Module 4—use of dental mouth mirror

Copyright © 2017 Wolters Kluwer • All Rights ReservedCopyright © 2014 Wolters Kluwer • All Rights Reserved

Module 4—Use of Dental Mouth Mirror

Section 1Fundamentals of Mirror Use

Copyright © 2017 Wolters Kluwer • All Rights Reserved

Dental Mirror

A dental mirror is used to view tooth surfaces that cannot be seen using direct vision. For example, a clinician needs to view the lingual surfaces of the maxillary anterior teeth using a dental mirror or mouth mirror.

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The working-end of a dental mirror has a reflecting mirrored surface.

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Types of Dental Mirrors

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Three Common Types

1. Front surface2. Concave3. Plane (flat surface)

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Front Surface

-Reflecting surface is on front surface of the glass-Produces a clear mirror image with no distortion -Most commonly used type because of good image quality-Reflecting surface is easily scratched

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Concave

-Reflecting surface is on front surface of the mirror lens-Produces a magnified image-Not recommended because magnification distorts the image

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Plane (Flat Surface)

-Produces a double image (ghost image)-Durable, resists scratching because the reflecting surface is on the back of the mirror lens-Not recommended because double image is distracting

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Stabilization of the Dental Mirror

-During instrumentation, clinician grasps mirror in the nondominant hand-The ring and index fingers are used to stabilize the mirror in the mouth-Clinician may rest fingers on the patient’s chin, cheek, or tooth surface to stabilize the mirror

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Fulcrums

-Extraoral fulcrum—a stabilization point outside the patient’s mouth-Intraoral fulcrum—a stabilization point for the hand on a tooth surface-Intraoral fulcrum optional with a dental mirror, but recommended when used with a periodontal instrument

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Extraoral Fulcrum

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Uses of the Dental Mirror

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Functions of the Dental Mirror

1. Indirect vision2. Retraction3. Indirect illumination4. Transillumination

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1. Indirect Vision

The use of a mirror to view a tooth surface or intraoral structure that cannot be seen directly

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Is Direct Vision the Best?

-For most clinicians the visual sense is the most dominant-During periodontal instrumentation TOUCH is the greatest asset for detection and removal of deposits-Mastery of indirect vision is important for preventing awkward body positions when trying to view teeth “directly”

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-Use of the mirror head to hold the patient’s cheek, lip, or tongue so that the clinician can view tooth surfaces that are otherwise hidden from view by these soft tissue structures

2. Retraction

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Retraction of Tongue

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Retraction of the Lip

-The index finger is used to retract the lip away from the teeth-More comfortable for patient than using a mirror for retraction of the upper or lower lip

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Retraction of Cheek

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-Use of the mirror to reflect light onto a tooth or soft tissue structure in a dark area of the mouth

3. Indirect Illumination

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4. Transillumination

-The technique of directing light off of the mirror surface and through the anterior teeth

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Functions of the Dental Mirror

The dental mirror has four important functions during periodontal instrumentation:

1. Indirect vision2. Retraction3. Indirect illumination4. Transillumination

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Copyright © 2017 Wolters Kluwer • All Rights ReservedCopyright © 2014 Wolters Kluwer • All Rights Reserved

Chapter 4—Use of Dental Mouth Mirror

Section 2Is Achieving Direct Vision Really Best?


Definition of Transillumination

-The technique of directing light off of the mirror surface and through the anterior teeth

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Transillumination

-Can reveal carious lesions as dark regions within enamel of interproximal surfaces of anterior teeth-The mirror is used to reflect light through the anterior teeth-Carious lesions and anterior restorations will both appear as dark shadows with transillumination

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Use of Transillumination

-Only anterior teeth can be transilluminated because these teeth are thin enough to allow light to pass through them

-Posterior teeth are “bulky teeth” that cannot be transilluminated

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Transillumination Indicating Caries

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Procedure for Transillumination

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Light Position

-Position unit light directly over the oral cavity with light beam perpendicular to the facial surfaces of the anterior teeth-Patient should be in the chin-down position

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Position Mirror

-Position yourself at 12:00-Hold the mirror behind the mandibular anterior teeth with reflecting surface parallel to the lingual surfaces

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View the Transilluminated Teeth

-Look DIRECTLY at the teeth, not in the mirror-Teeth should appear to “glow,” lighted by the reflected light

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Note:

When practicing transillumination on a student partner, you probably will not see any shadows on the teeth.This is because he or she most likely does not have untreated interproximal decay on the anterior teeth.

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Example: Interproximal Decay

Detection by Transillumination

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Indirect Vision

As seen here, no decay is visible when the lingual surfaces of these teeth are viewed with indirect vision in a mirror. (Courtesy of Dr. Robert P. Langlais)

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The same teeth as in the previous slide.Transillumination reveals interproximal decay—seen as shadows on the teeth. (Courtesy of Dr. Robert P. Langlais)

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Transillumination is a useful technique for detecting “hidden” decay on anterior teeth.

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Education

Module 4—use of dental mouth mirror