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Improve Ergonomics With Coaxial Illumination

The physical stress of clinical dental hygiene practice is an occupational risk factor for developing musculoskeletal disorders (MSDs). Coaxial illumination, combined with magnification, can improve visual acuity, ergonomics, and diagnostic capabilities for oral health professionals.

The physical stress of clinical dental hygiene practice is an occupational risk factor for developing musculoskeletal disorders (MSDs). Coaxial illumination, combined with magnification, can improve visual acuity, ergonomics, and diagnostic capabilities for oral health professionals. A quality light source and magnification will reduce strain on the eyes and the need to lean in closer to the oral cavity, improving posture.

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Let the Light Shine

The purpose of clinical illumination is to help oral health professionals see the oral cavity and anatomical features clearly while in a comfortable working posture. Good clinical illumination should provide the following:

  • Prevent the clinician from being forced into poor working postures
  • Help see the detail and color of the point of interest
  • Enable control of light intensity
  • Reduce eye strain and pain
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Possible Risks

Traditionally, the light used to illuminate the oral cavity during treatment has been an overhead light on a track or a chair-mounted light, neither of which provides significant benefit to visual acuity. Studies have found that overhead lighting is often out of reach, causing the clinician to use awkward postures to reach it, and it frequently cannot be adjusted with one hand. Study results also showed that overhead lighting provided inadequate luminance levels for the operating field. Iacomussi et al analyzed the effects of overhead lighting on dental hygienists. They found that this type of lighting created overhead glare, illuminance (brightness) and luminance (distribution) levels that were too high or too low, and luminance (distribution) uniformities that were too high or too low. While overhead lights are typically adequate for illuminating flat objects, they are less effective at illuminating deeper body cavities, like the oral cavity.

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Light Emitting Diode Technology

Light emitting diode technology (LED) lighting has become an excellent source of illumination in the dental field. LED lights are extremely small, lightweight, and provide a high-quality light source with greater output than traditional light sources and better color rendering. These are desired qualities in a mounted light as correct brightness and true color allow for more clear vision and may even make tissue and anatomic changes more discernable during dental hygiene diagnosis and treatment. However, the greatest output is not necessarily the safest.

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Choosing the Right Light for You

Finding the light that best supports ergonomic practice is important. LED headlights are classified into four types according to how the light beam is generated: single lens optic, reflective optic, single lens/reflective optic, and achromatic multi-lens optic. Single lens optics are not uniform, contain blue light around the main beam, and their beam patterns and color uniformity fluctuate with changes in working distance. Achromatic multi-lens optics offer uniformity in beam patterns and color.

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Color Coordination

LED lights come in varying colors: neutral white, cool white, and extreme cool white. It is important to evaluate the beam uniformity and color rendering before choosing a light. Shine the light on a white piece of paper to check for uniformity. The edges of the beam should not appear ragged or fading. Check the color rendering by illuminating anatomical objects to make sure they are true to color. In order to see accurate colors, consider an LED light with a neutral white color, or a color that accurately portrays the anatomical structure. The intensity of the beam should also be considered, as too high an intensity could cause a glare, which is potentially harmful to the clinician and patient. Too low of an intensity may lead the clinician to hunch or lean forward, or even strain the eyes to see more clearly. A light with an adjustable beam intensity may eliminate many of these issues. Ask the manufacturer about the photobiological standards of the LED light and what risk category the light falls under. The light’s weight and size should be considered, as a light that is too heavy or cumbersome may force the clinician into unhealthy postures or even harm vision.

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This information is from the article “Coaxial Illumination” by Emily Ludwig, RDH, MSDH and Margaret Lemaster, BSDH, MS. To read the article, click here.
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