Ergonomics in dentistry
Do you remember the last clinical procedure you performed? Were you leaning over the patient or were you trying to keep your back and neck straight?
It is not uncommon for dental professionals to find themselves in harmful positions throughout the clinical procedures they perform which will then put them at a high risk of musculoskeletal disorders.
The solution to this problem is ergonomics; which in general is the science of making the work environment better fit the worker, so that the worker doesn’t have to strain in performing the work. However, it’s a bit different in dentistry.
Proper Posture for Dental Professionals
Ergonomics in dentistry starts with keeping the body in a neutral position as much as possible meaning dental professionals should try to:
- Keep their posture straight instead of leaning over the patient.
- Be seated instead of standing when performing a clinical procedure.
- Be as close to the patient as possible to avoid overextending their arms and/or back.
- Place their feet flat on the floor or on their stool’s footrest.
- The thighs should slope slightly downward. This can be achieved by adjusting the stool height.
- Evenly distribute their weight in a tripod pattern by placing each foot on the floor and their buttocks.
- Minimize wrist movement.
- Avoid holding their dentistry instruments too tight.
- Hold handpieces and instruments at about arm level
- Keep instruments within a 21-inch radius of the assistant so that need to reach and turn is minimized.
- Use mirrors to improve visibility
- Position the overhead light in a way so that the shadows are minimized.
Proper Patient Positioning
In most cases, the patient will be in a supine position for procedures. The proper patient height is to position it at elbow level or slightly higher (about 10-degrees) while performing clinical procedures. Placing the patient too high is a common mistake which results in shoulder elevation or arm abduction, both being risk factors for MSDs. In RDH Magazine, physical therapist and dental ergonomic consultant Bethany Valachi (Founder and CEO of Posturedontics) recommends;
- Placing the patient chair back at a 10 to 15-degree angle from the floor.
- Making sure that the patient is at the end of the headrest to eliminate the need to lean over the empty space.
- For upper arch, the occlusal plane should be tilted 15 – 20 degrees from the vertical plane.
- For lower arch, the occlusal plane should be tilted about 30 degrees from the horizontal plane.
Ergonomics are also a key factor in selecting dental instruments. Weight, diameter, and grip surface of each dental instrument can play a role in reducing the amount of force needed when performing a specific procedure such as scaling. In addition, dental instruments need to be properly sharpened which is a critical factor for reducing hand fatigue, because the operator will need to apply more force to achieve the same result.
This highlights the very nature of ergonomics: the one-size-fits-all just doesn’t work in ergonomics. So, it’s important to consider your own unique needs and work environment so that you can design a workspace to promote your optimal wellbeing. There are many ways for providing care to patients in a standard way, but the trick is finding the right approach that allows you to perform at your very best. This may take some time, but even small changes can have a big impact as you continue to perform at your best.