Abstract:
One embodiment of the present invention provides a light device. The light device may include a mirror and comprises a handle having a longitudinal axis, a mirror attached to the handle and arranged at an angle from the longitudinal axis, a light source inside the handle, and a light waveguide adjacent to the light source. The waveguide comprises an internal reflector, and the reflector reflects substantially all of the light from the light waveguide. In one embodiment, an annular air flow substantially aligned with a longitudinal axis of the mirror cools the apparatus, including the light source. One embodiment of the light mirror keeps the reflective surface of the mirror free of debris, water, restorative materials, tooth structure, and aluminum oxide powder. Thus, the operator may continue to work without the constant cleaning of the mirror surface associated with conventional mirrors. Cleaning the mirror during a procedure can be time-consuming and counter-productive. Moreover, one embodiment of the light mirror is more ergonomic and reduces eye strain, enabling more accurate and precise results in far less time than possible with conventional light mirrors.

Description:
TECHNICAL FIELD  
       [0001]     The present invention relates generally to hand-held medical instruments, and, more particularly, to hand-held mirrors which may be illuminated by a light source and defogged by a fluid flow.  
       BACKGROUND  
       [0002]     Hand-held medical instruments such as dental mirrors have long been known and used the clinical field of dentistry. Dental mirrors allow clinicians to view various parts of the mouth and throat (if used with an extension) that may be difficult or impossible to see by a direct line of sight. However, some parts of the mouth are difficult to see even with the aid of a dental mirror. The lighting conditions inside of a patient&#39;s mouth are often poor, at best. A dark dental mirror is often of limited use. Therefore, over the years, the dental industry has sought to develop a mirror with its own illumination system rather than depending on the light available from an overhead lamp. Examples of such mirrors are disclosed in U.S. Pat. No.: 3,638,013 to Keller; U.S. Pat. No. 4,279,594 to Rigutto; U.S. Pat. No. 4,629,425 to Detsch; U.S. Pat. No. 4,993,945 to Kimmelman et al.; U.S. Pat. No. 5,139,420 to Walker; U.S. Pat. No. 5,139,421 to Verderber; U.S. Pat. No. 5,457,611 to Verderber; and U.S. Pat. No. 6,443,729 to Watson (hereby incorporated in its entirety by this reference). The most successful of these mirrors have been those which contain a light source built in the handle of the mirror. The mirror disclosed in U.S. Pat. No. 5,457,611 to Verderber is such a device and is the only known illuminated mirror that has been successfully marketed. The Verderber mirror is marketed by Welch-Allyn, Inc., of Skaneateles, N.Y. However, the Verderber mirror splits a light beam in multiple directions, reducing the intensity of light directed to portions of the mouth of interest. Some have also used unsophisticated penlights whereby a traditional mirror or a disposable plastic mirror is clipped on to the penlight. The penlights, however, are similar to basic flashlights, and the plastic clip-on mirrors have poor optical qualities. Therefore, the results have been less than satisfactory.  
         [0003]     One of the problems with illuminated mirrors is the heat generated by the illumination source. Prior illuminated mirror handles heat up to uncomfortable temperatures. As a result, the user (e.g., a dental clinician) may have a tendency to put the mirror down repeatedly during clinical procedures. Also, the clinician may be inclined to alternate mirrors during longer procedures to avoid the discomfort. These practices invariably prolong procedures, distract the clinician, and compromise accuracy, all to the potential detriment of the patient.  
         [0004]     One solution to the heat problem is proposed in U.S. Pat. No. 5,457,611 to Verderber. Verderber includes a high intensity lamp contained by a heat sink mounted within the dental mirror handle. The handle contains multiple vents spaced from and surrounding the heat sink. Heat from the lamp attempts to radiate through the vents from the heat sink. The radiating heat may create a thermal current, causing heated air to exhaust through the vents and be replaced by cooler air from the surrounding atmosphere (“ambient cooling”). Even with the aid of ambient cooling, the heat generated by the lamp becomes particularly noticeable within five to ten minutes. Handle temperatures for the Verderber mirror reach 134 degrees F., which is uncomfortable and distracting to the clinician.  
         [0005]     Another longstanding shortcoming inherent with conventional dental mirrors is the tendency of the reflective surface to become obscured during clinical procedures. Fog, mist, spray from dental drills, tooth debris, dental materials, etc., collect on the mirror&#39;s reflective surface, impairing the visibility of the image reflected by the mirror. The need for clear mirrors in dental and otolaryngology offices continues. Procedures ranging from routine hygiene to extensive oral surgeries can benefit from a clear, illuminated mirror.  
         [0006]     Currently, clinicians (or an assistant) must repeatedly clean or wipe the reflective surface, which requires repositioning of the mirror and redirection of the clinician&#39;s attention, the assistant&#39;s attention, or both. This repeated repositioning and redirection of attention, however, can disrupt the concentration of the clinician, leading to reduced accuracy. In addition, mirror-cleaning takes time, and in many cases a patient will benefit from shorter procedure times. In some cases, clinicians or assistants may attempt to wash the mirror with water, but water distorts the image in the mirror and again redirects the attention of the clinician and/or the assistant from the primary function of controlling the operative field.  
         [0007]     Another problem with dental mirrors is the susceptibility of the reflective surface to marring by tooth debris, dental materials, or aluminum oxide powder from air-abrasion systems. When such marring occurs, the mirror must be replaced. Replacement mirrors add to the cost of treating a patient. Water flows can be used to clean and protect (to some degree) the reflective surface from abrasion, but the use of water creates at least two new problems. As mentioned above, water distorts of the image reflected by the mirror, and the water must be removed from the patient&#39;s mouth.  
         [0008]     One other problem associated with dental mirrors is the risk of transmitting germs from one patient to another (i.e., “cross contamination”). Cross contamination may result from handle exposure to multiple patients. Currently, the recommended approach for preventing cross contamination is an autoclave procedure for the mirror handle after each use. However, this approach is time consuming and requires access to and handling of autoclave equipment and materials. The autoclave process increases the wear-and-tear on the mirror handle. Therefore, many clinicians do not follow the recommended approach.  
         [0009]     In addition, traditional dental mirrors are not ergonomic. Ergonomics refers to the ease and precision with which instruments can be positioned for control, direction, duration and distance of applied force. When dental clinicians changed posture in the late 1960s from a standing position to a sitting position, the same dental mirrors remained. The angle of the traditional dental mirror surface to the mirror handle is set at approximately thirty-eight degrees. This angle supplies reflected vision for an operator who stands slightly behind, completely behind, or beside a seated patient. However, the standard thirty-eight degree angle is not designed for clinicians sitting in relation to a patient. Dougherty, Dr. Michael: “Ergonomic Principles in the Dental Setting,” D ENTAL  P RODUCTS  R EPORT , July 2001, (http://www.dentalproducts.net/xml/display.asp?file=313&amp;bhcp=1).  
       SUMMARY  
       [0010]     The principles described herein may address some of the above-described deficiencies and others. Specifically, some of the principles described herein relate to light devices, light mirrors, and methods of cooling light devices and light mirrors.  
         [0011]     One aspect provides a light mirror. In one embodiment, the light mirror comprises a handle having a longitudinal axis, a mirror attached to the handle and arranged at an angle from the longitudinal axis, a light source inside the handle, and a light waveguide adjacent to the light source. In one embodiment, the waveguide comprises a reflector and the reflector reflects substantially all of the light from the light waveguide. In one embodiment, the light waveguide comprises a concave light exit surface for diffusing light from the light source. The concave light exit surface for diffusing light from the light source may be formed in a lateral edge portion of the waveguide. In one embodiment, the light waveguide comprises a first end adjacent to the light source, and a second end. The second end comprises a flat angled reflector aimed at a concave exit surface. In one embodiment, the light waveguide comprises a shank of the mirror. In one embodiment, the light source comprises an LED. In one embodiment, the light mirror further comprises an airflow annulus between the light source and the handle. The airflow annulus between the light source and the handle may provide convection heat transfer from the light source. In one embodiment, the light mirror further comprises an airflow annulus between the light source and the handle, and an elastomeric boot disposed between the mirror and the handle, the elastomeric boot comprising a flow channel in fluid communication with the airflow annulus and aimed at the mirror. In one embodiment, the light mirror further comprises an airflow annulus between the light source and the handle, and an elastomeric boot disposed between the mirror and the handle, the elastomeric boot comprising a plurality of diverging channels in fluid communication with the airflow annulus.  
         [0012]     One aspect provides a light mirror apparatus. In one embodiment, the apparatus comprises a handle having a longitudinal axis, a disposable mirror comprising a reflective surface attached to the handle and arranged at an angle from the longitudinal axis, an LED inside the handle, a light waveguide adjacent to the LED, the light waveguide directing light from the LED, an annulus disposed between the LED and the handle and extending between the light waveguide and the handle, and a flow manifold in fluid communication with the annulus, the flow manifold aimed at or across the reflective surface of the mirror. One embodiment further comprises a pressurized air supply coupled to the handle. One embodiment further comprises a roll-up sleeve attached around the handle. In one embodiment, the light waveguide comprises a shank of the disposable mirror. In one embodiment, the light waveguide comprises a first end optically coupled to the LED, and a second end. The second end comprises a reflecting angle aimed to a concave exit surface. In one embodiment, the light waveguide comprises a first end optically coupled to the LED, and a second end, the second end comprising a reflector aimed to a lateral light exit surface, the lateral exit surface comprising a light diffuser. One embodiment further comprises an LED socket, the LED socket comprising, in cross section, an LED receiving hole and a plurality of annular bulbs. In one embodiment, the light waveguide comprises a shank of the disposable mirror, the flow manifold comprises a rubber boot at a distal end of the handle, the shank extends though a hole in the rubber boot, and the rubber boot provides a friction fit with the shank.  
         [0013]     One aspect provides an illuminated mirror apparatus. The apparatus comprises a handle having a longitudinal axis, a mirror having a shank, the shank comprising a waveguide having only a single exit surface, the mirror attached to the handle and arranged with a reflective surface at an angle from the longitudinal axis. The apparatus also includes an LED inside the handle, and an internal air passageway substantially parallel to the longitudinal axis and open to the LED. The internal air passageway comprises an annulus between the shank and the handle, the internal air passageway in fluid communication with a manifold directed at the mirror. In one embodiment, the single exit surface comprises a lateral, concave, light diffusing surface directing light centered substantially perpendicular to the longitudinal axis. In one embodiment, the single exit surface is shaped to focus light from the LED on the reflective surface of the mirror.  
         [0014]     One aspect provides an illuminated mirror apparatus comprising a handle having a longitudinal axis, a mirror having a shank, the shank comprising a waveguide having a single exit surface, the mirror attached to the handle and arranged with a reflective surface at an angle from the longitudinal axis; a light source inside the handle and optically connected to the waveguide, an internal air passageway substantially parallel to the longitudinal axis and open to the light source, the internal air passageway comprising an annulus between the shank and the handle, the internal air passageway in fluid communication with a flow exit at the reflective surface of the mirror; and a boot attached to the apparatus at a distal end of the handle. The shank extends though a hole in the boot, and the boot provides a supporting friction fit with the shank. In one embodiment the boot comprises a rubber boot, and the rubber boot comprises a manifold between the annulus and the flow exit. In one embodiment the flow exit comprises multi-directional flow paths aimed at the reflective surface of the mirror.  
         [0015]     One aspect provides a method comprising providing a medical mirror configured for use in a patient&#39;s mouth, illuminating an internal light source of the medical mirror, directing substantially all light from the internal light source through only a single light outlet, cooling the medical mirror with a fluid flow in direct contact with the internal light source, and defogging a reflective surface of the medical mirror with the fluid flow. In one embodiment, the medical mirror comprises a longitudinal axis, and the cooling comprises directing the fluid flow through an annulus inside the medical mirror that is substantially parallel with the longitudinal axis. In one embodiment, directing substantially all light comprises reflecting substantially all light though a light diffuser outlet. In one embodiment, directing substantially all light comprises diffusing substantially all LED light though a concave surface of a light waveguide.  
         [0016]     One embodiment provides an illuminated mirror apparatus, comprising an ergonomic handle having a longitudinal axis, a mirror attached to the handle and arranged with a reflective surface at an approximate angle of forty-five degrees with respect to the longitudinal axis, a light source inside the handle, and an air passageway flowing through the handle, the air passageway in fluid communication with a manifold directed at the mirror. In one embodiment, the air passageway is internal to the handle, substantially parallel to the longitudinal axis, and open to the light source. In one embodiment, the internal air passageway comprises an annulus between internal components of the illuminated mirror apparatus and the handle.  
         [0017]     One embodiment provides an apparatus comprising an untethered, portable light mirror. The untethered, portable light mirror comprises a handle having a longitudinal axis, a mirror attached to the handle and arranged at an angle from the longitudinal axis, a battery pack providing power to the handle, a light source inside the handle powered by the battery pack, and a light waveguide adjacent to the light source. The waveguide comprises a reflector. In one embodiment, the reflector reflects substantially all of the light from the light waveguide. In one embodiment, the battery pack is attached within the handle. In one embodiment, the battery pack is portable and connected to the handle by a short cord. In one embodiment, the apparatus further comprises a fan powered by the battery pack. In one embodiment, the apparatus further comprises an airflow annulus between the light source and the handle, a fan providing air through the airflow annulus, and an elastomeric boot disposed between the mirror and the handle, the elastomeric boot comprising a flow channel in fluid communication with the airflow annulus and aimed at the mirror. In one embodiment, the untethered portable light mirror may include one or more portable canisters connected to the handle and in fluid communication with an airflow annulus between the light source and the handle. In one embodiment, there is at least one portable compressed air canister in the battery pack.  
         [0018]     One embodiment provides an apparatus comprising a trans-illumination light. The trans-illumination light comprises a handle having a longitudinal axis, an LED inside the handle, a longitudinal light waveguide adjacent to the LED and extending from a distal end of the handle, the light waveguide directing light from the LED; an annulus disposed between the LED and the handle and extending between the light waveguide and the handle; and a flow exit from the distal end of the handle. 
     
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0019]     The accompanying drawings illustrate certain embodiments discussed below and are a part of the specification.  
         [0020]      FIG. 1  is a perspective view of an illuminated mirror with associated components, in accordance with one embodiment.  
         [0021]      FIG. 2  is an exploded view of an illuminated mirror according to one embodiment.  
         [0022]      FIG. 3A  is a top plan view of an illuminated mirror showing a protective sheath prior to deployment according to one embodiment.  
         [0023]      FIG. 3B  is a top plan view of the illuminated mirror of  FIG. 3A  showing the protective sheath partially deployed according to one embodiment.  
         [0024]      FIG. 3C  is a top plan view of the illuminated mirror of  FIG. 3A  showing the protective sheath fully deployed according to one embodiment.  
         [0025]      FIG. 4  is a perspective view of the illuminated mirror of  FIG. 2 , shown with the mirror and associated components detached.  
         [0026]      FIG. 5  is a magnified side cross-sectional view, taken along line  5 - 5  of  FIG. 4 , of the illuminated mirror according to one embodiment.  
         [0027]      FIG. 6  is a magnified cross-sectional view, taken along line  6 - 6  of  FIG. 4  of the illuminated mirror according to one embodiment.  
         [0028]      FIG. 7  is a magnified side cross-sectional view, taken along line  5 - 5  of  FIG. 4 , showing air flow lines and light passages of the illuminated mirror according to one embodiment.  
         [0029]      FIG. 8  is an elastomeric boot manifold according to one embodiment with hidden lines illustrating flow channels.  
         [0030]      FIGS. 9-12  illustrate a connector according to one embodiment.  
         [0031]      FIG. 13  is a perspective view of an untethered, portable illuminated mirror with a battery pack according to one embodiment.  
         [0032]      FIG. 14  is a perspective view of an untethered, portable illuminated mirror with a remote battery pack according to one embodiment.  
         [0033]      FIG. 15  is a perspective view of a portable, untethered, illuminating rod with a battery pack according to one embodiment.  
         [0034]      FIG. 16  is a perspective view of an untethered, portable illuminated mirror with a self contained air supply according to one embodiment. 
     
    
       [0035]     Throughout the drawings, identical reference characters and descriptions indicate similar, but not necessarily identical, elements.  
       DETAILED DESCRIPTION  
       [0036]     Illustrative embodiments and aspects are described below. It will of course be appreciated that in the development of any such actual embodiment, numerous implementation-specific decisions must be made to achieve the developers&#39; specific goals, such as compliance with system-related and business-related constraints, that will vary from one implementation to another. Moreover, it will be appreciated that such a development effort might be complex and time-consuming, but would nevertheless be a routine undertaking for those of ordinary skill in the art having the benefit of this disclosure.  
         [0037]     As used throughout the specification and claims, the term “waveguide” refers to a system of material boundaries that may take the form of a solid dielectric rod or dielectric-filled tubular conductor capable of guiding electromagnetic waves. A “bulb” is a radial projection or part that may be rounded. “Convection” means heat transfer by a forced fluid current from one region to another. “Untethered” means not attached by a tether, cord, or umbilical to a relatively unmovable object. The words “including” and “having,” as used in the specification, including the claims, have the same meaning as the word “comprising.” 
         [0038]     Turning now to the figures, and in particular to  FIG. 1 , one embodiment of an illuminated mirror system  100  is shown. The illuminated mirror system  100  includes a light mirror  102 , which may include an optional protective roll-up sheath  104  covering the instrument. The light mirror  102  is operatively connected to a tether or an umbilical  106 . In one embodiment, the umbilical  106  supplies electricity and pressurized air to the light mirror  102 . The umbilical  106  may be coupled to an instrument holder  108 . The instrument holder  108  is receptive of the light mirror  102 .  
         [0039]     In one embodiment, the instrument holder  108  is removably secured to a mounting block  110 . The mounting block  110  is attached to a support structure  112 . An electrical power supply  114  may supply electrical energy to the mounting block  110 . The instrument holder  108  and mounting block  110  each contain a pair of electrical contacts. For example, electrical contacts  16   a ,  16   b  of the mounting block  110  may be in physical contact with matching contacts (not shown) of the instrument holder  108  when the mounting block  110  and the instrument holder  108  are interconnected. In one embodiment, electrical energy from the power source  114  is transmitted to the light mirror  102  via the mounting block  110 , instrument holder  108 , and the umbilical  106 . The construction and electrical operation of the assembly is well known and fully described in U.S. Pat. No. 5,385,468 to Verderber, which is incorporated herein by reference. However, the light mirror  102  may be connected in any way to any electric and air supply, or may even have on-board supplies. The system  100  illustrated in  FIG. 1  is one exemplary embodiment.  
         [0040]     In the embodiment of  FIG. 1 , the instrument holder  108  may include a compressed air fitting  116  connected to and in fluid communication between the umbilical  106  and an air supply line  118 . A typical medical or dental office air supply  120  may be coupled to the fitting  116  to provide pressurized air to the light mirror  102 . As shown in  FIG. 1 , in one embodiment, a compressed air filter/regulator  122  is arranged between the air supply  120  and the fitting  116  to remove most liquids and solid particles from the air and regulate air pressure. In one embodiment, air pressurized to about 10-60 PSI is supplied to the umbilical  106 . A quick-disconnect connector  124  may be used to connect the air supply  122  to the fitting  116 . Air pressure of about 10 PSI may be used to defog the mirror, and higher pressures of about 50-60 PSI may be used during operative procedures to remove debris resulting from the use of high speed instrumentation.  
         [0041]     In one embodiment, a manual shutoff valve (not shown) may be included between the filter/regulator  122  and the fitting  116 . In one embodiment, the holder includes an automatic shutoff valve. An electrical switch  126  may turn power off and on, and/or open and close an air shutoff valve. The switch  126  is depressed and turns off the electric power to light mirror  102  when the light mirror  102  is placed in the instrument holder  108 . Electric power is restored when the light mirror  102  is removed from the instrument holder  108 . Likewise, the switch  126  may control the compressed air. In one embodiment, the switch  126  is used with an electrically powered automatic shutoff valve (e.g., a solenoid actuated valve) located in the instrument holder  108  to turn the pressurized air on and off.  
         [0042]     Referring next to  FIGS. 2-6 , structures associated with certain embodiments of the light mirror  102  are shown. In one embodiment, the umbilical  106  is attached to a shell or handle  128  of the light mirror  102 . In one embodiment, the handle  128  comprises a tail end  130  having a strain release device. In one embodiment, the strain release device comprises a flexible tail  131 . Air and electrical transmission lines pass through the flexible tail  131 , and the flexible tail  131  facilitates any orientation of the light mirror  102  with respect to the umbilical  106 .  
         [0043]     In one embodiment, the handle  128  is ergonomically shaped. Therefore, the handle  128  may comprise a outer diameter and shape or curves conducive to comfortable, long term use. The handle  128  is shaped with contours that minimize hand stress when used by a clinician. Traditional dental mirror handles are very small and can be uncomfortable to use long-term. Some embodiments of the handle  128  described herein have diameters at least twice as large as conventional dental mirrors and are much more comfortable to use. However, some embodiments have diameters similar or identical to traditional dental mirrors.  
         [0044]     In one embodiment, the handle  128  is divided into separate components. For example, as shown in  FIGS. 3A and 4 , the handle  128  is divided into the tail end  130  and the head end  132 . The head and tail ends  132 ,  130  of the handle  128  may be selectively connectable. For example, in one embodiment, the head and tail ends  132 ,  130  may cooperate to form a quick-disconnect coupler  134 . The quick-disconnect coupler  134  is described below.  
         [0045]     The quick-disconnect coupler  134  includes a coupling pair such as a socket or female connector  136  in the tail end  130 , and a male connector  138  in the head end  132 , or vice-versa. The male connector  138  includes an external circumferential  140  groove receptive of one or more balls  142  disposed in the female connector  136 . A sleeve  144  around the female connector  136  includes an internal circumferential groove  145  ( FIG. 6 ) housing the one or more balls when the head and tail ends  132 ,  130  are disconnected as shown in  FIG. 4 . However, when the head and tail ends  132 ,  130  are urged together, the sleeve  144  is retracted, the male connector  138  enters the female connector  136 , and the one or more balls  142  enter the external circumferential groove  140  of the male connector  138 . A seal such as an O-ring  148  may be arranged between the male and female connectors  138 ,  136  when the head and tail ends  132 ,  130  are connected as shown in  FIGS. 3A, 5 , and  6 . The sleeve  144  may be biased by a spring clip  150  ( FIG. 2 ) to the position shown in  FIG. 5 , locking the one or more balls  142  in the external circumferential groove  140 . The head and tail ends  132 ,  130  may be separated by retracting the sleeve  144  to overcome the biasing force of the spring clip  150 , releasing the one or more balls  142  from the external circumferential groove  140 , and pulling the head and tail ends  132 ,  130  apart. One of ordinary skill in the art having the benefit of this disclosure will recognize that the quick-disconnect coupler  134  is one of any number of connecting devices that may be used to couple and decouple the head and tail ends  132 ,  130 . Moreover, in some embodiments, the head and tail ends  132 ,  130  may comprise one unitary structure.  
         [0046]     In one embodiment, a light source such as an LED  146  or any other light source (e.g. a halogen light bulb, a fiber optic bundle powered by LED, laser, or halogen bulb, etc.) is securely mounted to the female connector  136 . In one embodiment, the LED comprises conductor pins  152  that fit snugly or rigidly in a pair of pin receptacles  154 . The pin receptacles  154  are in turn disposed in a receptacle housing  156 . In one embodiment, the receptacle housing  156  fits at least partially inside, and may be connected to, a tube such as an LED tube  158 . The conductor pins  152  are electrically connected by the pin receptacles  154  or other component to a power supply such as the umbilical  106  ( FIG. 1 ). The receptacle housing  156  may comprise a shank  160  and an oversized head  162 . The LED tube  158  is generally cylindrical and sized with an inner diameter smaller than the outer diameter of the shank  160 . However, the oversized head  162  is larger than the inner diameter of the LED tube  158  and therefore the oversized head  162  abuts the LED tube  158 .  
         [0047]     In one embodiment, the LED tube  158  fits in the female connector  136 . As shown in  FIGS. 9-12 , the female connector  136  may exhibit changing inner and outer diameters. The female connector  136  includes a first end  166  and a second end  168 . The inner diameter of the first end  166  receives the male connector  138  ( FIG. 3 ). As shown in  FIG. 12 , the inner diameter of the first end  166  includes a shoulder  170 . The shoulder  170  coincides with a transition to the second end  168 . The inner diameter of the second end  168  is smaller than the inner diameter of the first end  166 . According to one embodiment, the inner diameters comprise a partially cylindrical passage  172  that is sized to receive the LED tube  158  ( FIG. 2 ). However, the partially cylindrical passage  172  includes one or more bulbs  174  or other projections that extend radially from a cylindrical diameter. In one embodiment, four equally spaced bulbs  174  extend radially from the otherwise cylindrical diameter. The cylindrical diameter securely receives the LED tube  158  ( FIG. 2 ), and the bulbs  174  create an annulus or flow passage between the LED tube and the female connector  136  ( FIG. 2 ).  
         [0048]     The first end  166  also includes one or more external recesses  173 , for example four recesses  172 , that hold the balls  142  ( FIG. 5 ). The first end  166  may comprise an outer diameter that is smaller than the outer diameter of the second end  168 . In one embodiment, the sleeve  144  ( FIG. 5 ) fits over the first end  166  and comprises an outer diameter approximately equal to the handle  128  ( FIG. 5 ), such that the sleeve  144  is substantially flush with the handle  128  ( FIG. 5 ).  
         [0049]     Referring again to  FIGS. 2-6 , in one embodiment, the head end  132  comprises a shell  175  that at least partially houses one or more additional components. In one embodiment, the shell  175  is substantially tubular and receptive of a brace or holder  176 . The shell  175  is tapered from a first end  178  to a second end  180 . Therefore, an internal diameter of the shell  175  decreases from the first end  178  to the second end  180 . The shell  175  is also sized to receive a portion of the male connector  138 . In one embodiment, the male connector  138  is a substantially tubular member and includes a change in outer diameter. For example, the male connector  138  may include a shoulder  182 . The shell  175  may include an internal shoulder  184  sized to bear against the shoulder  182  of the male connector  138  and limit the insertion of the male connector. In one embodiment, the male connector  138  extends from both the first and second ends  178 ,  180  of the shell  175 .  
         [0050]     The brace  176  comprises a tubular insert including radial protrusions  186 ,  188  at both the first and second ends thereof. The radial protrusions  186 ,  188  are sized to contact an internal diameter of the shell  175  at the first end  178  thereof. The second protrusion  188  may be smaller than the first protrusion  186  to facilitate insertion of the brace  176  into the tapered shell  175 . The taper of the shell  175 , however, limits insertion of the brace  176 . In one embodiment, the brace  176  is inserted until the first radial protrusion  186  is substantially flush with the first end  178  of the shell  175 . The brace  176  fits tightly or connects rigidly to the shell  175 .  
         [0051]     The first radial protrusion  186  comprises an outer diameter substantially matching the diameter of a distal end of the female connector  136 . Therefore, the first radial protrusion  186  may abut or interface the distal end of the female connector  136  when the head and tail ends  132 ,  130  are interconnected as shown in  FIGS. 3, 5 , and  6 .  
         [0052]     In one embodiment, the inner diameter of the brace  176  contacts or bears against the outer diameter of the male connector  138 . In one embodiment, an interface  190  between the brace  176  and the male connector  138  comprises a tight fit or a glued connection. The inner diameter of the male connector  138  defines an annulus or open space  192  for the LED  146 . When the head and tail ends  132 ,  130  are interconnected as shown in  FIGS. 3, 5 , and  6 , the LED  146  extends into the open space  192 .  
         [0053]     In one embodiment, the male connector  138  extends through a hole  194  in the second end  180  of the shell  175 . A distal end  196  of the male connector  138  extending through the hole  194  receives a manifold, for example an elastomeric boot manifold  198 . The elastomeric boot manifold  198  fits rigidly or snugly over the distal end  196  of the male connector  138 . The elastomeric boot  198  may include a radial protrusion, which may, for example, provide a convenient gripping surface to a user.  
         [0054]     In one embodiment, the elastomeric boot manifold  198  is receptive of a mirror, such as a disposable mirror  202 , by a friction fit. The disposable mirror  202  includes a base such as a shank  204  and a head comprising a reflective surface  206 . The reflective surface  206  may comprise a generally circular shape. The reflective surface  206  of the disposable mirror  202  is shown at an angle from the shank  204  (and thus at an angle to the longitudinal axis  101  of the light mirror  102 ). According to some embodiments, the angle between the shank  204  and the reflective surface  206  ranges between approximately twenty and sixty degrees, although any useful angle may be used. In one embodiment, the angle between the shank  204  and the reflective surface  206  is approximately forty-five degrees. A forty-five degree angle has been found to be more conducive to sitting arrangements of a clinician with respect to a patient than prior thirty-eight degree angles. In some embodiments, the angle between the shank  204  and the reflective surface  206  is approximately forty-six degrees or greater.  
         [0055]     In one embodiment, the shank  204  comprises a light waveguide or fiber optic shank. The shank  204  may comprise any material conducive to a light waveguide, including, but not limited to, Lexan.® The shank  204  includes a first end  208  and a second end  210 . The shank  204  is inserted through the elastomeric boot manifold  198  and into the male connector  138 . The male connector  138  may include a plurality of radially inward protrusions or divots  212  that guide and hold the first end  208  of the shank  204  at a substantially central location adjacent to the LED  146 . The first end  208  of the shank  204  is optically coupled to the LED  146 .  
         [0056]     The second end  210  of the shank  204  comprises a reflector  214  and a light exit surface  216 . The reflector  214  may comprise an angle formed at the second end  210  of the shank sufficient to reflect all light passing through the shank  204 . The reflector  214  may also comprise a polished or mirrored surface. In one embodiment, the reflector  214  comprises a flat angled surface that aims or directs substantially all light passing through the shank  204  to the light exit surface  216 . In one embodiment, no or minimal light exits through the reflector  214 . According to one embodiment, the light exit surface  216  comprises a lateral, concave surface that diffuses light reflected by the reflector  214 . In one embodiment, the concave light exit surface  216  is centered approximately normal or perpendicular to the shank  204  at line  218  ( FIG. 7 ). In one embodiment, the concave light exit surface  216  is aimed toward the reflective surface  206  or centered at another angle relative to the shank  204 . An open U-shape of the elastomeric boot manifold  198  may coincide with the lateral, concave light exit surface  216 .  
         [0057]     Referring to  FIG. 7 , according to one embodiment, the tail end  130  of the handle  128  is substantially hollow. Moreover, the tail end  130  is open to and in fluid communication with the umbilical  106  ( FIG. 1 ). Therefore, when the light mirror  102  is in operation, pressurized air from the umbilical enters the tail end  130  of the handle  128  as depicted by arrows  220  in  FIG. 7 . Pressurized air entering the tail end  130  flows through the female connector  136  via the annulus  221  created by the radial bulbs  172  ( FIG. 11 ). The annulus  221  created by the radial bulbs  172  ( FIG. 11 ) is substantially parallel to the longitudinal axis  101  ( FIG. 2 ) of the light mirror  102 . The pressurized air flows around and adjacent to the LED  146 , effectively cooling the LED  146  primarily by convection heat transfer. The pressurized air is in direct contact with the LED  146  and the handle  128  according to some embodiments. The pressurized air continues through the annulus  192  between the LED  146  and the handle  128  to an annulus  222  created between the shank  204  and the male connector  136 . Space between the divots  212  of the male connector  136  allow the pressurized air to continue distally through the handle  128 . The annular flow of air through the entire handle  128  and around the LED  146  keep the handle  128  cool and comfortable for clinicians indefinitely.  
         [0058]     The annulus  222  is in fluid communication with a main flow channel or path  224  through the elastomeric boot manifold  198 . Referring to  FIG. 8 , in one embodiment, the elastomeric boot manifold  198  comprises a plurality of branches  226  diverging from the main flow path  224 . Air streams through the branches  226  toward the reflective surface  206  of the disposable mirror  202 . In one embodiment, the branches  226  are aimed at or across the reflective surface  206 . Accordingly, air discharges through the branches  226  in a fan-like pattern at or across the reflective surface  206 . The air streams through the branches  226  and to the reflective surface  206  clears and/or defogs the reflective surface when the light mirror  102  is in operation in a patient&#39;s mouth without the use of water.  
         [0059]     When the light mirror  102  is in operation, the LED  146  is energized via the power source  114  ( FIG. 1 ) through the umbilical  106  ( FIG. 1 ). The LED  146  is adjacent to and optically coupled to the shank  204 . Therefore, light  205  emitted by the LED  146  is transmitted through the shank  204 . In one embodiment, rather than splitting the light from the LED  146  into multiple directions, substantially all of the LED light traverses the shank  204  and is reflected by the reflector  214  at the second end  210  of the shank. The reflector  214  redirects substantially all the light out of the shank  204  through the single light exit surface  216 . The light transmitted through the light exit surface  216  illuminates a patient in any direction aimed by the clinician. The reflective surface  206  of the light mirror  102  reflects light from the patient at the illumination areas. Therefore, the light mirror  102  may be used by the clinician to clearly see even the most dark areas of a patient&#39;s mouth or other area. Meanwhile, the air passing through the handle  128  keeps the reflective surface  206  clear. In addition, the forced air may also provide a barrier protecting the reflective surface  206  from tooth debris, old dental materials, and the high power water emitting laser technology and aluminum oxide powder from air-abrasion systems. In one embodiment, the light mirror  102  may comprise mostly plastics and elastomers such that the weight of the instrument is about the same as a traditional stainless steel handle and mirror. Further, the larger diameter handle  128  is more ergonomic than the smaller diameter stainless steel handle and mirror. In some embodiments, however, the light mirror  102  may comprise metal such as stainless steel and may be of smaller, more traditional diameter.  
         [0060]     As mentioned above, in some embodiments, the light mirror  102  includes the optional protective roll-up sheath  104  ( FIG. 1 ) covering most of the instrument. As shown in  FIGS. 1 and 3 A- 3 C, the protective roll-up sheath  104  is a skin that than can be deployed across the light mirror  102  to prevent the spread germs and debris. In one embodiment, the roll-up sheath  104  is an elongated tubular sheath open at both ends. In one embodiment, the roll-up sheath  104  is attached to the elastomeric boot manifold  198 . One end  232  of the roll-up sheath  104  is affixed around a perimeter of the elastomeric boot manifold  198 . An opposite end  230  ( FIGS. 1 and 3 C) remains open and free to allow manual deployment over the handle. The roll-up sheath  104  may simply roll up and roll down the handle  128  as desired.  FIG. 3A  shows the roll-up sheath  104  prior to deployment.  FIG. 3B  illustrates partial deployment of the roll-up sheath  104  as it is unrolled over the handle  128 .  FIG. 3C  shows the roll-up sheath  104  fully unrolled and covering the handle  128 . The roll-up sheath  104  may comprise any flexible, contaminant resistant material including, but not limited to: vinyl, latex, nitrile, and polyethylene. Once deployed as shown in  FIGS. 1 and 3 C, the roll-up sheath  104  provides a protective, contaminant-resistant barrier over the handle  128 , and including the quick-disconnect coupler  134  ( FIG. 5 ). In one embodiment, the mirror  202 , elastomeric boot manifold  198 , and roll-up sheath  104  are all disposable. Therefore, each of the disposable items may be used a single time and discarded.  
         [0061]     Referring next to  FIG. 13 , another embodiment of the light mirror  102  is shown. In the embodiment of  FIG. 13 , rather than attaching to the umbilical  106  ( FIG. 3 ), the light mirror  102  is untethered and portable. The internal components as described above with reference to  FIGS. 2-6  may remain, but there is no umbilical  106  or flexible tail  131 . Instead, the light mirror  102  of  FIG. 13  includes a battery pack  250 . The battery pack  250  is electrically connected to the LED  146  ( FIG. 4 ) and provides power thereto. In some embodiments, the light mirror  102  does not have access to air when it is untethered. However, the battery pack  250  may be removed, and the light mirror  102  may be connected to the umbilical  106  ( FIG. 3 ) when air is needed.  
         [0062]     Nevertheless, in some embodiments, the battery pack  250  also supplies power to an optional fan  252 . In one embodiment, the fan  252  is enclosed by the battery pack  250  but open by vents  253  to atmosphere. The fan  252  is also in fluid communication with the interior of the tail end  130  of the handle  128 . Therefore, air may be forced by the fan  252  into the handle  128  in the same flow path depicted by the arrows  220  of  FIG. 7 .  
         [0063]     In one embodiment shown in  FIG. 16 , the light mirror  102  may include one or more compressed air canisters  270  to provide air through the handle  128 . The compressed air canister  270  shown in  FIG. 16  may replace, or be in addition to, the fan  252  ( FIG. 13 ). The air canister  270  is self contained within the handle  128  or battery pack  250 . Like the fan  252  ( FIG. 13 ), the compressed air canister  270  may be in fluid communication with the interior of the tail end  130  of the handle  128 . A control valve  272  with a controller  274  may be used by a clinician to turn the air off and on. The air canister  270  may be used with or without embodiments including the battery pack  250 . Accordingly, the reflective surface  206  may be kept clean with a portable, stand alone, untethered unit. Moreover, the handle  128  may be kept cool by the flow of air from the air canister  270 .  
         [0064]     In one embodiment shown in  FIG. 14 , the battery pack  250  is remote from the handle  128  but still portable and untethered. A short cord  251  may connect the battery pack  250  to the handle  128 . The battery pack  250  may clip onto a user&#39;s belt, slip into a user&#39;s pocket, sit on an object near the handle  128 , or otherwise remain in proximity to the handle  128 . Accordingly, the battery pack  250  may not add to the weight of the handle  128  and also enable the light mirror  102  to be fully portable. The handle  128  may or may not include the optional fan  252 .  
         [0065]     Another embodiment is shown in  FIG. 15 . According to the embodiment of  FIG. 15 , a trans-illumination light  260  is shown. The trans-illumination light  260  may be portable with a battery pack  250  as shown in  FIG. 15 , or connected to the umbilical  106  ( FIG. 3 ) for power. The internal and external components of the trans-illumination light  260  are similar or identical to light mirror  102  of  FIGS. 3 and 13 , however, the trans-illumination light  260  does not include the disposable mirror  202  ( FIG. 3 ), and may not include the elastomeric boot manifold  198  ( FIG. 3 ). Instead of a disposable mirror  202 , only the shank  204  is inserted into the handle  128 . The shank  204  of  FIG. 15  does not include the concave light exit surface  216  ( FIG. 2 ). Rather, the shank  204  of  FIG. 15  directs all light out through a distal end  262  thereof. Air may optionally continue to flow through the handle  128  as described above in other embodiments to keep the handle  128  and/or the LED  146  ( FIG. 4 ) cool. Air may flow through the elastomeric boot manifold  198  ( FIG. 4 ), or the elastomeric boot manifold may be removed or replaced such that air simply exits the second end  180  around the shank  204 . The trans-illumination light  260  may be used in any medical environment to illuminate any area of interest with precision.  
         [0066]     The preceding description has been presented only to illustrate and describe certain aspects, embodiments, and examples of the principles claimed below. It is not intended to be exhaustive or to limit the described principles to any precise form disclosed. Many modifications and variations are possible in light of the above teaching. Such modifications are contemplated by the inventor and within the scope of the claims. The scope of the principles described is defined by the following claims. It will be understood that the figures and accompanying text are exemplary in nature, and not limiting.