Here you will find my thoughts on common questions posed by dentists. If you have any questions regarding microscopes please email me at Stefan.Luger@dentalmicroscopy.com, or call me directly at 1.410.977.2840.
Will a microscope improve my posture?
Do I need a monitor for my dental assistant?
How do I calculate the magnification on the microscope?
How can I keep the eyepieces from fogging?
What do I do if my view is blocked by the hand-piece?
Will a microscope improve my posture?
You be the judge. The first picture shows the dentist's posture when I arrived at his office. Notice the change in the second picture, after adding the scope and using it properly.
In the second picture, the dentist sits up straight and the assistant passes him an instrument without him having to take his eyes off the eyepieces. That grey arched tubing you see in the picture is from his laser. Of particular note is the innovative manner in which he installed a small monitor on the scope so his assistant can see what is going on exactly as the doctor is seeing it. In this manner she can better anticipate the doctor's need. The silver panel you see is the back of the LCD monitor. Notice his arms are hanging at his side and he is in a very relaxed position.
I have worked with many dentists who have been able to extend their careers due to the inclusion of a scope. They help prevent back and neck problems. Unfortunately I get too many dentists who purchase a scope from me because they are already having back problems, rather than to improve the dentistry they perform.. I would prefer dentists to purchase a microscope in order to help deliver better dentistry.
Just because you have a scope doesn't guarantee you that you will be able to use it properly. That is why I always suggest that one gets training rather than trying to learn it yourself.
Below is another perfect example of a scope user and the difference a little training can do. Look at these photos and see if you notice something:
Part of what in office training does for you is not only teaching you correct positioning of the patients, but also applied ergonomics for you and your assistant. In the first photo, the arms are lifted up like wings. In the second photo the doctor appears more relaxed because his arms are hanging down as opposed to supporting the weight when they are extended out to the sides. Of course one can't eliminate some of these movements, but if aware of the options, one learns to listen to his or her body when it tells you subtly that you are straining it.
Do I need a monitor for my dental assistant?
A dental assistant's monitor makes life a lot easier for both the dentist and the assistant. With a monitor, the assistant can really do things that many dentists never envision. First of all, when they can see what you see, they are able to anticipate your needs sooner and have instruments ready for you. When I train dentists to use a scope, I emphasize trying to keep the eyes on the eyepieces as much as possible in order not to break the rhythm of the work. I have the assistant transferring the instruments while the dentist keeps his hands at the oral cavity so he doesn't have to reposition them every time. I also have him or her change the burs of the hand-piece when necessary. It is so nice to have the assistant blow off a dirty mirror with the triplex syringe without having to tell her or needing to wipe it off yourself.
One of the real interesting things I have the assistant do is to make sure the tooth being worked on is centered on the monitor. It's amazing, when the assistant is able to see better, the dentist also sees better. On the picture below you will notice, the assistant is moving the scope ever so slightly so she can better see the tooth being worked. Some of the assistants are so good that when the dentist is conducting an exam, all the dentist does is either indicate what tooth he wants to see or all l she has to do is follow his explorer which eliminates to a large extent the dentist having stop working to reposition the scope.
Above is a Pediatric Dentist from Sydney, Australia working with his scope. (By the way, do you notice he isn't using the overhead operating light?)
The installation above was very clever in that the dentist had a large monitor on a moveable support arm that allows the monitor to be placed where it could be viewed by both the assistant and patient. On the monitor, not only can you see what he is seeing, but this image can saved. printed, or emailed and used in the same manner as an intra-oral camera. It’s also better because it is live action and you don't have to stop in the middle of your work to grab a camera.
On the above picture, you can see the monitor for the computer that can also display the image from the scope.
In order to work efficiently, the dentist does not use the tray on his over-the-patient unit or on his side delivery unit as the assistant cannot reach it. Instead, she has it on a tray or cabinet in front of her and she has everything she needs within easy reach.
On the picture above, the dentist keeps his eyes on the eyepieces as he rolls his hand back and the instrument is being placed into his hands without him looking up or breaking stride. Here you see my arm in the picture showing the assistant how to do it.
How do I calculate the magnification on the microscope?
Here is the formula for determining the total magnification:
Total Magnification = Binocular Focal Length x Earpiece Magnification x Turret Magnification Factor
Objective Lens Focal Length
If you have an Inclinable head, you probably have a 160 mm focal length. If you have a 10x eyepiece magnification, if you are on a 0.5 position on your dial of the turret, and you have a 25 mm objective lens, then you will have 3.2x magnification.
How can I keep the eyepieces from fogging?
There are a couple of things to consider regarding eyepiece fogging . The problem is that eyepieces may be cool and breath is hot, causing condensation on the lens. Usually the fogging it is a result of your breath being diverted up to the eyepieces via the face mask. Try wearing your face mask in a different position usually lower down your nose. Also pinch the little insert at the top of the mask to fit your nose better.
If you are using eyeglasses, the eyecups should be either removed or folded back out of the way. If you are not using eyeglasses, then the eyecups should be fully extended and you eyes should be in contact with the eyecups. The closer you get your eyes to the eyecups, the wider the field of view and it has a tendency to keep the lenses from fogging.
The other thing you can do is use eyeglass cleaner spray which prevents fogging
What do I do if my view is blocked by the hand-piece?
There are multiple options you can try:
1) You can move the patient’s head slightly one way or the other.
2) You will find that if you use indirect vision by using a mirror instead of direct vision, you will be able to see better.
3) You can angle the hand-piece differently.
4) You can use surgical length burs to move the head of the hand-piece out of the way, yet see where the bur is engaging the tooth.
How do I keep from poking the patient when I am bringing an instrument into the oral cavity? I can’t determine where I am without removing my eyes from the scope.
The best method is to establish a “finger rest” with your pinky finger of the hand with which you hold the mirror so you have a point of reference. If you just hold the mirror suspended in mid-air without this point of reference, you will not know where you are and run the risk of hurting the patient.