By Anne Nugent Guignon
In a perfect world, all of our dental equipment and instruments would be easy to lift, manipulate, grasp, reposition, or rotate. That's the perfect world.
Every practicing hygienist faces the very real risk of developing a repetitive stress injury because equipment doesn't work that way. In the real world, many dental hygienists experience never-ending discomfort and fatigue. Many of these problems stem from equipment that has been around for years — equipment that may not appear to be dangerous at first glance, but harbors all types of risk.
Consider the potential ill effects of the hoses you pick up and use, day in and day out. While more and more cordless devices are being developed for hygienists and dentists, it seems unlikely that we will ever be free from hoses. Hoses of every weight and torque are everywhere. Most polishers have an air hose. All air/water syringes are attached to a hose. Saliva ejectors and power scalers have hoses as well. Since this is the case, are there ways to lighten this load?
There is a way to immediately reduce the weight and torque of a handpiece cord. While there are many variations of this trick, the principle is the same — limit the amount of hose you are forced to support. Place the air hose on top of your forearm or in your lap during polishing or power scaling. Wouldn't you rather have the hose resting on your arm or in your lap than tugging on your wrist? The hose can also be secured between your pinkie and ring finger. If the hose is long enough, it can be looped over the overhead light handle. Some scaler cords are long enough to loop around a clinician's neck. Be creative and see what you can come up with.
Some of you may be practicing in a dental hygiene closet. You know what I mean — an operatory with barely enough room in which to turn around. Sometimes repositioning the patient chair will shorten the distance between the polisher and the patient's head. If the polisher is located in an out of the way location, consider moving the handpiece bracket closer. New brackets are available from supply houses or catalogues.
Utilizing a lightweight, slow-speed polishing handpiece is an obvious way to reduce weight. Newer models, weighing about three ounces, are generally well balanced, requiring very little pinch grip. There is even a cordless polisher available today. One company has developed an ultra-lightweight handpiece cord specifically for the scaler they manufacture. Earlier models of this scaler can be retro-fitted with this handpiece.
Devices that swivel help reduce handpiece torque as well. Several brands of slow-speed polishing handpieces have swivel mechanisms built right in, either at the hose end or at the fingertips. More recently the concept of swiveling has been built in to ultrasonic scaling inserts. Now two scaler manufacturers have designed handpieces that swivel. In some selected cases, clinicians will be able to retro-fit their scalers with a new swivel handpiece. It is certain that every clinician who has ever used a swiveling device prefers equipment that is more user-friendly to the wrist. In recent years, dental equipment manufacturers have become more tuned in to our ergonomic concerns. It is likely that we will see even more swiveling devices in the future.
Now examine the air hose attached to your slow-speed polishing handpiece. Is the hose short, heavy, rigid, or tightly coiled? If so, your hand, your wrist, your shoulder, or neck will pay the price over time. It takes strength and energy to support a heavy hose, and these hoses require a greater amount of pinch grip, which leads to hand, wrist, and forearm fatigue. Tightly coiled or rigid hoses also
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 [email protected].