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Dr. Bethany Valachi, PT, DPT, MS, CEAS is DPR’s ergonomics editor and author of the book,“Practice Dentistry Pain-Free” and clinical instructor of ergonomics at OHSU School of Dentistry in Portland, Ore. She is also the author of the evidence-based "Online Dental Ergonomic & Wellness System for Dental Professionals." A physical therapist who has worked exclusively with dental professionals for more than 15 years, she is recognized internationally as an expert in dental ergonomics, and has been invited to lecture at more than 300 conferences worldwide. She has published more than 50 articles in peer-reviewed dental journals and has developed patient positioning and exercise DVDs specifically for dental professionals. Bethany offers free newsletters, articles, videos and product reviews on her website at www.posturedontics.com and can be reached at firstname.lastname@example.org.
Loupes are an expensive investment that should last you many years. Find a loupe that will improve your health-not make it worse.
Dear Bethany: I am a dentist whith neck pain. I bought some ergonomic loupes and it feels like my neck pain has actually gotten worse! Is it possible for loupes to cause neck pain?
Dear Doctor: YES. There are both ergonomic and non-ergonomic loupes on the market today. Unfortunately, the term “ergonomic” is used freely (and with little understanding of the word) by many dental loupe manufacturers.
Research shows working with your neck bent forward only 20 degrees or more for 70 percent of the working time has been associated with neck pain. Therefore, to prevent musculoskeletal injury, your loupes should enable you to work with less than 20 degrees of neck flexion.
To stay within this safe head posture requires loupes with a large declination angle- 40 degrees or greater (Fig. 1). The smaller the declination angle, the worse the head posture. When shopping for dental loupes, check the manufacturer’s literature and/or website. Many companies mention the word “ergonomic,” however, if there’s no mention of declination angle, it’s unlikely their loupes will keep you in a safe head posture.
Vertically adjustable flip-up loupes are generally the most ergonomic style on the market that consistently keeps operators in a safe head posture because you’re in complete control of the declination angle. Many of the new ultra-lightweight flip-ups on the market today are as lightweight as through-the-lens (TTL) loupes.
FIg. 2Fig. 1
The declination angle of TTL loupes is typically much smaller than the flip-up style and often forces the operator into unsafe forward head postures. Among my dental students, I’ve repeatedly measured the declination angle of TTL loupes that were promised to have a large declination angle of 40-45 degrees, only to discover they had only a 20-25 degree declination angle (Fig. 2). There are, however, two loupe companies on today’s market who can make a specially ordered TTL loupe with a 40+ degree declination angle.
When assessing flip-up loupes, keep in mind scope position is critical. You can have loupes with the best declination angle on the market, but if they sit high in relation to your pupil, you’ll lose much of the ergonomic benefit because you must lean further forward to look through the scopes. There are several non-ergonomic flip-up loupes on the market that aren’t vertically adjustable, which will cause the same poor postures as seen with most TTL loupes. Therefore, vertical adjustability is an essential feature on flip-up loupes.
Declination angle and many other important loupe ergonomic considerations are discussed in the video, “Dental Loupes that Prevent Neck Pain” at www.posturedontics.com:
Loupes are an expensive investment that should last you many, many years. Take the time, do the research, and find a loupe that will improve your health-not make it worse!