Ideal dental loupe magnification

by KEVIN KUO

In the end, the ideal dental loupe magnification is subject to one's own preferences and treatment menu. The following article is meant more to open the dental world to another magnification option besides the standard 2.5x. As an endodontist, I only use a microscope and not loupes. However, I did utilize my 2.5x loupes for 4 years in dental school and my 5x loupes for 1 year in my general practice residency (GPR) a few years ago.

This is what I have learned in my 5 years wearing high magnification loupes in a variety of dental treatments, and why 5x is my ideal dental loupe magnification for all things dentistry.

Using higher magnification certainly requires some level of adjustment

The most common argument against higher magnifications is that higher magnifications are much more difficult to learn as compared to lower magnifications. This is true for two main reasons.

1. There is more of a learning curve at higher magnifications as one's field of view is much smaller. At 2.5x, one can see the entire quadrant at the very least. But at 5x, one can only see around 1-3 teeth at a time, depending on the brand and type of loupes. This difference takes time for the brain to adjust fine motor skills with a smaller field of view. Our brain needs more non-visual feedback to be able to know where our hands are located when we do dentistry. In other words, more proprioception is required to prevent doctors from accidentally hitting patients on the side of their faces when they are trying to move instruments in place intraorally.
2. Secondly, just looking through the higher magnification itself, even without doing dentistry, can be nauseating at first. It is a similar negative experience to wearing a virtual reality headset or polarized glasses at a 3D movie for the first time.

But, I would not say higher magnification is harder to use overall.

Just like indirect vision with dental mirrors, high magnification can become an indispensable tool after some initial adjustment. When I first received my 5x loupes, I already had endodontics in mind. At that point in my GPR, I was already accepted into my endodontics residency. I got the loupes as a transition for my future microscope use--thinking I would only use the 5x loupes for only endodontics in my one-year residency. However, by the end of my general practice residency, I used 5x for everything. 

This absolute use all started in my self-imposed training schedule that I had created to get accustomed to higher magnification. I did not feel comfortably using the 5x loupes right away on root canals, a procedure I was not that familiar with at the time. Instead, I started using 5x loupes for something that most would find ridiculous--prophies. It is indeed an unnecessary procedure with high magnification, but prophies allowed me to practice high magnification safely. Once I became proficient and comfortable with cleanings, I moved on to restorations and crown preparations. It was at this time that I realized that I no longer was just prepping (pun intended) for endodontics.

I came to fruition that high magnification made dentistry easier, all of dentistry. I ended up using 5x loupes for even more dental procedures, like implant placements and surgical extractions. 

Watch the corresponding video about this topic here on KevinKuoProductions YouTube Channel.