Word games

Aug. 1, 2006
What does the adjective ergonomic mean to you? Does it have a positive connotation? Does it create images of safety, comfort, or protection from injury?

What does the adjective ergonomic mean to you? Does it have a positive connotation? Does it create images of safety, comfort, or protection from injury?

Words like ergonomic are powerful and can give purchasers a false sense of security. The dictionary defines this frequently used buzzword as: designed for maximum comfort, efficiency, safety, and ease of use, especially in the workplace. According to this definition, using the term ergonomic implies that a device, action, or workstation will have these four characteristics.

While I don’t want to sound argumentative, the word ergonomic has been overused and misapplied in describing many products and work settings. Since dental health-care workers are not all the same size, the term ergonomic is only appropriate when the specific characteristics of the user are considered.

Periodically, hygienists and dentists contact me regarding the equipment they are currently using, plan to purchase, or the injuries that they have sustained. Sometimes their stories have happy endings, but more often the damage is done, or they feel powerless to change their working environment.

The solution to every ergonomic woe in the dental office can’t be addressed here, but it is possible to analyze your current work environment to identify dangerous practices, poorly selected supplies and improper equipment. The key is to understand that one size does not fit all.

For example, even though a pair of gloves may have features that are considered ergonomic, such as textured fingertips, a particular brand or size may not be appropriate for a specific user.

The glove may be too small across the palm, or the wearer’s fingers may be significantly shorter than the glove fingers. So even though the fingertips are textured, the glove is still not ergonomically correct for some users. Gloves that are too tight or force one’s thumb into an awkward position will put significant pressure on delicate nerves, blood vessels, ligaments and tendons. Over time this microtrauma can lead to workplace-related musculoskeletal disorder (WRMSD).

Consider the size of your hands and those of your co-workers. All hands are not identical. Are you free to select the glove that provides not only protection from blood borne pathogens, but also a safe and comfortable fit? Many clinicians minimize the long-term risk of improperly fitting gloves, yet how will they practice if they are sidelined with a cumulative trauma disorder in their hands?

Now think about operator chairs. Petite clinicians are forced to perch at the edge of the seat pan when they use operator stools designed for tall, large-boned males. Even if the stool has a fully adjustable lumbar support and seat height mechanism, arm rests that can be repositioned, and a gently-sloping seat pan with a waterfall edge, it is still not ergonomic if it is designed for a large operator.

What about hand instruments? Are yours heavy, skinny and smooth with short stubby blades? Have you ever compared the length of the entire instrument? Some companies make short instruments for clinicians with small hands. Other brands feature long handles that are easy to hold for those with big hands.

Speaking of instruments, do you take advantage of your ultrasonic scaler as much as possible? Slim tips and machines with low power settings and lightweight cords not only create patient comfort, they reduce stress to the user’s body. Swivel mechanisms, padded grips and easy-to-use footswitches all create safer scaling for clinicians, and are an effective and efficient way to disrupt plaque biofilm.

Old polishing handpieces are heavy and unbalanced, and are often kept in service for too many years. New designs are 60 percent lighter, swivel, have various body shapes, and are cordless. Perhaps it is time to retire your old Model T handpiece.

Pre-existing workstations create another set of nightmares. Current dental office design trends encourage all treatment rooms to be planned identically with rear delivery setups. Manufacturers tout the wonderful ergonomics of this type of treatment room; however, this layout is designed for clinicians with full-time dedicated assistants. Solo dental hygienists confronted with this delivery system spend their days twisting, turning and reaching for equipment. Constantly working in awkward body postures is not ergonomic.

As much as I believe in magnification loupes, these marvelous devices can be another source of ergonomic woes. It’s incredible that some clinicians make a decision on whether or not to use magnification based on briefly using someone else’s magnification system in the clinical setting. Hand-me-downs or cast-offs can have terrible consequences.

If the new user’s working distance varies from that of the original user, there will be some type of postural compromise. The same thing will happen if there is a significant difference in the declination angle, convergence point or pupillary distance. While flip-up systems are designed so the user can change everything but the working distance, this feature must still fit the new user.

Through-the-lens (TTL) configurations are precisely designed for a specific clinician’s measurements.

The next time you walk into your treatment room, look around at the layout. Critically look at the equipment and supplies you use. Does your environment really fit you, or are you straining your body every minute that you work?

Five minutes of muscle strain to your neck, hands, arms or back won’t end your career, but multiple microtraumas experienced eight hours a day, four days a week, 50 weeks a year will add up. You may not remember the exact day you noticed the aches and pains created by repeated ergonomic microtraumas, but your body won’t ever forget the abuse.

Learn about ergonomics. Explore your options. Find out what equipment works best in your hands. Open a dialogue with your employer. Ask for safer equipment. Consider purchasing your own equipment. Find a new practice if necessary.

Your physical, emotional, professional and financial wellbeing are at stake. Ergonomics is a hot topic based on real science. With awareness, you can build your own ergonomic comfort zone.