It is common today to see dentists and even some hygienists donning strange-looking and cumbersome spectacles that look like something from a sci-fi film. The days of the bright overhead operating lights are also coming to an end as clinicians today wear portable headlamps that seem to balance off their glasses. Some dental offices are even equipped with microscopes. The fact of the matter is that dental magnification and illumination is here and it’s likely not to go away.

For years, I have been frustrated when I have diagnosed something like a crack that I can clearly see in a tooth and the patient goes to another dentist who tells them that they have nothing to be concerned about regarding that crack. Due to an accident with my dental loupes (magnifying portable loupes) that have magnified my dentistry by about 5 times normal size for the past several years, I was forced to revert to my old loupes from dental school for a short period of time while my “heavy hitters” were in the shop for repair. Those ones only magnify 2x, and I now know why those dentists have not supported my diagnoses – they simply could not see what I have been seeing!

The most common dental loupes in use today magnify 2x. However, some dentists opt for higher magnification, and many dentists still opt not to utilize magnification. There really is a difference.

Dental magnification
This represents a view that is approximately magnified 2x, similar to 2x loupes. Can you readily identify any major issues with the mandibular left second molar (image flipped for clarity)?
Dental magnification photo
This photo represents approximately what is seen under 5x magnification. The vertical fracture on the lingual of the left second molar is clearly visible.

So, does magnification make for a better dentist? There is no current literature to support that it does. However, I can say from personal experience that magnification does allow early discovery of many problems, like cracks in teeth that may likely lead to tooth loss, pain from which the source is elusive, and infection. In our office, my hygienist uses 2x loupes, I use 5.6x loupes with a 2x mirror (actually allowing me to see a tooth 10 times its usual size), and we occasionally use a video microscope for even closer evaluation. 

Like many dentists, my assistant, my hygienist and I also use portable illumination rather than overhead lighting, which helps to eliminate shadows and allow for better viewing with magnification. If any of these tools would be taken away from me, I truly would be crippled in my dental practice.

Kevin D. Huff, DDS, Spear Moderator and Contributing Author