A comparative study of postural impact and benefits from loupes in undergraduate and graduate dentists

Musculoskeletal disorders (MSD) are prevalent in dentists, with neck and upper back pain being the most common. The effectiveness of dental loupes and chair designs in improving posture and reducing MSD risks is uncertain. Dental school curricula lack adequate training on loupe selection and usage, despite the need to evaluate recent advances in loupe design.

This study aimed to assess the impact of loupe types and dentist chair designs on postural risk among dental students and dentists.

This comparative observational study employed a standardised photographic method to evaluate the posture of 146 dental students (years 1-4) and 30 dentists. Participants completed identical tasks in simulation laboratories or clinics. Posture was assessed by measuring forward head tilt, torso lean, and upper/lower leg angles. Loupe types were categorised as nil, Galilean, straight, or refractive prismatic. Outcomes were graded as low, medium, or high risk, and participants were interviewed about their loupe selection criteria.

There were significant differences between the cohorts for neck angle, torso angle, and leg angle (all P < 0.0001). Students in years 1 and 2, who did not use loupes, exhibited high to moderate neck posture risks. Refractive prismatic loupes were associated with the lowest neck posture risk, while Galilean loupes worsened posture compared to no loupes. Dentists using refractive loupes and saddle chairs demonstrated the best posture. Most students showed limited knowledge of loupe selection and usage.

Refractive loupes combined with saddle chairs yielded optimal posture, while Galilean loupes offered no postural benefits. Incorporating loupe training into ergonomics education is essential to reduce MSD risks in dental practice.

This study highlights the critical role of ergonomics in preventing musculoskeletal disorders (MSDs) among dental professionals. Refractive prismatic loupes, when used with saddle chairs, significantly reduced neck and upper back postural risks, offering a practical solution to a long-standing occupational health issue. In contrast, Galilean loupes may worsen posture if not appropriately used. These findings emphasise the need for dental schools to integrate structured training on loupe selection and ergonomic practice to promote long-term practitioner health and clinical sustainability.