OUR DENTAL MOUTH MIRRORS
Years ago, I came to a very
simple conclusion: Clinical dental practitioners are brilliant. How else
could they look at an image reflected in the surface of a mouth mirror
and navigate effectively around the deep, dark crevices of the oral
Using a mouth mirror is not a skill that every Dick and
Jane possess. Dental professionals acquire this basic skill either while
working in a dental office or during the first few weeks of school. We
train our brains to understand and interpret the image on the mirror
surface. It takes practice and skill to understand how to travel around
the mouth viewing images on the tiny mirror surface.
Mirrors are used to assist in indirect vision, illuminate
a worksite, and aid in retracting a giant, squirmy tongue or rock-hard
buccal mucosa. While you may not give this simple, universal tool much
thought, there are ways to make your mouth mirrors more effective assets
in daily practice.
From an ergonomic standpoint, it is important to keep
your grasp on the handle of a mouth mirror as light as possible. Many
clinicians have developed significant workplace-related musculoskeletal
disorders from gripping a mirror handle too tightly, especially when
Most mouth mirrors are autoclavable and used repeatedly,
resulting in a cost effective product. In contrast, single-use mirrors
are an ideal product for situations such as screening large numbers of
patients at a health fair. Single-use mirrors are also perfect for
air-abrasion restorative techniques, where a poorly aimed nozzle can
destroy the reflective surface in a millisecond.
Single-use mirror surfaces are not as crisp as a more
durable mirror, but they reflect light and are an effective retraction
There are several disadvantages to using single-use
mirrors as the primary reflective tool. First, the quality of the
reflective surface is not that of a standard mirror. Second, the overall
cost of these mirrors is higher than purchasing and maintaining a high
quality autoclavable mirror. Finally, they join the generation of
unnecessary landfill waste.
Some mirrors screw into permanent handles that are all
metal, metal/resin combinations, metal with silicone padding, or all
resin. Clinicians concerned about instrument weight prefer all-in-one
lightweight resin designs that feature medical-grade silicone padded
Round mirror surfaces predominate. The mirror number
indicates the relative diameter. Size four and five mirrors are the
practical favorites for most clinicians, but the small diameter of a
number three comes in handy when mirror size is an issue. Double-sided
mirrors help with visualization, improve light reflection, and are
ergonomically beneficial because of the unique bend in the mirror stem.
For years, there was little variation in the size, shape,
or overall design of mouth mirrors. With the increased interest in
ergonomics and visual acuity, however, there is more to mirrors these
days than a shiny round surface. One manufacturer makes a disposable,
one-time-use mirror with a rectangular head that fits nicely into tight
areas, giving clinicians an enhanced view of the buccal surfaces of the
maxillary molars, or the lingual surfaces of the mandibular posterior.
The other side of the rectangular mirror has a surface that improves
The surface quality in mouth mirrors varies by
manufacturer. The reflective coating on the front surface of a dental
mouth mirror is applied to the top of the glass rather than the
backside, like a bathroom mirror. This provides an optimal reflective
surface with minimal image distortion.
Rhodium, a hard silvery-white durable metal found in
platinum ores, is the most reflective element in the periodic table. For
years, specialty mirrors such as those found in lighthouses, high
performance car headlamps, and searchlights relied on rhodium to produce
high quality reflective surfaces.
Until recently, rhodium was also the reflective material
of choice for high quality dental mirrors. However, recent advancements
in reflective-surface technology have produced a mirror surface that is
considerably brighter, crisper and with more accurate color rendition. A
side-by-side clinical comparison with a rhodium mirror demonstrates the
differences. The result is a more accurate clinical image with a higher
Forty-three layers of metal oxides create the
breakthrough technology found in Zirc’s Crystal mirror, which is
available as either an all-metal cone socket screw-in mirror or an all
resin mirror, with or without silicone handle grips. The manufacturer
recommends drying the mirror surface prior to autoclaving to prevent
Combination mirror/suction devices serve double duty by
providing illumination, as well as capturing fluid aerosols created
around the clinical worksite. A new mirror/suction device featuring an
ergonomically friendly swivel will be available to clinicians sometime
in autumn 2007.
Intraoral dental photography uses reflective mirror
surfaces made from either highly polished metal or front surface glass
mirrors. Mirrors come in three shapes for various full and partial-arch
occlusal, palatal, buccal, and lingual shots.
Fogging is a big issue with any type of mirror. Years ago
clinicians were taught to slide the surface of the mouth mirror across a
patient’s buccal mucosa, coating the mirror surface with saliva while
warming the metal. While this works reasonably well for a short
appointment, today’s epidemic of patients with xerostomia issues make
this approach less practical.
Warming a mouth mirror under warm tap water will bring
the temperature of the mirror closer to that of the patient’s oral
cavity and reduce fogging. Mouthwash-dampened gauze or commercially
prepared solutions also eliminate fogging. Periodically wiping the
mirror surface with these solutions during an appointment will keep the
Finding a scratch-free mirror is every clinician’s dream.
Even though scientists crack the most complex scientific mysteries,
dental professionals are still stuck with mirrors that scratch. But we
can slow down the inevitable aging process.
First of all, it’s downright cruel to throw lovely, new
unscratched mirrors into an ultrasonic cleaning bath with dozens of
other sharp instruments - a fast track to ruining their shiny new
surfaces. Mirrors should be treated with respect. Consider processing
them and all instruments in autoclavable boxes or cassettes in either an
ultrasonic bath or instrument washer. If mirrors are batch-cleaned in a
box in the ultrasonic cleaner, the mirror heads can be wrapped in dry
gauze and placed in individual autoclavable bags containing other
instruments. Or think about individually bagging mirrors to preserve
“Mirror, mirror on the wall, who’s the fairest one of
all?” The fairest one in your comfort zone is just the right size with a
crisp, clear, fog-free surface that is devoid of scratches and
illuminates your dental hygiene world.