September Theme: Ergonomics
At Last, I See The Light
by Jim Nail, DDS
Dentistry is a visual profession. If you can see better, you can do better work. There is a whole industry centered on enhancing your eagle eyes with magnification. Whether using loupes or a microscope, magnification has become an essential tool for many providers. But, there is a part of magnification that is not considered essential for many dentists: the head light.
With dentists working longer into their careers than ever before, having good posture and making good ergonomic choices is critical for long-term ability to work. Our profession is tough on the back and shoulders. Two out of three dentists have occupational pain. One third of all dentists who retire early do so because of a musculoskeletal problem. One quote I heard estimated that every year there is more than $131 million in lost income due to dentists not working because of pain. If you can see better, you can work faster and have better posture. So, what can a head light do for you, and why should you consider one if you don't have one yet?
It is dark in someone's mouth. So, yeah everyone knows you need light. Most patient lights are mounted on arms which place the light in a less-than-ideal spot over the patient shining down. In order to see perfectly, a light source needs to be placed parallel to the vision of the operator. Traditional overhead lights should be placed behind the operator's head and slightly to the side in order to get the light almost parallel to your vision. This is often out of the assistant's reach. If you roll around the patient to see different angles, you have to move an overhead light every time you move. Also, that gets hot by your head, even with LEDs. No matter how hard you try, the light will never be exactly parallel to your vision. A light mounted on your head moves with you, so it shines where you look every time. Plus, lights can get as close as possible to your line of sight.
The first head lights I ran into were mounted on the forehead with a head strap and a wire to a light source of some kind. Battery packs and LED lights have eliminated most light source boxes, but the head straps are still around. These lights put their weight on the top of your head, which is better than your nose or ears like other designs. They also are easy to remove and can be replaced or repaired independent of a pair of loupes. This means you can switch between glasses without switching your light. But the light shines down from your forehead and is close, but not perfectly parallel, to your vision. Also, those head things can get scratchy and uncomfortable.
The second style, and most common light I see, has a mount or clip between your optics with a wire that runs down your back to a battery pack. This is my favorite style. The light is as close to parallel as possible to your vision. The creation of lighter weight, smaller and brighter bulbs has minimized the weight born on the operator's nose and ears. My biggest complaint is that no one has mastered the battery pack wire. Wires are notorious for failing under fatigue. Plus, the pack can get heavy or get in the way some times. Also, while they can be removed, this type of light is so good, if it fails or goes bad, you could feel like you are using a candle to see. Like early complaints about magnification, they can be so good you might feel you can't work without it.
A newer type of headlight still has the light between the optics, but instead of a battery pack with a clip, the batteries are mounted into the frames themselves. You get all the same benefits of the second light, but no cumbersome cords or pack. However, weight is a huge drawback. With everything contained within the loupes themselves, they are far heavier. A variety of interesting frames shift where you bear the weight, but it still comes down to somewhere on your head. They may feel great when you first try them on, but I worry about their comfort at the end of an 8-hour day.
In the end, if you can see better, you can work faster and have to bend yourself around less. Head lights are becoming an increasingly popular choice for many providers. If you feel you are having some musculoskeletal pain, proper choice of magnification and lighting can make a huge difference throughout your career. I hope at last you can see the light.
Dr. Nail is an MDA member dentist who practices in Springfield, Mo.
He has served as the editor for the Association since 2013. Click to email him.
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Just the FACTS ...
The No. 1 reason for dentists' early retirement is musculoskeletal disorders.