Dental professionals know that “incorrect working posture is the major cause of musculoskeletal problems in dentistry”16 Improved vision and a balanced posture are easier to accomplish if the patient is in a supine position. In addition, bending can be relieved if the chair is void of wide wings and has a thin and narrow back (Figure 2).
Figure 2. Patient Dental Chair with Thin Back.
Operator stools are available that help maintain the natural “S” curve of the spine thus improving posture (Figures 3a and 3b). Assistant stools need to provide abdomen and back support bars (Figure 4). In addition, eyestrain and headache are related to poor posture. Trigger points in the sternocleidomastoids can be activated by maintaining the head and neck in unbalanced positions.
Figure 3a. Operator’s Stool with Elbow Support.
Figure 3b. Basic Operator’s Stool.
Figure 4. Assistant Stool with Back and Abdominal Support.
Treatment room set up with all equipment in place for true Four Handed Dentistry. Note the dental unit is near the assistant to reach within 21 inches (Figure 5).
Dental treatment room setup with ergonomically designed patient chair, transthoracic dental unit, operator and assistant stools, and mobile cabinet in place for the assistant.
Concern for ergonomics should not lay claim only to the clinical areas of the dental office but should be a concern for the business office, too. The same factors that relate to reaching and stretching are factors for stress in the business area (Figure 6).
Figure 6. Business Office Assistant Seated Properly.
Apply the principles of motion economy to the business office by considering the following:
Because dentistry is a sedentary profession it is incumbent upon the dental professional to exercise regularly. Short stretching or exercise breaks have benefits such as:
Stretching is very important and can be integrated into a daily routine. An aerobic exercise program is recommended along with chair side exercises that target specific areas. Kumar et al. aimed these exercises to withstand the forces involved in activities a dental professional performs daily. They made them as simple as possible so they could be practiced chairside.18
Physical activity seems to play a pivotal role in the presence and severity of musculoskeletal pain in members of the dental profession. A study performed by Koneru and Tanikonda compared musculoskeletal pain among dentists who engaged in yoga, those who engaged in physical activities, and those who were inactive. The practitioners who practiced yoga had the least amount of musculoskeletal pain at 10.5%, those participating in other physical activities were second at 21.7%, and the patients with no physical activities exhibited the greatest amount of pain at 45.6%. They concluded that the role that physical activity plays is significant in the quality and quantity of work related MSD’s, with yoga more efficient because of its controlled nature and positive effect on the psychological stress and strain.10 A study by Gupta et al. looked into how complementary and alternative medicine (CAM) therapies, such as acupuncture, herbal medications, meditation and music therapy, along with massage and yoga exercise, affected muscle pain. The authors noted that the dentist’s degree of pain decreased significantly after using CAM therapies.19