How to reduce the chicken wing (arm abduction) in dental hygiene practice
We all know what the chicken wing is, and many of us were constantly reminded not to do it while we were in school. I know I was! But so many of us are guilty of this and might not even know how to change it. But just because it’s common doesn’t mean it’s OK. Arm abduction (aka the chicken wing) is a risk factor for pain, fatigue, and injury. Ideally, you want your arms as close to your body as possible.
Through my years of assessing dental clinicians, I see this nearly 100% of the time in the nondominant, or mirror, arm. When your patient is reclined (usually not far enough back) and you start working, here comes that chicken wing. (Having the patient positioned too high also causes chicken wing, which is a topic for another time.)
If you think about it, your mirror arm may be at even greater risk of injury than your working one. Why? It usually flares out in the chicken wing to retract a strong lip or cheek, and stays in this static, awkward position for long periods. The body is meant to move (movement provides blood flow), not hold static positions. It’s this lack of movement and blood flow that eventually leads to pain and injury.
This can be avoided with a simple change in your mirror grip. I call it the “mirror slam,” and when done correctly, it eliminates the chicken wing. Many clinicians hold the mirror handle toward the top or middle, which leads to arm abduction when you’re retracting.
The mirror slam shifts the grip toward the head of the mirror, which naturally brings the arm in and provides a stable fulcrum to rest the mirror arm and provide stable and strong retraction. When the grip is down by the mirror head, you can rest your fingers on the patient's teeth, face, lip, or anywhere you can find a rest.
Watch a video demonstration of this technique.
In addition to the mirror slam, it’s crucial to use truly ergonomic mirrors. Features of ergonomic mirrors are wide, light, balanced, and textured handles. You’ll use far less pinch force when gripping something with a wide handle than with a thin one. Do you have those skinny, metal mirror handles in your kits? It might be time for an ergonomic upgrade.
Clarity of the mirror surface is also essential. Whenever I have a scratched-up mirror in my kit, I want to throw it out the window! Be sure your mirror lens is clear, bright, and fog-free. Many mirror defoggers are on the market to keep your lens clear and functional.
Being mindful of the chicken wing isn’t just for your comfort now; it’s for your long-term health and career longevity. You didn’t spend all this money and time in school to have your career cut short due to an injury. Remember, your nondominant arm deserves as much attention as anything else in your career does. Try this technique and feel the difference; your body will thank you.
