Microscope dentistry and what it means for you

What is microscope dentistry?

I have been using a microscope for all aspects of dentistry for the last 2 and a half years, and there are very few things that have changed my work so much.

Microscope dentistry is the use of a special microscope to give very high magnification for dental procedures. In a job where the size of the area we work on is measured in millimetres, precision is important. Gaps of 50 microns are likely to lead to failure of the work we are doing, so clearly the ability to see well is important.

Dental microscopes also give very strong lighting – this is very important when we are working in what is essentially a dark environment. Traditional surgery lights work reasonably well, but are often not strong enough for microscopic work, and also can leave a shadow if not at the correct angle.

My dentist wears magnifying glasses – is that similar?

Magnifying glasses, or loupes, are a step in the right direction but give nowhere near the magnification given by a dental microscope. To give you an idea of what is visible, have a look at the pictures below.

I used loupes since being a student, in fact I have never worked without magnification. Loupes are typically available in 2.5-3.5X magnification for general use, and 6X for more specialist procedures.

Microscopes vary, but my microscope goes from 3-30X, with most routine examinations involving teeth being looked at under 20X magnification. Microscope dentistry gives so much more than loupes. There is a steep learning curve for the dentist BUT it is well worth it – it makes it so much easier to get good results.

My colleague Dr. Andre Haigh maintains a very useful website related to microscope dentistry - http://www.magnificationindentistry.com/ - which details the use of magnification in dentistry.

But surely it can’t make that much of a difference?

To put it in perspective, these are some pictures of the same tooth, taken this morning.

Tooth under 3X magnification

Tooth under 3X magnification

At 20X magnification, a crack is becoming visible on the back surface of the tooth

At 20X magnification, a crack is becoming visible on the back surface of the tooth

The crack is very clearly visible. An X-ray confirmed the presence of decay in this area.

The crack is very clearly visible. An X-ray confirmed the presence of decay in this area.

These photos quite clearly demonstrate the advantages in diagnosis – once you can see problems clearly, it is the first step in dealing with them.

Please note that the first image is already magnified to a similar level as dentists using loupes see – how anyone can diagnose without some form of magnification is beyond me – well, actually, it isn’t – diagnosis relies upon problems being at an advanced state before action is taken. Microscope dentistry means that you get small problems dealt with before they become big problems.

For dental treatments, working under high magnification is an absolute godsend. It has been estimated that working on one tooth results in damage to the adjacent tooth in approximately 64% of cases. Working under very high magnification reduces the chances of this happening – but I also use guards to protect the next teeth.