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Solving Work Related Pain in Dentistry

Are Your Dental Loupes Causing Pain?

-Dr. Bethany Valachi-

Click below to watch Dr. Valachi’s NEW VIDEO:

“Ergonomic Guidelines for Selecting Dental Loupes”


Imagine spending $1,500 on new loupes, and you suddenly begin to develop neck pain, or, your existing neck pain worsens. This is an all-too-common problem that I frequently encounter in my dental ergonomic consultations.   On the other hand, I have repeatedly seen well-designed ergonomic loupes improve or completely resolve neck pain.  So how do you know if your loupes are improving or worsening your health?

Of all the criteria for selecting loupes (working distance, frame size, scope position, declination angle, co-axial adjustment), declination angle is the most important ergonomic factor that can make or break your health.

Consider that working with the neck flexed forward only 20 degrees or more for 70 percent of the working time has been associated with neck pain.  While no loupe systems provide completely neutral head posture (ear-over-shoulder), loupes with a steep declination angle may significantly improve operator working postures in dentistry, thereby lessening risk of musculoskeletal disorders and improving clinician comfort.   Therefore, to prevent musculoskeletal injury, loupes should enable you to work with less than 20 degrees of neck flexion.

Vertically adjustable flip-up loupes enable the steepest declination angle (45 degrees shown) which allows the operator to work with a safe head posture.

Declination angle. The angle that your eyes are inclined downward toward the work area is the declination angle. This angle should be steep enough to help you attain a comfortable working position with minimal forward head posture.  To stay within this safe head posture requires a loupe with a steep declination—from 40 to 50 degrees.   Vertically adjustable flip-up loupes are the only option on the market that I have seen that consistently keep operators within this safe head posture.

Student was told these loupes had a 40 degree declination angle. In reality it was only 20 degrees.

Many team members opt for through-the-lens loupes, which typically cannot achieve greater than a 30 degree declination angle, and very often force the operator into unsafe forward head postures.  Among my dental students, I have repeatedly measured the declination angle of TTL loupes that were promised to have a declination angle of 40-45 degrees, only to discover they had only a 20-25 degree declination angle

In the past, many female dentists and hygienists have steered clear of flip-up loupes due to the heavier weight.  With the new ultra-light weight flip-ups on the market today, weight is a no longer an issue.

When assessing flip-up loupes, keep in mind that scope position is critical.   If your loupes sit high in relation to your pupil, you will lose much of the ergonomic benefit, since you must lean further forward to look through the scopes.   Therefore, vertical adjustability is an essential feature on flip-up loupes.  

Vertically adjustable flip-up loupes with 40 degree declination angle improved head posture. At the time of this writing, there are only 3 loupes manufacturers that make vertically adjustable loupes.

Working with truly ergonomic loupes involves much more:

  • How to select an ergonomic frame
  • How to adjust flip-up loupes after you received them
  • 3 strategies to make the TTL loupes you already own more ergonomic.
  • Properly measure working distance
  • Select proper shield length

Learn how in Dr. Valachi’s video: “Ergonomic Guidelines for Selecting Dental Loupes”

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Dr. Bethany Valachi

Beat Pain and Extend Your Career

Dr. Bethany Valachi has helped thousands of dental professionals for over 20 years, and is recognized internationally as an expert in dental ergonomics. Let Dr. Valachi help you work pain-free and take back your practice!

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