Sir, I am continually surprised and disappointed regarding the number of recent graduates who seem not to use magnification as a matter of course for operative dentistry procedures.

Recently, whilst delivering various topics in the postgraduate arena to cohorts of dentists less than two years out of dental school, a show of hands in a group of around 12 (from a hybrid mix of training hospitals nationally) to the question as to 'who uses magnification (loupes or microscope) routinely as a part of delivering procedures to patients?' produces a dismal three or four positives at most. Loupes are alien and microscopes are outer galaxy! Dreadful!

A similar result is forthcoming in that no one has ever shown them how to appropriately use a close support dental nurse to effectively help to deliver what are operator-demanding procedures less haphazardly. The parameters of the 1950s and even earlier hold sway.

Both of these areas are examples of where the long overdue use of even simple innovation will transform the way in which the microsurgical procedures of operative dentistry are delivered for patients and team. Can someone currently involved in teaching undergraduates operative techniques explain to me why this has gone unchanged for 40 or 50 years or more? Is there any surgical speciality that does not now use magnification routinely (let alone one that is 90% or more microsurgery – ie dentistry!)?

Nothing perhaps will evolve in any effective way unless the undergraduate schools address this. Maybe they do and graduates are not convinced? It also begs the question – do their teachers use magnification? Please enlighten me. Are these simple conclusions and my concerns totally wrong?

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