It’s a no brainer that the dentist is the most valuable asset to any successful dental practice. However, it is estimated that more than half of practitioners have some sort of musculoskeletal disorder that is career-related. The research suggests that 64%-93% of dentists, hygienists and dental students have an episode of skeletal or muscular pain. With the most prevalent areas being in the lower back (36.3%-60.1%) and neck (19.5%-80%). Musculoskeletal problems are the leading cause (29.5%) for early retirement in the dental profession, followed closely with cardiovascular disease (21.2%).
Dentistry typically does not contribute itself to good ergonomics, though with the proper equipment and tools, along with practice to correct bad postural habits, it is possible. A dentist can spend upward of 60,000 hours in a lifetime of practice in tense, distorted positions resulting in stress, pain and long-term musculoskeletal problems. The scope of ergonomics in dentistry is extensive; dentists need to alter and guarantee good working pos-tures, adequate lighting and easy access to required tools for diﬀerent working practices, while keeping the patient and operator comfortable.
When looking at lower back pain as the leading musculoskeletal issue, con-sider your operating stool as a piece to the puzzle. There are six key elements to consider when choosing an operating stool: gender, lumber curve, height, operatory, disc health (Figure 2 – above) and body type. Of these six factors, lumbar curve is probably the one that will yield the biggest impact on lower back pain. You need to assess your natural lumbar curve and be able to maintain that position when seated and working on a patient. The seatpan inﬂuences lumbar posture signiﬁcantly; most people want the seat pan tilted down to help achieve a natural lumbar curve. Lumbar support is the number one way to reduce lower back pain and relieve symptoms of musculoskeletal issues (Figure 3 – below).
Neck pain is another common musculoskeletal issue in dentists resulting, most of the time, from rounded shoulder posture and working with the neck ﬂexed greater than 20 degrees (Figure 4 – below). Repositioning the operator, patient and loupes are great options to improving neck pain. However, when choosing lens loupes, you must also consider the proper ergonomics of face shape, distance between eyes and nose bridge. Thus, consider the correct ergonomic frames for loupes to be most eﬀective.
Another factor to consider is whether your operating stool has an armrest. The absence of an armrest can cause stress in neck-related musculoskeletal issues. Using a stool with an armrest can allow the shoulders and neck muscles to relax, therefore reducing tension and pain in the neck region. It is important to use head posture exercises and trigger point therapy to address these issues. A great simple neck exercise to perform before each patient is a chin tuck (Figure 5).
Although some of these issues require assistance from a manual therapist, new tools or equipment to improve ergonomics, others can be addressed through small changes and self-discipline. Start to make alterations in your posture and the way you practice by integrating some of these suggestions into your daily routine and oﬃce. You will discover that you have less fatigue and pain at the end of the day, and you will be able to oﬀer the quality of service that you and your patients mandate.
Here are seven guidelines for a dentist to improve wellness while working more comfortably with less fatigue—which ultimately can extend his/her career:
Bonus tip: Schedule a 10-minute stretch break for the whole oﬃce to participate once a day.