Sitting down on the job

Avoid perching on the edge of the chair, as if you`re ready to jump up at any moment. If you have a back support on your chair, use it. You`re there to stay for a while.

Anne Nugent Guignon, RDH, MPH

Avoid perching on the edge of the chair, as if you`re ready to jump up at any moment. If you have a back support on your chair, use it. You`re there to stay for a while.

In the days of Jurassic dental hygiene, dental chairs were tiny, backless, round, and wobbly stools. One brand even attached directly to the patient chair, dictating exactly where you sat! Since most operators stood all day, seating was not a priority.

Every time we sit down, we place our bodies in a chair that can literally make or break our day. Do you ever go home at the end of the day with an aching back, sore shoulders or neck, pain in your legs, or just a bad case of overall fatigue? The culprit may be as simple as the chair you sit in.

As with anything else, there are good operator chairs, bad chairs, and some chairs that should be permanently retired. Other chairs can be given an extended lease if you know what to do. Factors to consider include:

- Should your chair be donated to the Smithsonian?

- Do you know what to look for in a new chair?

- Can your current chair be made more ergonomic?

- Would your doctor agree to purchase a new chair?

- Should you consider investing in your own chair?

Chair anatomy 101

First, let`s review basic chair anatomy. Once you understand the components, you`ll be able to give your chair a complete physical.

What makes the perfect chair? When you sit, your entire upper-body weight should be supported comfortably. Less body stress accumulates if you can vary your sitting posture throughout the day.

Your buttocks and thighs need support from a seat that is large enough, preferably square, and well-padded. The seat should allow for a few inches of clearance between the back of the knee and the front edge of the seat. It is much easier to balance on a seat that measures at least 16 inches wide - or 25 percent wider than the operator - than a small, round stool. Seats with a molded "tractor" design can limit your ability to shift positions. A chair designed with a gently sloping, seamless front edge will not impinge on leg circulation.

If you are able to change the seat tilt, adjust it so that your hips are slightly higher than your knees. This creates approximately a 100-degree angle in the hip area, thus reducing stress on the lower back. Adjust the chair height so that your thighs are nearly parallel to the floor and your feet are flat on the ground. Check to make sure your chair swivels freely, doesn`t wobble, and permits you to sit in a tripod fashion.

Avoid perching on the edge of the chair, as if you`re ready to jump up at any moment. If you have a back support on your chair, use it. You`re there to stay for a while. Most chairs allow you to change the height of the backrest and the distance from the back of the chair seat. You can create a slight positive pressure in the lower back or lumbar region by adjusting the tension setting. Larger backrests are made to support the entire back, in contrast to the smaller lumbar pillows. Customize your chair using the control mechanisms found on the back, side, or bottom of the chair. A properly adjusted back support can make your chair feel as comfortable as your favorite chair at home.

Consider a chair with arms. Arms come padded or firm, and in fixed, sliding, or swing-away models. You can even choose to have one or two arms. All types function to keep the operator`s shoulders in a relaxed position while supporting the forearms.

Initially, have someone help you position the arms. Sit with shoulders relaxed, forearms parallel to the floor, elbows at a 90-degree angle, arms close to the body, and wrists in a neutral position. Learning to use a chair with arms may take practice, but soon you`ll appreciate the comfort. In time, an armless chair will feel very strange.

You can sit more securely on a seat covered with textured fabric. Texture gives you traction. Avoid using cleaning products designed to keep synthetic "leather-like products" looking new. They`ll make the seat slick, and you`ll spend your day trying to keep from slipping off your chair!

Well, we`re finally at the bottom. A five-caster chair, rather than four, is less likely to tilt over. The wider the spread of the casters, the more stable the base. Also, chair casters need to move smoothly and freely across the floor.

Check casters that are binding, because the strangest things get caught up in the wheels! Several years ago, I gave up trying to remove the little bits of dental floss caught between the wheels and casters on my chair and just replaced the entire set.

Five who played musical chairs

Finding your dream chair often takes a bit of work. You`re going to spend countless hours in a chair, so test drive it before you make a permanent commitment, ensuring that it suits you. Take a look and see how five hygienists handled their chair dilemmas:

(1) Paula spent the last 10 years using a chair that was so decrepit she nearly fell out of it every time she sat down. She developed chronic leg pain from trying to balance in this antique. Paula`s doctor recently purchased a new chair for himself and agreed to an equal sum for her new chair. There was one catch. Paula had selected a more expensive model, one with arms, so she paid the difference. It was worth it because her leg pain vanished within weeks.

(2) Ann heard about the benefits of ergonomic seating at a recent course. After using a loaner chair in her practice for several weeks, she noticed how much fatigue she felt when she sat in her old chair again. Ann`s employer was unwilling to purchase a new chair, so she scouted the options at her local office supply company. Her "starter chair" is an inexpensive, cloth-covered model with a modest amount of padding and some arm adjustments.

(3) Within the first year of dental hygiene practice, Tracey had surgery on her left hand and had another surgery scheduled in the near future. She thought her career was coming to an abrupt halt. When Tracey heard a proper chair might help, she ordered one immediately. She quickly got back on track. Tracey considers her chair a career-saving investment and takes it to all of her temporary assignments.

(4) Marsha had wanted an ergonomic chair for years, and she acted quickly when she heard that a well-known style was being discontinued in favor of one with a more contemporary look. Her doctor agreed to purchase the older model at a reduced price.

(5) Mary perched all day on the very edge of an old round stool, and she had been experiencing back pain. Another operator stool, loaded down with magazines, sat in the corner. Even though this "find" was not an ideal chair, the larger square seat gave Mary better thigh support and the lumbar pillow was positioned closer to the back of the seat, fitting her petite frame better.

There are other creative ways to tackle the chair problem. Some companies will sell the demo models used in exhibits at dental meetings, saving you the shipping fee and allowing you to use your new chair immediately. If you`re a petite operator working in a chair with a seat that is too large, consider one of the lumbar pillows available at stores, in specialty catalogues, or on Web sites. Wedging the pillow between you and the chair back may move you forward enough.

Two final notes to remember are:

- If you buy your own chair and plan to take it on the road with you, make sure you can fit it in your vehicle. Many are designed to disassemble easily.

- Some dental professionals have obtained a prescription for ergonomic devices from a physician or other licensed health care practitioners. In some cases, insurance companies have reimbursed policy holders for the purchase of ergonomic chairs. It may be worthwhile to determine if you have this type of coverage.

It took a giant leap of faith to purchase my own ergonomic chair years ago, but it is one of the best decisions I have ever made. I never practice without it, even on a temporary assignment. Picture me relaxed all day, even in the most stressful situations. You can`t imagine how wonderful it is to practice in the comfort zone!

Chairside at the Comfort Zone

The following companies offer ergonomic dental chairs with arms:

- Orascoptic Research

(800) 369-3698

www.orascoptic.com

- Ergomax

(970) 925-3104

ergoim@rof.net (e-mail)

- RGP

(800) 522-9695

www.rgpdental.com

- Global Surgical Corp.

(800) 861-3585

www.globalsurgical.com

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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