Microscopes deserve your consideration. They offer you so many benefits above and beyond loupes, that I call loupes “training wheels” for scopes.

Most Dentists think that scopes are only for endodontics, but if the truth were known, 85% of my sales are to GPs. It is absolutely the best modality for consistent accurate visualization for most dental procedures. Anything else is just a compromise.

Scopes are important in four main areas:

I. MAGNIFICATION

Microscopes provide multiple telescopic magnifications with a twist of a dial, from 3x to 20x. The range of magnifications allow your choice of 3,5,8,13 and 20 x and to be able to have a wider field of view and a deeper depth of field than loupes, which only have a single magnification factor. If one chooses loupes with anything over 3x, they become increasingly longer and heavier while the field of view becomes progressively smaller. Combined with their weight, this makes holding one’s head still enough a challenge, it can be uncomfortable on the nose and the use of higher magnifications becomes difficult at best.

For a laser dentist, the magnification has tremendous benefits. If you are doing a frenectomy, you can watch the individual fibers ablate one at a time and you can trace them right to their origin.

As you are contoring tissue, you can easily jusge the optical density so that you can hold the tip at the precise distance from the tissue that gives you the optimum cutting without charring or moving the tip to quickly. You also tend to remove less tissue to accomplish your goal of minimally invasive surgery.

When cutting hard tissue, you are not watching the tip as much as you are watching the effect on the hard tissue. Its amazing the control one gets while viewing your work at high magnification coupled with wonderful light. The magnification available to use is much higher than that’s available with loupes.

2. ILLUMINATION

Whenever you increase the degree of magnification, you spread out the available light. That’s why anything seen under higher magnification seems darker. It requires additional light to compensate for this phenomenon. To achieve adequate illumination with loupes, one should purchase the optional headband light which provides the spot illumination needed.

Microscopes on the other-hand have an integrated, through the lens, bright light source. It completely eliminates shadows because it incorporates a coaxial (line of sight) light path that is always directed where you are looking. Additionally some microscopes have a built-in curing light filter that prevents light activated composites from polymerizing. This intenselight eliminates the need for fiber-optic handpieces and the overhead operatory light.

3. ERGONOMICS

Microscopes really deliver on the promise of comfortable sit-down-dentistry. With a scope, it is no longer necessary to contort and bend your body every which way to obtain good visualization. With proper microscope training, one can sit at the 12 o’clock position even while working with mandibular molars by learning to bring the patient to you, instead of you bringing yourself to the patient. Under a microscope, subtle head movements by the patient are all that is required for proper patient positioning to affect a more comfortable operating posture.

Sitting at the 12 0’clock position is wonderful and is easy to do because the scope alters the normal visual path. Instead of a straight line from your eyes to the opject being viewed, the microscopes extends the visual path forward and then down so that its like looking straight down into the oral cavity.

Because you are sit at the 12 o’clock position, the patients head is looking up at the ceiling. This allows you and your assistant to see better.

Four-handed dentistry is enhanced with a scope because the dentist is not squirming all over the place, and the assistant handing-off instruments to the dentist and keeping everything in the “zone of influence” makes working so much more enjoyable.

4. IMAGING

When one adds an integrated video camera and a monitor to the scope for image capture, the scope will fulfill the same functions as an intra-oral camera, but with the advantage of doing it in “real time”. While working with the scope, one doesn’t have to stop in the middle of the procedure to get the wand, find the tooth, focus, and capture the image. What you see is what you get, in “live action video”. The image can be saved to the computer, emailed, printed on a video or computer printer, or even by recording on a VCR or DVD Recorder. Additionally you can attach a digital still camera.

PATIENT ACCEPTANCE

When patients view their teeth as seen through a scope, it is an impressive education tool that shouts that their dentist is state of the art. They become participants in their treatment planning process and actually help suggest work they want to have completed. They are impressed because they have participated in the planning process, and have ownership and agreement in their proposed treatment plan.

Cost.

Microscopes need not be expensive. You can acquire a basic entry-level unit for abour &#364495 but for the most part, dentists are purchasing units in the &#3611K – 15 K price range. For approximately &#36300 a month on a lease, you too, can be the user of a scope. That’s less than the fee for one RCT. In my warped way of thinking, it costs you more money NOT having a scope than it costs FOR having a scope, because of all it could do for you.

If you are interested in becoming a scope user, feel free to contact me.