1812rdhgui P01

Use caution when ordering ergonomic products online

Dec. 2, 2018
Ordering online is convenient, but when it comes to ergonomics, there could be a cost to your health. Anne Guignon, RDH, has this advice for dental hygienists.

Purchasing products on the internet is big business. Most companies now have some type of online presence. Using just a few keystrokes, it’s easy to research items, select a product, choose shipping preferences, make a payment, and have the product shipped directly to your doorstep.

Over the last month, I’ve ordered my favorite crostini crackers, a tried-and-true cosmetic, and a replacement battery for my Garmin GPS. I couldn’t find the crackers in my local store, ordering the cosmetic online was convenient, and I needed the battery ASAP.

While online shopping can be effortless, it isn’t always painless. This is especially true when it comes to products that are important to your health and safety.

For example, the adjective “ergonomic” is frequently tossed around carelessly by companies that think this will help sell a product. As a result, the term is now worn out and used without real regard to what it means.

It’s easy to think that an inexpensive saddle, headlight, or pair of loupes will allow a clinician to work more safely, but this a dangerous assumption. Workplace ergonomics allows a worker to perform a task using tools that adapt to the worker. If the product is poorly made or does not fit the worker, then ergonomics flies out the window.

While I love the ease of online purchasing, I would never order certain products online unless I had already tried them out personally or had spent time learning about them at an exhibit hall or from a manufacturer’s representative. Making purchases should be done wisely, and the internet is not always the best place—especially if you are not familiar with the company or its products.

To flesh this out, let’s look at purchasing an item such as a saddle stool via an online portal. A Western saddle fits very few people, while a wider seat pan provides healthy support for the spine, buttocks, and thighs of most people. Those who love Western design typically dislike modified-English design, and vice versa. The differences may not be readily apparent when looking at these products online.

Similarly, magnification loupes should be made using custom measurements. They should not be purchased off the shelf, which is what happens when loupes are ordered online without measurements being taken.

Companies can put any product picture on the internet, but there’s no guarantee the photo represents what is delivered to your doorstep. Some companies will use a competitor’s product photos, implying that they sell these products. Recently, I learned of an internet-based company that was forced to delete photos of products it did not actually sell.

Online testimonials can be glowing, but unless you actually know the person who is making the statement, there is no way to know who actually wrote the review. Repair and return policies can be murky and confusing, and warranty terms can be misleading.

Bargain products, which can be found all over the internet, are cheap for a reason. Typically, products are made with poor-quality components, are easily damaged, and can be a nightmare to repair—if repair is even an option.

In the seating world, cheap saddles are made with poor-quality foam that quickly breaks down. They are also made with particle board substructures and poor-quality casters that break and bind easily, which can lead to a nasty tumble. By contrast, a high-quality saddle will have a seat pan shape that fits the pelvic width and musculature, be made of durable medical-grade upholstery, and contain high-density foam that provides comfort and lasts. It also will have an adjustable seat pan tilt, which is critical to support a neutral spinal posture, and a cylinder height that corresponds to the user’s leg length.

Saddles that cost $50 to $100 do not have premium features, and they may actually cause harm by increasing ergonomic stress. They may be right for other professions, but not ours. For example, many hairdressers use saddles in this price range, but their work positioning is quite different from the postures that dental professionals use. Hairdressers sit more erectly, while dental professionals move their torsos more forward into the clinical space. Similarly, saddles made for the hairdressing world are frequently designed with a prominent bulge at the front, which can create discomfort for hygienists because of increased pressure on the pubic bone. The hump also positions the user farther away from the patient. This increased distance forces clinicians to reach beyond a safe neutral zone, thereby increasing stress to the upper body musculature, which includes the shoulders, neck, and back. Unsafe seating for long periods of time is also known to contribute to low back pain and sciatica.

The same principles apply to eyeware. Loupes that are not custom-fitted can be found all over the internet. Their prices are low, but again, the components are marginal at best. These loupes are made with flimsy frames and glass or plastic of poor optical quality. A number of internet-based companies sell through-the-lens systems that have an insufficient working distance and do not correspond to the user’s pupillary distance, convergence point, or declination angle. If any of these measurements are off, the user is at risk for significant muscle pain, eye strain, nerve impingement, and decreased range of motion. As the body tries to accommodate for these deficiencies, the risk increases for developing a bulging disc or losing the natural healthy curve in the cervical spine.

In 2018, Mark Vetraino, MD, reported some startling information at an ergonomics conference about bone remodeling and the development of bone spurs. In 1989, the average age for the diagnosis of a forward head posture was 43 years old. By 2009, the average age for this diagnosis was 28 years old. Sadly, poor postures pave the way to degenerative disc disease, which is the human body’s attempt to remodel the bone and compensate for dangerous postures.

Oftentimes, clinicians have their first encounters with products while temping or when first joining a practice. As a result, it is not uncommon for users to have a bad experience if a product does not fit their body, can’t be adjusted to provide a neutral posture, or no one understands how to properly adjust the product. A number of companies have online videos showing how to properly adjust a saddle, but if the product design is incorrect for the user, no adjustment will help.

In other words, the right equipment, adjusted properly, does not create pain. The same lesson is in the fairy tale of Goldilocks and the three bears: one size does not fit all.

When it comes to ordering online, pay close attention to how easy it is to contact the company. If the company doesn’t or won’t answer your questions, don’t order the product. If you are offered a free trial period, understand the terms. Know your rights if you want to cancel the order and return the product for any reason. Remember, it is rare to be able to return products that are made with custom colors or nonstandard upholstery. If immediate payment is required, understand that credit cards offer consumers more layers of legal protection than debit cards.

Here’s an update on my latest purchases: The makeup was perfect, so no surprises there. The crackers were dropped into a box without any packing material. Now, I have lots of flavorful crumbs and few intact crackers. (It was not worth it to complain, but I won’t order from that source again.) Finally, my Garmin got a new battery, giving my trusty GPS a new lease on life.

When ordering online, know what you are getting, understand the terms, and be wary of too-good-to-be-true sales tactics. Follow this advice and your online purchases will have a better chance of turning out as you expect.

Anne Nugent Guignon, MPH, RDH, CSP, provides popular programs, including topics on biofilms, ergonomics, power-driven scaling, hypersensitivity, and remineralization. She is the recipient of the 2004 Mentor of the Year Award and the 2009 American Dental Hygienists’ Assocation Irene Newman Award. Anne has practiced clinical dental hygiene in Houston since 1971 and can be contacted at [email protected].

About the Author

Anne Nugent Guignon, MPH, RDH, CSP

ANNE NUGENT GUIGNON, MPH, RDH, CSP, has received numerous accolades over four decades for mentoring, research, and guiding her profession. As an international speaker and prolific author, Guignon focuses is on the oral microbiome, erosion, hypersensitivity, salivary dysfunction, ergonomics, and employee law issues. She may be contacted at [email protected].