work with someone who does not want you to practice at your best. Your doctor may feel threatened. Put on your educator hat again.

5. My doctor won`t pay for magnification. As harsh as this sounds, get beyond this. We are professionals and generally have more income than many of our patients. Re-evaluate your priorities and remember it is your body that`s hurting.

6. I can`t do this. I work in several dental offices. Pack the magnifiers and take them with you in their handy storage case.

7. I can`t afford it. It`s not in my budget. If you`re hurting, you can`t afford not to use magnification. Think how you could afford something else you really wanted, such as a new car.

8. If I get hurt, I?ll do something else. If you get injured badly enough, you may be limited on what else you can do. Besides, who wants to get hurt because of a job?

9. Loupes aren?t attractive. Is a hygienist bent over like a pretzel attractive? Loupes are available in fashion colors just like everything else in dentistry.

10. I don?t want to look like a geek. If it weren?t for the geeks, we?d still be in the 1950s. Think of yourself as a trendsetter.

A decade ago, I didn?t know a single hygienist who was wearing magnification. Then I met a hygienist at a dental meeting in Vancouver. My unknown mentor told me: OIf you ever begin practicing hygiene with loupes, you?ll never be without them.O Her wise words gave me the courage to go forward. When I began wearing loupes, I felt awkward, conspicuous, and perhaps a bit pretentious. My doctors and co-workers laughed when I first put them on. Now is my chance to say Othank youO to that unknown hygienist for her life-altering advice.

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].