But not in the way most people think! Do you sometimes feel like you’ve been through the wringer at the end of the day and wonder whether you are a dentist or a contortionist? Studies show that nearly two-thirds of dentists who retire early are forced to do so because of musculoskeletal disorders and work-related pain. Having pain at the end of the day isn’t “just part of the job.” Just as you treat a patient who is pain, properly identifying the source of the issue is a critical step in providing a solution.
As an equipment specialist and technician visiting dental offices for the past 25 years, I have found that most ergonomic issues can be addressed by focusing on three equipment-related factors: 1. Patient positioning; 2. Operator and assistant positioning and seating; and 3. Dental delivery system configuration and location.
Studies show that any procedure that requires a forward head posture of more than 20 degrees will contribute significantly to neck and shoulder pain issues. Practitioner feedback on proper posture usually focuses on their inability to see properly or patient comfort concerns, but with correct equipment and training, both issues are easily addressed.
Vertically adjustable, flip-up loupes with a declination angle of about 55 degrees addresses the head posture issue and allow you to sit in a neutral, vertical position. But even the right loupes won’t be effective unless you properly position the patient. Dental chairs are equipped with a variety of headrest styles, but the most versatile is the double articulating headrest. Too often we see dental chairs equipped with a fixed or flat style headrest that doesn’t allow for proper patient positioning, or dentists and staff who haven’t been trained how to utilize the headrest so they just leave it in the same spot for every patient and procedure.
With the patient positioned properly, the occlusal plane of the upper arch should be 20 to 25 degrees beyond the vertical. A properly positioned headrest or cushion will allow you to do this and should be adjusted immediately after the patient is seated. A double articulating headrest should be brought up and forward to support the base of the patient’s skull and keep them in a relaxed, open position, with only small adjustments to be made after reclining dependent on patient feedback or the region you will be treating. Patients will tolerate a fairly high level of reclining without complaint when properly supported.
Operator and assistant positioning and seating
Dental stools are a specialty piece of equipment and should be customized and fitted specially for your body type. The evolution in dental seating now includes all manner of body supports options, molded and adjustable seat cushions, and gender-specific saddle type models fit specifically to your preferences and body type.
A properly fitted stool will enhance breathing, circulation, spinal position, and put your body into a stable and comfortable position and enhance patient access. Always try before you buy, preferably with an in-office demo that you can use for several patients.
Dental delivery style and positioning
Of the three focus areas we’ve discussed, this is the most open to user preference. Dental treatment spaces have seen a significant shift to 12 o’clock rear delivery, four-handed style equipped space, which when properly utilized is very effective at minimizing fatigue, twisting motions and provides versatility for a left- or right-handed operator. Side or over-the-patient delivery systems however, are ideal for the operator who prefers to switch instruments or handpiece usage frequently and keep everything out in front of their body. There isn’t a right or wrong answer here, but you should go through a proper interview process about your preferences and learn the trade-offs before selecting an equipment style and location. A delivery system in the wrong location will have a very negative effect on your posture and daily fatigue.
We also commonly address light and noise issues in the treatment space. Improper light color and balance from all sources can contribute greatly to eyestrain and fatigue and ambient noise from equipment and handpieces is a frequent source of distraction and can significantly affect hearing loss.
If you’re struggling with these or any other factors in your practice, we are here to help. We provide ergonomic advice, stool demos and treatment space evaluations.
Contact a WDA Equipment Solutions specialist at 888-213-7300 to set up a free equipment and ergonomics evaluation.