In it for the long haul

April 1, 2004
Today, I'm sending my suitcase back to the factory in Missouri. It needs a few minor repairs. I'm a bit anxious about letting this great piece of equipment out of my sight. You're probably thinking that this is a bit nutty.

by Anne Nugent Guignon

Today, I'm sending my suitcase back to the factory in Missouri. It needs a few minor repairs. I'm a bit anxious about letting this great piece of equipment out of my sight. You're probably thinking that this is a bit nutty. It's a suitcase, for goodness' sake! But, since I travel 30-plus weeks a year, it is an essential piece of equipment to me.

I spent a lot of time selecting my suitcase and its mates. The list of essential features was critical. It had to be durable, lightweight, and easily packed and handled during travel. After several weeks of searching, I selected one that features a handgrip that can be positioned in either a horizontal or vertical design, mounted on a gently sloping handle. It is the ultimate ergonomic suitcase.

A friend thought it was crazy for me to spend so much time and money searching for the perfect suitcase. She purchased "cute" luggage for a bargain about the same time. Six months later, a wheel fell off one of her suitcases. She was miserable dragging her gimpy, rolling bag along the sidewalks of the Windy City.

My suitcase is just as important to me as my dental hygiene treatment room. The Swiss Army Knife folks designed this suitcase. It glides smoothly over both hard and carpeted surfaces. The padded, arched handle pivots gently with every bump and turn, allowing me to keep my wrist in neutral and my elbow close to my side. Quality performance and ergonomics are critical when navigating a 60-pound suitcase through congested airports six to eight times a month.

As we travel through our clinical day, the equipment and setup in our treatment rooms are just as important. First, consider your operator stool. Is it adjusted too low to the ground? Contrary to what you probably learned when you were in school, it is a good idea to raise your chair so that your hip joint is a few inches higher than your knees. This position significantly reduces lower back strain and increases circulation to your legs.

Petite clinicians must sit on the edge of their stool for two reasons: either their chair cannot go low enough or the seat pan is too big. Chairs are now available that feature a short hydraulic lift that allows shorter clinicians to work with their feet flat on the floor. If the seat pan is too big, special ergonomic pillows are available that can be placed in front of the chair's lumbar support to shorten the depth of the seat.

When possible, use a chair with arms. Even though it may seem bulky at first, once you get used to them you'll never want to sit in anything else. Of course, it takes time to fine-tune the position of the arms so that you use the arms to the fullest benefit.

My friend, Karla, just got a great chair in the strangest way. She used to work for a dentist that had purchased two chairs with arms. He never got used to it, even after he removed the arms. One chair wound up in his deer stand. He stuffed the other castoff into a closet. When Karla heard about this, she told her former employer that she'd love to have one. He agreed to give her the now armless chair. A new set of arms is on the way from the factory. The moral of this story is: Go on a treasure hunt in the office storage area. You never know what you might find hidden away in some nook or cranny.

Finally, check your chair to make sure that it rolls smoothly on the floor. If the casters are binding, most likely they are full of bits of floss. It is important to clean them out to avoid a nasty fall if the casters lock up. Years ago, I tried to remove the offending material but quickly found out that most dental floss is difficult to remove, especially if the floss is wound tightly around a caster's rolling mechanism.

In addition, different kinds of casters are available from some manufacturers. Some casters operate better on hard, smooth surfaces, while others are designed to perform on carpeted surfaces

Since most of us practice solo (without a dedicated dental assistant at our side), it is important to have all equipment and instruments in handy, easy-to-reach locations. Rear delivery systems are an ergonomic nightmare for hygienists. This type of room configuration is perfect for four-handed operations but not for clinicians who work by themselves. Over-the-patient delivery systems prevent clinicians from needless twisting or making a dangerous reach to get a handpiece or air/water syringe. This configuration also lessens cord torque, which reduces unnecessary strain on a clinician's hands, wrist or forearms.

In many cases, it is possible to unlock the patient chair at the base and swivel it so you can have more room or better access to your patient. At other times, the entire patient chair can be repositioned to another area.

However, the location of built-in cabinets, plumbing, x-ray machine or overhead light may limit re-configuring a treatment room. Room setup can be clumsy for other reasons. Treatment areas that are set up for right-handed clinicians may not be appropriate for left-handed hygienists. Additional stress is placed on the entire body for left-handed clinicians that are forced to work with a right-handed setup. Poor equipment positioning that results in compromised body postures can further accelerate the development of repetitive stress injuries.

So whether you're traveling across country or across your treatment room, make sure that your equipment is well designed and properly positioned. Remember, it is your comfort zone and it's important to have a pain-free journey.

P.S. Just in case you were wondering, my suitcase could not be repaired, so the company sent me a brand new one, and several of my speaker friends got new luggage like mine for the holidays. Now they are traveling in the comfort zone as well.

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].

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