August 30

Posture, ergonomics and wellbeing

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Article in the Australian Dental Association’s (ADA) monthly ‘Bulletin’ magazine, featuring AUSTAT member, Aniko Ball.

When it comes to the importance of physical wellbeing in dentistry, it appears there’s both good news and bad news on the contemporary report card.

According to a variety of international studies, like the Prevalence of Musculoskeletal Disorders in Dentists by Evangelos Alexopoulos1 and Dental Ergonomics by Tim Morse2,3,figures of chronic pain can be as high as 87 per cent in dentists and up to 96 per cent in dental hygienists.

The good news is, dentists appear more aware today of the importance of taking care of their physical wellbeing in an attempt to avoid and alleviate problems relating to neck, back and arm pain.

The bad news is, however, repetitive strain injuries and physical discomfort arising from practising dentistry is showing up not just in long-term practitioners but also those starting out on their careers.

There has been a significant rise in reported musculoskeletal disorders (MSD) resulting from awkward posture, prolonged standing, unsupported sitting and a host of other problems caused by poorly designed workstations, poor work habits and instruments that are difficult to manipulate.

THE CONCERN WITH CHANGING DEMOGRAPHICS

It’s an issue of serious concern to Dr Anikó Ball of Optimum Dental Posture, a Melbourne agency that specialises in the recovery and prevention of work-related injuries in the dental profession. A decade ago, Dr Ball was about to give up dentistry after years of suffering crippling pain but changed her physical health – not to mention her career options – through the Alexander Technique. It’s a system that teaches you how to move, sit and stand in a way that minimises strain and pressure on your body.
Now Dr Ball is also a practitioner of the Alexander Technique and lectures on how dentists can take control of their musculoskeletal health. But it’s the demographics of the groups she is now talking to she admits is causing the most concern.

“When I first started talking about this, I expected more mature dentists to be coming to my courses, but in more recent times, my courses are sometimes 90 per cent full of young dentists, barely out of dental school,” she says. “It’s actually the young ones who are in more trouble. They’ve grown up using mobile devices, tilting their heads and spine down to the devices, and that’s now on top of the work they are doing as practitioners in the clinic. I get young dentists telling me they’re already thinking of retraining because they’re in too much pain. This is something we need to be addressing head on as it has become so common.”

THE ALEXANDER TECHNIQUE

Through practising the Alexander Technique and addressing the issues of posture and movement, Dr Ball was able to change the way she worked, through learning where important joints are located and effective methods to release muscle tension.

“It’s also about turning on inner ergonomics so you engage the right muscles to support your body against gravity without compressing the spine as you work,” she says. “It comes down to learning where your joints are, how to use them properly and how to do things that are still effective for the processes we need to do when treating a patient but are placing the least amount of strain and stress on our bodies. I teach dentists how to function so they’re not compressing the spine, pressing on nerves and contracting muscles that are not designed to be in that state for lengthy periods.”

THE MOST PRECIOUS INSTRUMENT

To achieve a new approach to the physicality required in dentistry takes a new way of thinking, explains Dr Ball.

“My motto has long been, ‘take care of yourself as you are your most precious instrument’,” she says. “I also often say in my workshops that I’ve seen dentists who take better care of their cars and their various clinical handpieces than themselves!”

“It requires a new way of thinking and knowing it’s no longer okay to twist ourselves into a pretzel in order to do the job. Before you think about that complex job in the patient’s mouth and what instruments to use, you need to implement a process where you think about how you are going to bend, what posture you need and what is the best position to do this.”
are now considering biomechanical design principles in far more important ways than they did when I was first starting out – and that’s a good thing for all of us.”

1. Alexopoulos, E.C., Stathi, I.C. and Charizani, F., 2004. Prevalence of musculoskeletal disorders in dentists. BMC musculoskeletal disorders5(1), p.16.

2. Morse, T., Bruneau, H. and Dussetschleger, J., 2010. Musculoskeletal disorders of the neck and shoulder in the dental professions. Work35(4), pp.419-429.

3. Morse, T., Bruneau, H., Michalak-Turcotte, C., Sanders, M., Warren, N., Dussetschleger, J., Diva, U., Croteau, M. and Cherniack, M., 2007. Musculoskeletal disorders of the neck and shoulder in dental hygienists and dental hygiene students. American Dental Hygienists’ Association81(1), pp.10-10.


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