Location, location, location!!

Oct. 1, 2000
... we would all be more comfortable if we adapted our work space to fit our bodies, instead of continuing bad habits and forcing our bodies to work in poorly designed spaces.

... we would all be more comfortable if we adapted our work space to fit our bodies, instead of continuing bad habits and forcing our bodies to work in poorly designed spaces.

Anne Nugent Guignon, RDH, MPH

A basic formula for success in the real estate world is: location, location, location. Each one of us should memorize this mantra and utter it under our breath every time we design or work in a treatment room. What good does it do to have a beautiful treatment room or wonderful new ergonomic equipment if we don`t know how to position ourselves effectively in it?

Do you remember how you felt before you moved into your current home? You probably started visualizing where everything would go, how you would position your favorite furniture, and how you could make that empty geometric space feel comfortable. In other words, how could you make this space work for you? Did you have to move a piece of furniture an inch or two to make it "feel just right?" Did you reposition everything several times before you were finally satisfied? Have you ever had a room that just didn`t "work" suddenly - after rearranging everything - become a joy to live in?

We`re not architects or designers; we`re not educated to think automatically about where everything fits or how everything flows. But we would all be more comfortable if we adapted our work space to fit our bodies, instead of continuing bad habits and forcing our bodies to work in poorly designed spaces.

Even though I practice full time, I work primarily on temporary assignments. I have seen and worked with every type of equipment and room configuration ever invented. At least it seems that way! The only hygiene room I have ever declared utterly hopeless measures approximately seven feet wide and eight feet long. The patient chair, circa 1960, must be manually reclined. When the patient is in a semi-prone position, there is only a two-inch clearance between the top of the head and the cabinet drawers. Forget about any kind of seating other than the "9 o`clock" position. If you try to straddle the chair, for example, your left knee will be bruised from bumping the heavy metal chair lock on the back. The chair can`t be swiveled. The cuspidor, polisher, and the saliva ejector dangle in a remote location on the other side of the treatment chair, forcing the hygienist to crawl across the patient to grab anything. The counter tops were built in the days of stand-up dentistry, so you do stretching exercises all day long just to reach your instruments. If you dare to bring in an ergonomic chair with arms, you`ll spend the entire day backing into a gigantic old-fashioned water fountain - strategically placed right behind your seat! Documentation available upon request!

Let`s consider some possible "dental" real estate problems you may have before beginning an onsite analysis:

* Your dental practice is designing a brand new office.

* Your treatment room needs a small facelift, not major surgery.

* Your room and equipment are outdated, but nothing is worn out or broken.

* You`ve inherited a "dental hygiene closet" with everything bolted down in place, but a complete overhaul is not in the budget.

Before rearranging your treatment room, take some time to study your current situation. For example, how many entries/doors are in the treatment area? Is there a smooth flow of traffic in and out of the room? Is there a lot of dead space? What is the typical sequence of events for hygiene appointments? Is any part of your body sore or stiff by the end of the workday? Consider these factors before proceeding to the next level of analysis.

Can you make your treatment area more ergonomically friendly? It seems a straightforward concept, but what sometimes looks like a good idea can have an unforeseen negative impact. For example, you may want to position the patient chair differently, making it closer to a wall, or perhaps further away from the cabinets. Anything to gain a few inches! But you must also consider how this new chair location might affect other procedures within the treatment room, such as X-rays. If you have to strain, or possibly lose your balance to reach the X-ray unit, how much have you gained?

If you prefer to work in an 11 or 12 o`clock position, you`ll need more room to sit behind the patient`s head. You`ll also need more room if you sit in an ergonomic chair with arms. Do you have a patient chair with an extra-wide back or a large metal base on the floor? Positioning yourself behind the patient will keep you from leaning forward in an unsupported position. Wearing magnification lenses improves things even more.

Wasted space often can be recaptured by moving the patient chair closer to a wall - a real bonus if you have a tight traffic area. In a small room, many chairs can be unlocked, positioned diagonally during treatment, and returned to their original position at the end of the appointment. It sounds like a lot of trouble, but it beats ending your day in pain.

Patient chair design is critical. Thinner backs, especially in the headrest area, allow us to sit closer, reducing the risk of back, arm, and shoulder strain. Sitting in the operator chair in a tripod fashion and positioning yourself as close to the patient as possible reduces the liklihood of strains or soreness.

Before proceeding, consider a few more details. Operator lighting can be an issue, especially if it`s track-mounted in the ceiling - you may be unable to position it effectively in the new floor plan. Pole-mounted lights generally are more adaptable. Remember to consider the X-ray unit and suction unit positions as well as the location of electrical outlets. These are important considerations when designing a new office.

An architect or someone skilled in installing dental office equipment can help you solve other problems. It may be cheaper to reposition equipment, make plumbing or electrical modifications, or install new cabinetry than to move to a new location. Seek the advice of these experts before trying a do-it-yourself project that you could later regret. Also, remember that these facelifts often take more time than projected.

No matter how impossible your environment may seem, there are workable solutions. I hope you can look at your present location with at least a small glimmer of hope, and that your future has you practicing in a dental hygiene 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 (www.ergosonics.com). She can be reached by phone at (713) 974-4540 or by e-mail at [email protected].