I’ve been practicing hygiene for 17 years, and while I’m an ergonomics specialist now, I haven’t always been. Before I became certified in ergonomics, I rarely considered the equipment I was using as it pertains to ergonomics. This is crazy because dentistry is a high-risk profession for ergonomic injuries. If I had the chance to go back in time, I would assess a new office with an “ergonomic eye.” While there are many things to consider regarding ergonomics, I’ll highlight three important aspects when you look at a new office.
1. Dental operatory layout
There are many types of operatory layouts and configurations; a common one I see is rear delivery. While this layout is great for four-handed dentistry, it’s an ergonomic challenge for clinicians who work alone, such as hygienists.
Unless a clinician has received ergonomic training, they may end up reaching and twisting since everything (the bracket table, air/water, and suction) is behind the patient and off to one side. Repetitive reaching and twisting leads to pain, fatigue, and potential injury over time. I created a video on how to use this type of design in a more ergonomic manner. It’s possible to use this design as a single clinician, but it’s important to know how to use it properly to minimize repetitive reaching and twisting.
If I was looking at a new office today, I’d check the layout I’d be working with. I prefer the left/right or split operatory design. This design is balanced, with a bracket table on one side and the suction on the other. This design can be used for both left- and right-handed clinicians.
2. Dental stools
Before I understood proper ergonomics, I used whatever stool the office had available when I started with them. I didn’t know it then, but it’s crucial for us to have the proper “fit” when it comes to a stool. I like to compare stools to a pair of pants. The one that fits me likely won’t fit you. We all have different heights, inseams, pelvic widths, and more, which makes it impossible to have a universal stool.
I am a supporter of elevated saddle seating, which supports in a natural, healthy posture. Many stools with a flat seat pan tend to cause the pelvis to roll backward, which flattens out the lower lumbar curve. When clinicians experience back pain, it’s often because this curve has flattened out, pinching the nerves and spinal discs. We want that curve! Saddles help support a healthy spinal posture. I have created numerous videos on stools, and you can watch one video about dental stools here.
Just as important as having the right fit is ensuring the stool is adjusted correctly. If the stool has a backrest, you want to feel that against your back. In addition, you want the seat pan tipped forward just a bit and the stool adjusted high enough so your hips are above your knees. All these adjustments ensure the spine is in alignment, the hips are open, and you are in a healthy, upright posture.
3. Dental instruments
A major risk factor for developing pain and injury is the force used to hold onto the instruments (or anything else for that matter). You want a grip that is as light as necessary without dropping what you hold. No more death grip!
Regarding instruments, you want the handle to be wide, light, and textured. These factors all reduce the force needed to grip them. When doing assessments for clinicians, I often see ergonomic scalers; however, I also often see nonergonomic mirrors. If you think about it, we use our mirrors more than any other instrument, so it’s crucial for this to be ergonomic as well. If you have the old, skinny, heavy, metal mirror handles in your kits, replace them with wide, ergonomic mirror handles.
Also, evaluate the instrument blades (and power scaler tips) for wear. The more worn down an instrument or scaler tip, the less efficient it is. Using dull instruments or tips will increase your pinch force and the time it takes to remove deposits. The small things make a big difference, so check those tips!
Starting at a new office can be exciting but be sure you’re looking at offices with an ergonomic eye so that you set yourself up for long-term success. Your health and wellness start with you, so be sure you’re taking care of yourself now and in the future.
