See yourself in pictures

March 1, 2004
Some people are naturally photogenic. You know the type; they even have a good photo on their driver's license. Other people would rather burn every negative or digital image created that shows their image and likeness.

by Anne Nugent Guignon

Some people are naturally photogenic. You know the type; they even have a good photo on their driver's license. Other people would rather burn every negative or digital image created that shows their image and likeness. Then there are folks that feel comfortable on either side of the camera lens.

So what do photos have to do with practicing dental hygiene? Two trite phrases come to mind immediately. You've heard them a thousand times: "A picture is worth a thousand words," and "Seeing is believing." For the past four years, I've tried to describe how to practice dental hygiene in safety and comfort. That's particularly hard to do in a text-only format.

You may think that your posture is more than adequate, or that you are a long way from developing an on-the-job injury. But how many of you have gone one step further and had a co-worker take pictures of you on the job? This doesn't include friendly chats around the water cooler or the monthly birthday parties; we're asking how many of you have taken a serious look at how you practice?

A recent discussion with my fellow columnist, Shirley Gutkowski, prompted this column. Shirley and her co-worker, Ann, were both experiencing muscular soreness. Their neuromuscular therapist asked them to take pictures showing how they worked in a clinical setting. The photos revealed some very interesting information about each woman's clinical posture. This documentation helped their therapist, Hanna, customize treatment and recommendations that reduced their discomfort.

Another friend of mine, Dee, really wants to wear loupes. The process has been more difficult than she ever imagined. She has been desperately seeking comfort and felt the settings on her loupes were not correct. She remembered the suggestion about having someone take photographs. She was worried that she was not sitting up straight enough. After looking at the pictures, it appeared that sitting up straight is only one part of her complex puzzle. The treatment room is set up with a rear delivery, and the patient chair cannot be positioned low enough. Loupes are a definite help but they cannot be expected to overcome obstacles such as this.

Why don't you take a good look at how you are working?

You may be amazed at what you see. Ask a co-worker to shoot candid photos. In other words, forget about posing. Just work like you always do. Don't forget to tell your doctor and patients about this project. Most will want to be part of this fact-finding mission.

Ask your co-worker to take pictures of you scaling, polishing, applying sealants, taking radiographs, charting, and any other tasks that you perform. It is important to take photos from many different angles: front, side, and rear. Also remember to take some close-up shots showing how you position your fingers, hands, wrists, and head. It will be worth it to take a dozen or more photos over a period of several days.

Once you have the opportunity to analyze the photos, you'll be able to see just exactly where your body stressors are coming from. Here are some things to look for:

o Is your head bent to one side, or is it upright, comfortably supported by your upper body musculature?
o Are you leaning over, or is your head extended out from your shoulders?
o Are you leaning forward from the shoulders or the hips?
o Are your shoulders hunched up or rounded, or do they appear relaxed?
o What about your wrists? Are the wrists straight, or in all kinds of awkward positions?
o Do your hands and fingers look comfortable, or are you holding onto your instruments or handpiece with a death grip?
o Is your operator chair too high or too low?
o Are your hips slightly higher than your knees when you are seated?
o Are you leaning to one side, with all of the weight of your upper torso supported by one hip and buttock?
o Do you use your chair's lumbar support, or do you perch on the edge of the seat?
o How about your forearms? Do you look like you are ready to fly, or are your arms close to your torso?
o Are your feet flat on the ground, or are you balancing on tiptoes?

Now that you've gotten a handful of photos, would you consider sharing them with your dental hygiene colleagues? How about submitting some of them for a unique pictorial in the July 2004 issue of RDH that would show just exactly how we work?

Any ideas that solve workplace-related ergonomic issues are also welcome.

Bethany Valachi, MS, PT, CEAS, is a physical therapist and ergonomic expert with a special interest in helping dental professionals. Her first dental client was her husband. She helped him reduce his workplace-related aches and pains. Together, they have developed several seminars and tapes specifically designed to target our problems. She even has an article in this month's issue of RDH devoted to chair-side stretching exercises.

If you are interested in participating, let's have some fun with this project. Bethany has agreed to review your photos and ergonomic tips. It will be interesting to hear her perspective of how we work and how we can create a better comfort zone.

Anne Nugent Guignon, RDH, MPH, practices clinical dental hygiene in Houston, Texas. She writes, speaks, and presents continuing- education courses on ergonomics and advanced ultrasonic instrumentation through her company, ErgoSonics ( She can be reached by phone at (713) 974-4540 or by e-mail at [email protected].

Do you have the best posture or a great idea?

If you submit either a photo or an idea, you'll automatically be entered into a drawing for some great prizes — prizes specifically designed to create your own ergonomic comfort zone. And the icing on the cake — you may see your picture in an upcoming issue of RDH!

You'll have the opportunity to win:

• Orascoptic 2.5 TTL loupes
• Benco Pirouette Handpiece with Young Dental's Contra Prophy Angles
• Accubite AccuComfort Handpiece with Young Dental's Contra Prophy Angles
• Bethany Valachi's Chair Side Stretching Video
• Taskall Wizard Cordless Handpiece from Brasseler USA-NSK America

You don't have to be a photo expert to participate in this event. If you are taking photos with print film, ask your film processor to make either a floppy or a CD in addition to your prints. Digital camera images will work as well.

That's all there is to it.

Just send either ideas or photos showing either the best or the worst in the following categories:

• Overall clinician posture

• Head or shoulder position
• Hand position
• Clinician chair positioning
• Ergonomic solution

Good luck, and we should all have fun looking at how we work in an upcoming issue of RDH!

All entries must be received by April 15, 2004, to be considered for the article and contest.

1 Provide your contact information: name, address, phone number, and email address with your entry.
2 Either email individual jpeg images to ergophotos@ or send a CD to me in care of RDH, attn: Comfort Zone, 1421 S. Sheridan Road, Tulsa, OK 74112.
3 If you are sending jpeg images electronically, please send one at a time.
4 Print your name and contact information on all CDs.
5 If you get stuck on these directions, contact me at [email protected].