Application of Ergonomics in the Dental Surgery
The International Ergonomics Association defines ergonomics as “the scientific discipline concerned with the understanding of interactions among humans and other elements of a system, and the profession that applies theory, principles, data and methods to design in order to optimize human well-being and overall system performance”.
Fundamentally, it is the design of tools and equipment that fits the human body in order for it to remain healthy in the short and longer term. It has been a popular topic in many work places over the years and becoming even more important in the dental arena, probably due to the recent research and shocking statistics found. One of which is that 30% of dental professionals claim they retired prematurely due to a musculoskeletal disorders.1
Some of the issues that dental practitioners face if they do not work in an ergonomically friendly environment are:
• Repetitive Strain Injury (RSI): a general term used to describe discomfort and pain in the muscles, nerves and tendons caused by overuse of these body parts and continual repetitive movements.
• Musculoskeletal disorders (MSD): an example of a particular MSD is carpel tunnel syndrome (CTS); a median entrapment neuropathy that causes pain, numbness, and other symptoms in the distribution of the median nerve due to its compression at the wrist in the carpal tunnel. Particularly relevant to the dental profession.
• Back injuries due to the stress forced on the back during long treatments using inadequately designed equipment. Studies indicate that back, neck, and shoulder or arm pain is present in up to 81% of dental operators.2
The dental profession are particularly susceptible to these issues because of the fundamentals of the job; repetition, vibration from equipment, force, and posture. The immediate consequence of symptoms is the pain and discomfort caused whilst at work and beyond the working day. After time, the trauma can only be withstood for a certain period and then days off work are required due to sickness, and ultimately leading to early retirement.
The statistics are a depressing read, however there are many strategies that can be implemented to help reduce and possibly avoid one or more of the aforementioned problems. According to the International Standards Organization (ISO #6385)3, there are some core interventions applicable to every workplace, including the dental surgery:
• Adapt workspace and equipment to account for operator and work being performed with preferred body postures.
• Provide sufficient space for body movements.
• Provide variety in tasks and movements to avoid static muscle tension caused by postural constraints.
• Design work to allow machinery to do/assist highly repetitive tasks.
• Avoid extreme posture when exerting high force.
Four-handed dentistry is a technique used to reduce fatigue and repetitive movements. A dentist works directly with a dental nurse in a safe, stress-free environment. Originally learnt in1960s, it was used to help quicken procedure time. It is most effective when the dentist does not have to reach for instruments or other tools. Many dental teams claim they practice four-handed dentistry, yet when assessed, this is often not the case; the dentist can be seen twisting and reaching to change their own bur, which should really be performed by the dental nurse who is positioned correctly for the task.
Body strengthening exercises can help to toughen the vulnerable parts of the body that are particularly susceptible to injury from repetitive movements and awkward positions. There are multiple exercises available for the neck, shoulders, hands, fingers, arms and back that should be routinely performed. It is best to consult with a doctor or physiotherapist first.
Ideally, a neutral posture is required with minimal awkward and static movements. Various pieces of equipment around the surgery can now help with this. The advancement of magnification allows the practitioner to treat patients while sitting in an upright position, with a straight comfortable back, but also allowing excellent visualisation of the oral cavity. When magnification isn’t used, the head and neck is held unnaturally in a forward tilting position and other muscles then compensate for this abnormal posture, becoming strained and causing discomfort too.
Magnification for Perfect Posture
The OPMI Pico dental microscope supplied by Nuview is an excellent choice when investing in a piece of equipment to help with better ergonomics in the dental surgery. It is high performing, even for the most demanding of dental procedures, and allows easy adjustment to suit the user and their preferred working position. The Varioskop 100 allows the user to conveniently adjust the focal length helping to alleviate neck and back strain. Further still, adjustable connectors make it possible to individually arrange the handgrips to the correct angle depending on the treatment being provided.