Microscope

[drmithila]

It is universally recognised that what often influences the quality of treatment is the level to which the clinician can see.

The dental microscope is unparalleled in its ability to provide an intensely illuminated, magnified image of the operating site. Despite the fact that Surgical Operating Microscopes [SOM] have been used by medical specialties since the sixties; the SOM has not been so readily accepted into dentistry.

Whilst general dental practitioners have predominantly seen dental microscopes as specialist equipment, typically endodontists have recognised and readily acknowledged the benefits of operating at higher magnification with powerful illumination. More recently however, it is becoming an increasingly held belief that the dental microscope offers considerable advantages over direct visualisation and loupe magnification.

Improved Magnification and Lighting

The higher magnifications achieved with a dental microscope improves the end result by not only enlarging the operating site, but also by providing intense homogenous co-axial lighting. Both these factors allow the clinician to visualise features not otherwise perceptible to the naked eye or even with loupes. Such improved visual acuity improves precision and the range of treatment options available. Microscopic examination methods and microsurgical techniques have transformed the way that the modern clinician operates.

Improved ergonomics and reduced musculoskeletal strain.

Other than the obvious advantage of higher magnification, the microscope offers distinct ergonomic advantages over loupes and the naked eye. Dentists work in conditions that frequently produce musculoskeletal disorders. Physical load, repetitiveness and poor body posture when seeking visual approaches to poorly illuminated areas of the mouth all contribute towards the high risk of developing shoulder, neck and back complaints. The more upright posture of the clinician when using a dental microscope may contribute to less neck and back strain.

Improved Patient Communication and Acceptance of Treatment

One of the great benefits of capturing digital images is improving the patient’s dental awareness and their recognition for the necessity of a particular treatment. In the absence of symptoms, the majority of patients are unaware of the conditions of their mouths. Communication between the clinician and patient is improved infinitely by the clinician being able to demonstrate to the patient the condition of their teeth before, during and after treatment.

With a digital video or stills camera attached via a beam splitter to a surgical microscope, patients are clearly able to observe the enlarged image of their teeth. Cracks, failing restorations, defective crown margins and periodontal pathologies can all be easily identified by the clinician and shown to the patient as a high quality digital image. What is more, the patient can clearly see the improvement in the quality of care they have received by the use of a microscope.

Disadvantages of Dental Microscopes?

Some dental practitioners have concerns that the use of the microscope may unjustifiably slow down treatment; and feel that patient and staff resistance to this new technology may prove to be an insurmountable problem. Whilst it is true that the learning experience for the whole dental team is steep; a new approach to treatment fully integrating the microscope will gradually reduce the longer appointment times initially required.

Support staff will require time to learn the new methods of working, with fourhanded dentistry offering a considerable advantage. Besides, time wasted attempting to locate root canals, or refining crown or cavity margins, will be significantly reduced when compared to using loupes or the naked eye.

“There is no question that the introduction of the microscope into the delivery of dental care is profoundly significant…”