Ergonomics in the Dental Office. Susan S. Parker

Any attempt to constrain the spine will be met with failure and pain. Low back pain is one of the leading MSDs for dental practitioners. This is directly related to too much sitting.

After teaching ergonomics to dental students for many years, I began to see that something more was needed in the dental curriculum to address this problem. We need to look for better practitioner positioning as we practice. Within the last decade, 47 percent of US dental schools have indicated that ergonomics is a very important part of the dental curriculum. Some dental schools have made ergonomics an elective if the dental curriculum cannot be expanded further, so that the study of ergonomics is at least available to dental and dental hygiene students. Students of dentistry and dental hygiene should begin to envision ergonomic awareness as an angel (the subconscious mind) that lifts us (the practitioners) into a balanced posture when our conscious minds do not remember to do so (Figure 1.1). This is an imperative part of the dental curriculum. It is never too early to raise students’ awareness of ergonomic principles for dental practitioners and the consequences that can result from practicing without using this ergonomic knowledge. It is important as a preventive measure as well. It is a known fact that we stimulate the same brain regions when we visualize doing something as when we actually do it physically. It is so very important for dental students and hygienists to learn their individual neutral position when working on a patient. This is how ergonomics needs to be taught. Once an understanding of it is generally accepted and understood, the process of incorporating knowledge of ergonomics into the dental curriculum will be a lot easier and much more natural to each student. Thomas Edison said, “There is a better way for everything. Find it!” It is the quality, not the quantity of life that matters.

One must remember that the body is a machine consisting of optics, mechanics, chemistry, and electronics. The key factor in maintaining musculoskeletal health is maintaining the body’s neutral position as much as possible during the day. What is this neutral position? The neutral position (or comfort zone) is defined as the position of an appendage that is neither moved away from nor directed toward the body’s midline, nor laterally twisted (Figure 1.2). There is always a neutral zone for every joint and muscle. An individual must keep their entire musculature evenly balanced. Our posture and how we habitually use our body the most are what can lead our body and spine to begin to shorten and to curve into unhealthy patterns. Keeping the spine healthy at every age is crucial to the general health and longevity of the physical body.

Figure 1.1 Ergonomic awareness.

Figure 1.2 Neutral position.

Figure 1.3 Neutral position for the registered dental hygienist.

How a dental practitioner stands, walks, and uses their feet can lock patterns into the feet, ankles, knees, and hips. The key is movement – this is the goal of the practitioner. We must keep the body in motion as much as we can during our daily dental work. The neutral position is key and encompasses a deeper journey for the practitioner, in that the sides of the body are released (Figure 1.3), thus freeing the “stuck ribs” that ultimately shorten the body, resulting in the ribcage and head becoming “weighed down” on the lower body. The abdominal muscles must be strong, as they play such an important role in connection to the health of the back and spine. Strong gluteal muscles are important as well to help the individual attain this personal neutral position.