Prevention is Better Than Cure: Ergonomics in Dentistry
Back, neck, shoulder and arm pain are more common in dental professionals than not, and if you are in the not category give it a little time. It is a hazard of the job, however thanks to the study of ergonomics, more and more we are seeing products and equipment that help reduce occupation induced chronic pain in dental professionals. In a review article published in early 2016 in the Journal of Applied Dental and Medical Sciences the authors present ways to prevent musculoskeletal disorders (MSD) associated with the dental profession.1
Early retirement is far too common in the dental profession, this is often attributed to MSDs. Certain risk factors put dental professionals in a higher risk category for acquiring MSDs than many other professions. These risk factors include awkward postures, static position, force, repetitive movements, and contact stress. The authors go on to make suggestions to reduce the risk associated with these occupational hazards.
Proper equipment layout can help in reducing the risk of MSDs. Equipment should be in an easy to access location that allows the operator to remain in a neutral working position. Frequently used items should be within 22-26 inches from the operator and not above shoulder height or below waist height. The normal work area is 15 inches from the operator and the maximum work area should not exceed 24 inches from the operator.
Sitting posture is important to reduce lower back pain. The best way to reduce lower back pain is to stand, however, this is not always feasible for some procedures. Therefore, it is advised to alternate between sitting and standing. When sitting is necessary being aware of your posture is imperative, helpful tools that may encourage good posture include tilted seat plane, saddle stools, and lumbar support. Additionally, regularly repositioning feet will shift the workload and reduce static position. Be aware of patient position, if they are not in the proper position and the right height this could cause the operator to use forward head posture, in this posture the vertebrae no longer support the spine, which causes the muscles of the thorax and neck to contract constantly to support the spine.
Other MSD prevention strategies consist of the use of magnification, high-quality hand instruments, high-quality ultrasonic scaler inserts, and exercise. Magnification allows the operator to maintain a head posture with a < 20-degree angle reducing stress on the cervical region of the spine. High-quality hand instruments incorporate hollow or resin handles, round, knurled, or compressible handles, and carbon steel construction. Exercising can consist of something as simple as chair-side stretches, frequent stretching reduces detrimental physiological changes associated with static and awkward postures.
Other miscellaneous recommendations that can be incorporated in the dental professionals daily routine are micro-breaks (30 seconds to 1-minute breaks), weight control (for each additional 10 lbs. of weight you carry, 100 lbs. of force is generated to the lower back), scheduling (provide sufficient recovery time between patient, alternate difficult and easy patients, or shorten patients recall interval).
The authors conclude, “Every dentist has an opportunity for ergonomic improvement. This represents a paradigm shift for the daily dental practice. It is important that dentistry incorporate these strategies into practice to facilitate balance musculoskeletal health that will enable longer, healthier careers; increase productivity; provide safer workplaces, and prevent MSDs.”
Do you suffer from MSDs? Has it impaired your ability to work in any capacity? Do any of these strategies seem helpful and practical? Have you already incorporated some of these strategies into your current routine?
Yogita Khalekar, Amit Zope, Lalit Chaudhart, Ujawala Brahmankar, Hemant Gadge, Swapnil Deore. Prevention is Better Than Cure: Ergonomics in Dentistry. Journal of Applied Dental and Medical Sciences. 2(1); 209-216.
