Fitting solutions

Oct. 1, 2003
When I started my dental hygiene studies at University of Missouri-Kansas City in 1968, all 50 hygiene students were women, and 598 of the 600 dental students were men.

By Anne Nugent Guignon

When I started my dental hygiene studies at University of Missouri-Kansas City in 1968, all 50 hygiene students were women, and 598 of the 600 dental students were men. One of the women dental students dropped out during her first year.

My dental hygiene class completed our first two clinical semesters in the old dental school. We learned stand-up dental hygiene, and were taught to wear sturdy white shoes, white hose, and the classic starched white dress uniform topped off with a perky starched cap.

Then something exciting happened. The entire dental school moved to a new ultra-modern building. The clinic was brand new, and, as a result, we had to learn to practice sitting down. We were still wearing dresses and, for the sake of modesty, were required to keep our knees firmly glued together. This knee-to-knee posture made it very difficult to reach a patient's mouth comfortably. My grade was frequently lowered due to improper seating. I was always jealous of the class behind me because they were allowed to wear pants.

Today's hygiene and dental students are very different than those of four decades ago. While dental hygiene remains a predominately female profession, close to 50 percent of today's dental students are women. The diversity of today's students resembles a United Nations roster, quite a contrast to the predominantly white, Anglo-Saxon student bodies of years ago. There is also quite a difference in the body size and shape of each student.

In defense of this column that might be more aptly titled "The times they are a changing'," consider these facts: Most dental equipment was designed for men, whose average height was 5'8" to 6'2" and average weight from 150 to 220 pounds. For many years, dentists were the ones buying equipment, and manufacturers wanted to make purchasers happy.

At the beginning of the sit-down dentistry era, no one gave much thought to operator stools. Some had backs, others did not. Most were round, but a few had square seats. The stool height could be adjusted by either twirling the seat to achieve the desired height, or by using a lever to raise or lower the hydraulic lift.

No manufacturers considered short clinicians. They were doomed to perch on the edge of the seat just so their feet could reach the floor — hardly ideal ergonomic positioning. No matter what chair they tried, clinicians with an inseam length of less than 29 were never able to find a comfortable stool. For years chairs have been manufactured with a hydraulic lift, but none have allowed the chair to go lower than 15 inches, which is still too high for those who refer to themselves as vertically challenged.

Dr. Charles Caplan, of Madison, Wis., never found a chair that comfortably supported his tall body, so he founded a company that eventually became known as Orascoptic Research. He was one of the first to develop a fully adjustable chair with arms, one that resolved many ergonomic issues. But it still could not be positioned low enough for other clinicians.

As an interesting twist, Orascoptic's BodyGuard chair, the brainchild of an extremely tall dentist, is now available with a seat that adjusts from 14 to 19 inches in height, perfect for even the shortest clinicians. Short hygienists from all over the country were able to evaluate the first prototype at the recent RDH Under One Roof conference in Chicago. The chair received rave reviews, and the new model is now in production. With BodyGuard, any clinician, regardless of height, can have a chair that suits their build without sacrificing good ergonomic seating principals.

Finding a chair that provides adequate support is a lot simpler than trying to figure out how to work with a wide-bodied patient chair. I'm sure you know the ones I mean. Unless clinicians are tall or have long arms, these patient chairs are impossible. One more thing: Have you noticed that dental equipment never dies? It gets repaired, re-upholstered, and only occasionally does it get replaced.

Sure, patients are comfortable in a chair well suited for them, but the clinician's body can be completely worn out by the end of the day. Since there are more women and petite clinicians practicing today than there were 20 or 30 years ago, the dimensions of the patient chair need to be reconfigured to suit small operators. In addition, many clinicians now practice with magnification loupes, which allow the patient to be positioned waist high. We need to be able to move in closer, and that just isn't possible with a wide-bodied chair.

This is an important consideration if a new purchase is on the horizon, but what if you've been blessed with a treatment room that has one of these chairs? A-Dec has a solution for you. If you have either their Performer or 1040 Cascade chair, you're in luck. Both of these chairs can be retrofitted with a narrow backrest that is very easy to install. While the price of the replacement back varies according to the model of the chair and type of upholstery, a new back ranges from $450 to $600. This is less than 10 percent of the cost of a new chair, and it's a very reasonable solution for a very difficult problem.

A-Dec holds close to 50 percent of the market share in patient chair sales. This means that the odds are good you'll be able to detoxify your existing chair. Contact A-Dec customer service for information, and make sure to have the model number and upholstery information available. There are 60 other companies that make patient chairs. If your patient chair came from one of them, contact the company to see if they can recommend an easy solution.

Unfortunately, far too many clinicians have suffered needless daily discomfort for many years. The financial, psychological, and physical tolls are staggering. Regardless of your size, there are now chair solutions that will allow you to practice in the comfort zone.

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 ( She can be reached by phone at (713) 974-4540 or by e-mail at [email protected].