Once in a while we have that patient who challenges our ergonomic practice standards and sends our backs, necks, and hands screaming in pain for days. As a profession, we pride ourselves in caring for our patients. In trying to always do our best, we often compromise ourselves for the care of others. Twisting, turning, and contorting into unnatural positions will contribute to the risks of musculoskeletal disorders that often affect dental workers. Sixty to ninety-six percent of dental professional care workers report musculoskeletal pain, including neck, back, wrist, and hand.1
And let’s face it—not all operatories are set up for the ergonomics that are taught in school and continuing education courses throughout the country. Along those lines, patients are not always “ideal” to work on either, with some not able to lean back or open very wide. If a patient is extremely overweight, it is difficult to seat ourselves close enough to see the oral cavity without trying to lean in.
With some offices offering an over-the-patient delivery system and others offering a 12 o’clock system, it can be challenging to access the equipment we need on a daily basis. If we can’t change the office setup, we have to look at other methods to reduce the risk of repetitive injuries over time.
Use sharp instruments
You are only as effective as the tools and instruments at your disposal. Working with dull instruments will increase wirst strain and hand fatigue. Don’t forget that removing calculus will also take longer and require more working strokes. Use of good quality instruments that stay sharp and strong and that are thin enough to adapt into the interproximal spaces can spare the hand and wrist on a daily basis. Take the time to sharpen as needed or consider sharpenless instruments (e.g., XP scalers by American Eagle).
Invest in ergonomic products
Two must-have items for prevention of musculoskeletal disorders are loupes with personal illumination and a saddle stool. The loupes not only increase your ability to see and perform better, they also reduce eye strain and allow you to stay at a safe working distance in respect to neck and back angulation. Using a personal light will eliminate the need to constantly reach above to adjust the overhead light again and again during each appointment.
Consider a cordless handpiece
The third item I love in daily practice is my cordless hygiene handpiece, and I have used one for many years. Over my career I have tried many and most recently switched to the newly released Young Infinity handpiece, which is lightweight and can take any prophy angle (we all have our favorites we like to use).
Look for a handpiece that has a swiveling nosecone and autoclavable piece to comply with Centers for Disease Control and Prevention (CDC) standards. Elimination of cord drag reduces wrist strain and is a small investment when compared to the cost of lost work and potential medical costs due to injury.
Use of a cordless handpiece has been a lifesaver many times for me. If I have a patient in a wheelchair who is not able to transfer to the dental chair, I am able to do more than just scale—I can polish without wrestling cords around the patient. I am a left-handed hygienist, and we know nothing in dentistry is designed for lefties. Having my personal cordless handpiece has been a game-changer, especially when filling in at various offices or for my friends who work in mobile dentistry.
Take care of yourself
There is much you can do to invest in yourself and the longevity of your career, starting with self-care. Establishing a strong core through exercise can help ensure a strong body to counteract the effects of the profession. Along with regular exercise, taking a moment to straighten and stretch throughout the day or during a particularly long procedure can give the mind and body a momentary break from the stress and stain of the job. Regular visits to the chiropractor and/or your massage therapist for maintenance can go a long way in preventing the aches and pains progressing to a long-term injury.
Much like we preach prevention in oral care, preventing long-term musculoskeletal disorders through self-care is key. Even when your employer isn’t willing to make a financial investment in the desired items such as a stool or handpiece, the cost to purchase yourself will be less in the long run compared to health costs and lost wages. Investing in the self-care practices and the tools to make the body healthier and happier allow for a long and successful career.
Reference
1. Kanji Z. The impact of occupation-related musculoskeletal disorders on dental hygienists. Can J Dent Hyg. 2016;50(2):72-79.
