Left, right ... right, left

Right out front, I'll admit that I admire anyone on this planet who is a leftie. Every one of you has had to put up with living in a right-handed world. There are no special dispensations for left-handed people. Left-handedness is not a recognized disability, so southpaws have been forced to conform to our world whether they like it or not.

When I was in dental hygiene school more than 30 years ago, all hygiene students were trained to practice right-handed. Some were forced to go against their natural inclination, but that was just the way it was back then. In retrospect, we were all beginners and hand instrumentation was a challenge regardless of our hand dominance. Left-handed students did just as well clinically as the rest of us. Only a few enlightened souls realized that these students were being given a huge advantage. The lefties were going to enter a foreign world armed with the skills to survive.

Fast-forward a few decades. Left-handed dental hygiene students now were demanding to be trained to instrument with their dominant hand. From their point of view it was an equal opportunity issue, but this may have been a very shortsighted approach. Consider the fact that 99.999 percent of all clinical dental hygienists are employees in a dental practice subject to the equipment whims of the employer. Forget the fact that most of us are the original queens of the leftovers. While there are hygienists who do practice with the latest equipment, many of us get the hand-me-downs whenever the office is remodeled. The equipment may be recovered or repainted, but it is still the same old design underneath. If that set-up is for a right-handed clinician, then the bodies of left-handed hygienists are at greater risk for developing workplace-related repetitive stress injuries.

In my opinion, lefties have magical powers. They can work from every angle imaginable. If you translated their skills to language, they are the bilingual hygiene experts at instrumentation. Do I envy people who can speak multiple languages fluently? Of course. So I envy the lefties every time I have trouble seeing just what I am doing in the treatment room. Lefties have had to overcome an obstacle that most of us can only imagine.

Since I admire the lefties' adaptability I decided to go to the experts and get their view of the world. Their viewpoints were varied and their experiences were all over the map. I received comments from hygienists who graduated in every decade since the 1960s. Here are their reflections:

• While most of the hygienists who graduated more than 20 years ago weren't given a choice about working with their dominant hand, several took the matter to a higher authority. When Becky was learning to scale on mannequins she was not allowed to scale left-handed. She became so concerned about trying to learn to practice right-handed that she went to the program director, who she remembers looked like Albert Einstein. He called in the instructors and told them that it was their problem and that they must figure out a way to teach the left-handed students. Even though Becky scales as a leftie, she can polish with either hand.

• After their first semester at the Fones School in the mid-1960s, Diane and six of her classmates went to the director with the following argument: Why try and make us right-handed when you can't be a leftie? By the second semester the students were allowed to teach themselves, but they did not get any special equipment. Three continued to learn with their right hands and three chose to be leftie scalers. Diane ended up learning both ways, so she now can work on either side of the chair, as well as scale the lower anterior teeth or use an explorer with either hand.

• Twenty years ago, Donna's faculty advised her that it would be very difficult to find a left-handed operatory. She found it was not too much trouble to learn with her right hand and feels that she might have been ambidextrous to begin with. In contrast, Candace and Cappy have always practiced as lefties and feel that some of the operatory set-ups have made it much harder to practice ergonomically. Beth finds that when she has to practice in a room set up for a right-hander she must stretch to the max to reach whatever she wants to use.

• Candace and Sue feel that being lefties has helped see things on the left side of the mouth that the rest of us never see — so their doctors have learned to rely on their observations. Their doctors joke about their ability to find "left-handed sticks" with the explorer. Another hygienist named Sue relates that the standing joke at her practice is that patients should alternate between a leftie and a rightie to make sure everything is really done well!

• Cheryl and Paige both graduated in 2001. Cheryl only had right-handed instructors but never considered switching, even though the scaling techniques her instructors suggested did not always work for her. It took practicing for six months to figure out what was best for her. Cheryl's first office was an ergonomic nightmare and her back, neck, and shoulder hurt constantly. Now she works in an office where the chairs are reversible — just like they were in school — and she is much more comfortable. Paige also trained as a left-handed hygienist and her clinical instructor was relatively new and had never taught a leftie. When she graduated, she had to reorganize the entire treatment room to accommodate her body. During the interview process, she found that potential employers often were concerned about the cost of converting a unit for a left-handed clinician. Both Paige and Cheryl feel that they got very little information about ergonomics when they were in school.

Manufacturers have started designing equipment that can be adapted for the needs of any clinician, but if your treatment room is right-handed and you are not, there are some other solutions. Consider a bracket table on an extension arm that bolts to the wall or a light pole. Equipment also can be repositioned so that the slow speed handpiece, air/water syringe and saliva ejector are placed in a convenient location. Mobile carts are another answer. If the floor plan will allow it, carts can be positioned to bring everything in close for the leftie. Consider unlocking the patient chair and repositioning it in the room.

It is critical for all of us to position equipment so it is easy to reach and we don't have to spend our day stretching our bodies just to reach a power scaler or saliva ejector. What should the left-handed hygienist do? All of the hygienists surveyed reported that their employers were very accommodating to their needs, which is probably why they have been so happy in their current practices. However, if your doctor turns a deaf ear to your needs, you may want to check out other employment options. Look for a dental practice that has treatment rooms designed for left-handed clinicians or equipment that is ambidextrous. Working as a temporary hygienist was the one time that being a leftie presented a real challenge to all of these clinicians.

Dental hygiene practice places strain on all of our bodies, and it is critical that each one of us strives to maintain neutral body postures.

If we can't do this, then we can't practice in the comfort zone.

And yes, I still think the lefties have magical powers.


Anne Nugent Guignon, RDH, MPH, practices clinical dental hygiene in Houston, Texas. She writes, speaks, and presents continuing- education courses on ergonomics and advanced ultrasonic instrumentation through her company, ErgoSonics (www.ergosonics.com). She can be reached by phone at (713) 974-4540 or by e-mail at anne@ergosonics.com.

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