Ergonomics for Enhanced Clinical Performance

At some point in our dental career, most of us have some sort of physical pain associated with providing patient care.  Physical pain, more often than not, is an indicator of poor ergonomics.  Many things can contribute to ergonomic challenges, for example; poor lighting and visibility, inadequate seating, poor placement of equipment and so on. If you are experiencing pain, the first thing you should do is evaluate your workspace and personal habits for the three most common challenges; seating, magnification and lighting. Use the checklist below to get started. In addition, I encourage you to view my new Ergonomics video on the Spear Course Library.

The Ergonomics Checklist:

• Lighting & Visualization – do you strain to or ‘tweak’ your body to see inside the patient’s mouth? Do you use illuminated magnification?
• Position of patient – does your treatment chair offer multiple adjustments?
• Position of operator & chair – does your stool allow for proper lumbar curvature, a decline position, pelvis rotated forward and downward with knees below hip level (Fig. 1)
• Poor or improper placement of equipment – do you rotate or twist your body to reach your equipment?

Lighting and visualization challenges can contribute to a wide variety of painful upper body muscle strains. All clinicians should invest in illuminated magnification.  Hygienists frequently ask me if their employers should purchase loupes for them. Since loupes are customized for the individual user, another clinician cannot use them.  In my opinion, loupes are personal property and fall in the same category as prescription glasses.  The purchase is therefore the responsibility of the Hygienist, and I might add, a very wise investment.  In most cases, the cost of loupes is the equivalent of two or three days’ salary, at most, for a Hygienist and can be easily budgeted with some planning. It’s critical to choose a high quality loupes that accommodate illumination.  And when it comes to choices, there are a lot out there.  You have to touch them, feel them… try them on to see what works best for you.  Loupes are definitely not one-size-fits-all and of course, you get what you pay for.  So take your time and invest wisely in loupes that will best meet your needs. Because we so often strain to see into our patient’s mouths, neck and/or shoulder pain is a common challenge.  Let me recommend a couple of easy to do exercises and stretches that can be done between patients and right in your operatory.  Let me urge you to take matters into your own hands.  Train, stretch, and be fit!  Working clinically at a dental chair all day is physically taxing.  We must take ownership!

Thoracic Outlet Stretch:

1. Extend one arm straight out to the side, parallel to the floor, palm up and elbow straight. (Fig. 2)
2. Keeping your elbow straight, curl the wrist and fingers toward you as far as you can. Hold 15-30 seconds. (Fig. 3)
3. NOW bend your neck to the opposite side as pictured in figure 4, hold for 30 seconds. (Fig. 4)
4. Repeat on the opposite side.

Shoulder and Deltoid Stretch:

1. Find a corner. Place a hand at eye-level on the wall on each side of the corner as pictured here.  (Fig. 5)
2. Push your nose into the corner as far as you can and feel the stretch in your shoulders and across the front of your chest.  Hold for at least 30 seconds.  Repeat 3-4 times.

Kim Miller, RDH, BSDH, is Contributing Author for Spear Education. Want to dive even deeper into clinical topics like this? Check out our clinical categories in our Course Library. Not yet a member of Spear Online? Click here to learn more.