ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Magnifying Loupes Can Effectively Reduce Poor Posture Among Dental Professionals
Clinical Question Can the use of magnifying loupes effectively reduce poor posture in the dental professions compared to those using only traditional safety glasses?
Clinical Bottom Line Magnifying loupes can effectively reduce poor posture in the dental professions and possibly reduce resulting MSDs.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 15038640Branson/2003 22 Dental Hygiene Students Random Crossover Design
Key resultsThe objective of this study was to quantitatively assess dental hygiene students’ posture with and without the use of magnification loupes. Student clinicians were videotaped during two clinical sessions: one while providing dental hygiene care with magnification loupes, and one while wearing traditional safety glasses. The camera would continually follow the clinician throughout all chair side procedures, thus documenting posture. Following completion of data collection, students were asked to respond to a brief survey that assessed their perceptions of magnifying lenses. The survey contained three major categories regarding student perceptions of: 1) The Adjustment Period, 2) Impact on Clinical Skills, and 3) Impact on Posture. A panel of evaluators comprised of five dental hygienists was convened. Calibration sessions were held to orient the panel to Branson’s PAI (Posture Assessment Instrument). Panel members independently reviewed videotapes for a five minute period and, using established criteria, rated posture components as: 1) Acceptable, 2) Compromised, or 3) Harmful. A weighted composite score was then computed such that the final score represented posture impact over the five minute time frame. Means and standard error of the means (SEM) were recorded. PAI scores for students wearing magnification lenses were significantly better (p=.019) when compared to PAI scores without magnification. In regard to student’s perception, 81 percent (n=17) adjusted to the lenses in two days or less. 76 percent reported improvement in skills and overall performance. Of particular note, 100 percent reported that their posture improved during magnification lens use. The results of this study quantitatively support statements in the literature that report improved posture with the use of magnifying lenses.
#2) 18172233 Maillet/200835 Novice Dental Hygiene StudentsRandom Crossover Design
Key resultsDental Hygiene students’ posture was assessed while providing dental hygiene care with and without loupes. Students were randomized into two groups. Group one used loupes in the first session and did not use loupes for the second session. Group two reversed this sequence. For the preliminary study all students were videotaped and their postures were assessed by a version of Branson’s Posture Assessment Instrument (PAI). A paired t-test compared scores with and without loupes for each student. Scores showed a significant improvement in posture when using loupes (p<0.0001). In the formal study the PAI was adapted to create the Posture Assessment Criteria (PAC). The PAC rates nine posture components. It can be applied to place each component into a category (acceptable, compromised or harmful) reflecting the degree of departure from Niel-Gehrig’s ideal posture. Each category was associated with a numerical score; acceptable components scored zero points, compromised components scored one point (Indicating some departure from ideal posture) and harmful components scored two points (indicating further departure from ideal posture). Group I (used loupes)had a mean score of 5.69 points from the ideal posture, compared with a mean score of 10.96 points from ideal posture for Group II (did not wear loupes). (t=4.37, df=23, p-value = 0.0001). The result was statistically significant, providing strong evidence that the use loupes improved posture.
Evidence Search The following search strategy used in PubMed: Dental Hygiene, Magnification Loupes,Operator Posture,Ergonomics
Comments on
The Evidence
These studies represented the full spectrum of dental practices- general dentists, dental specialists as well as hygienist because participants’ positioning applies to all. The criteria for the conclusions were explicit and credible. The diagnostic work-ups were comprehensive and consistently applied. The studies did not include a follow up. There were no competing interests in either study.
Applicability The study participants were representative of the profession (General Dentists, Dental Specialists and Hygienists). The selection/use of magnifying loupes is feasible in the dental operatory of General dentists, Dental Specialists and Hygienists.
Specialty/Discipline (Oral Medicine/Pathology/Radiology) (Endodontics) (General Dentistry) (Oral Surgery) (Orthodontics) (Pediatric Dentistry) (Periodontics) (Prosthodontics) (Restorative Dentistry) (Basic Science)
Keywords Magnification, Operator Posture
ID# 2477
Date of submission: 05/07/2013spacer
E-mail ronald.brown@ucdenver.edu
Author Ronald N. Brown, DDS
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