For decades, dental hygienists have battled chronic and acute pain caused by musculoskeletal disorders (MSDs). Work-related MSDs are very common among dental hygienists due to the nature of their work. Studies show 75% to 92% of dental hygienists report hand and wrist pain at work, with 56% showing classic symptoms of carpal tunnel syndrome (CTS). Data shows that dental hygienists who work on patients with heavy calculus are 2.3 times more likely to develop hand problems, and those who practice for more than 10 years are 1.9 times more likely to have CTS symptoms.1-4
CTS is a painful neurological condition that affects the hands and fingers. It’s caused by a compression of the median nerve passing through the carpal tunnel at the front of the wrist. For dental hygienists, CTS is often caused by repetitive movements and poor ergonomics over long periods of time.³ Besides pain and discomfort, CTS symptoms include numbness, tingling, weakness, swelling, and a burning sensation. There are numerous measures to prevent injuries.
The goal of ergonomics is to prevent MSDs by helping practitioners adopt a neutral posture, as well as design and arrange the operatory and our tools to improve efficiency, productivity, and ease. Successful ergonomics means preventing illness and injuries and increasing satisfaction among workers. One major ergonomic advancement for dental hygienists in recent years is the cordless handpiece.
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Traditional vs. cordless handpieces
Handpieces are an essential tool in the daily practice of dental hygienists, and they allow clinicians to achieve greater patient outcomes in the removal of stains and biofilm. However, the traditional corded handpieces come with limitations that can hinder our comfort and lead to MSDs and CTS. Here are some of the advantages cordless handpieces have over their corded counterparts that shed light on the ergonomic considerations that make them the most viable option.
Traditional handpieces rely on cords to connect to a power source, limiting their mobility and flexibility. Cordless handpieces use a rechargeable battery, which offers increased freedom of movement and eliminates the obstacles of a heavy, coiled hose.
While cordless handpieces have been available for years, the designs have improved drastically, making them easier for clinicians to seamlessly integrate these lightweight, balanced handpieces. Because the design of each handpiece varies, there are multiple options to find the right fit for our practice.
It’s time to ditch the cord
One of the key advantages of cordless handpieces is their ability to enhance the patient experience. Reduced noise and vibration creates a more comfortable environment while reducing the risk of clinician injury. No cord also eliminates potential patient discomfort caused by tangled cords or accidental tugging, ensuring a smoother and more pleasant experience.
Cordless handpieces provide us with unparalleled freedom and flexibility during routine procedures. The absence of cords allows for increased range of motion, which facilitates better access to all areas of the mouth. Furthermore, the portability of cordless handpieces enables seamless transitions between treatment rooms, enhancing the efficiency of office workflow.
Cordless handpieces contribute to significant time savings and a streamlined workflow. With no cords to contend with, we aren’t constantly adjusting, untangling, or lugging around heavy cords. Instrument changes and adjustments are quicker, allowing us to focus on delivering quality care.
Improving ergonomic outcomes
Small movements such as screwing a handpiece into the cord and resisting the pull of a heavy cord may not sound like much, but repetitive movements, day after day, really do add up. The ergonomic design of cordless handpieces plays a crucial role in reducing physical strain and fatigue.5 They are typically lightweight, making them easier to handle for extended periods. Because most cordless handpieces swivel, less movement is required from the practitioner. Going cordless eliminates the need to screw the handpiece into the cord, which helps reduce effort and strain and increase efficiency and productivity.
A wireless foot pedal reduces tripping hazards and enables more freedom of movement and easier accessibility, allowing us to focus on optimal body posture and body mechanics. Corded handpieces often require us to bend, lean, or twist, increasing the risk of injury. Practitioners may fiddle to adjust or pull against the cord with their body, which contributes to possible work-related injury. This is especially true for leftie hygienists, who already battle to practice in operatories that are designed for right-handed practitioners.
The freedom of movement from cordless options allows easy positioning and adjustment, reducing strain on the neck, back, shoulders, hand, and wrist. We’re able to adapt a neutral wrist position as we work. Traditional handpieces often require us to adopt a tight grip to keep the cord secure and steady. Cordless handpieces enable improved accessibility and visibility. The cord-free design allows us to reach and clean hard-to-access areas with ease. The weight, cord drag, and tubing torque of a traditional handpiece, coupled with awkward, static posture and repetitive movements, puts hygienists at greater risk for MSDs.
Converting to cordless
A thriving dental hygiene department is a key component of any dental practice. Hygienists deserve equipment that supports their ergonomics and overall health, while also providing patients with a superior experience. Many improvements have been made since the introduction of cordless handpieces. They now offer longer battery life, making it a more seamless transition.
From an ergonomic and patient perspective, the transition from traditional to cordless handpieces is a no-brainer. With such a high prevalence of injury, MSDs, disability, and early retirement among dental hygienists, clinicians should prioritize their own health and seek ergonomic solutions. When our bodies are in alignment, we enjoy career longevity. Investing in tools like a cordless handpiece not only helps us deliver the best quality care, but also protects our most valuable tool: our body.
Editor's note: This article appeared in the August 2023 print edition of RDH magazine. Dental hygienists in North America are eligible for a complimentary print subscription. Sign up here.
References
1. Hayes M, Cockrell D, Smith DR. A systematic review of musculoskeletal disorders among dental professionals. Int J Dent Hyg. 2009;7(3):159-165. doi:10.1111/j.1601-5037.2009.00395.x
2. Saccucci M, Zumbo G, Mercuri P, et al. Musculoskeletal disorders related to dental hygienist profession. Int J Dent Hyg. 2022;20(3):571-579. doi:10.1111/idh.12596
3. Lalumandier JA, McPhee SD. Prevalence and risk factors of hand problems and carpal tunnel syndrome among dental hygienists. J Dent Hyg. 2001;75(2):130-134.
4. Harris ML, Sentner SM, Doucette HJ, Brillant MGS. Musculoskeletal disorders among dental hygienists in Canada. Can J Dent Hyg. 2020;54(2):61-67.
5. McCombs G, Russell DM. Comparison of dorded and cordless handpieces on forearm muscle activity, procedure time and ease of use during simulated tooth polishing. J Dent Hyg. 2014;88(6):386-393
