1. Ergonomics for the Dental Hygienist

2. Definition O Ergonomics is the study of the relationship between workers and their work environment. O “Ergonomics is the science of making things comfy. It also makes things efficient.” 1

3. Ergonomic Factors O Ergonomic factors are the elements that create comfortable working conditions that lead to a long happy career. These elements can also create uncomfortable working conditions, which can lead to physical or psychological injury. O Michele L. Darby, BSDH, MS, and Margaret M. Walsh, RDH, MS, EdD, list factors that affect the dental hygienist in their book Dental Hygiene Theory and Practice. The list is as follows:

4. Ergonomic Factors Environmental Equipment Positioning Performance Instrument Exercises

5. Environmental Factors O The temperature should be at a comfortable level in the office. If it gets to cold, you tense up. If it gets to hot, you sweat. Either of these situations can cause undo strain on your muscles. O Keep the radio noise at a good level.

6. Equipment Factors O Use a good clinician chair that allows you to move into the positions you need to be in. O A good client chair will benefit not only you but also the client. The client will be more relaxed if he/she is lying in a comfortable chair that supports them. A good chair will have controls that are easily assessable by foot or have side bar controls, which puts less stress on you as a clinician. O Make sure you have an overhead light and a tray (or cart) that is easily assessable. You don’t want to be stretching for the light or instruments.

7. Positioning Factors O Make sure you are sitting in the proper position when scaling. Shoulders should be level Elbows should be close to your body Forearms should be on the same plane as your wrist, hands, and the client’s mouth O Make sure the client chair is in the proper position. When scaling the maxillary teeth, the chair should be in a supine position When scaling the mandibular teeth, the chair should be at a 20˚angle with the floor

8. Good Technician and Patient Positioning Photo curtsey of Dimensions of Dental Hygiene

9. Poor Technician and Client Positioning Photo curtsey of Dimensions of Dental Hygiene

10. Performance Factors O Make sure to hold the instrument properly, use the proper strokes, and use a proper fulcrum, otherwise this will cause undo stress on your hands, wrist, and forearms. O Try to keep your client schedule at a reasonable pace so that it does not over stress you physically or emotionally. For example, don’t schedule 3 scaling and root planings (SRP) in a row.

11. Instrument Factors O Make sure the blade on your instrument is sharp. O Alternate between manual and ultrasonic scaling O Alternate instrument setups so that you’re using instruments with different diameters. O Avoid tangling up the cords of your hand piece, air/water syringe, suction, and ultrasonic scaler.

12. Exercise Factors O You should do strengthening exercises such as, sit-ups or hyperextension. O You should stretch in between clients (stretch both while standing and sitting in a chair). Examples include using a doorway to stretch, squeezing a rubber ball, or neck stretches.

13. Musculoskeletal Conditions Some of the common conditions associated with poor ergonomics, according to Esther. Wilkins, include the following: Bursitis Carpal Tunnel Syndrome Disc Herniation Tendonitis Thoracic Outlet Syndrome

14. Musculoskeletal Conditions There are more conditions associated with ergonomics that Darby and Walsh list. These include, but are not limited to: Cervical spondylolsis De Quervain’s syndrome Guyon’s canal syndrome Rotator cuff tears

15. Conclusion O Remember, being a dental hygienist is a privilege and a pleasure. Having a career in dental hygiene is very rewarding. O If you want to maintain your career, you need to practice good ergonomics—make sure you remember that you will be doing this for a long time, so your back, neck, wrist, etc., need to withstand the manual work.

16. Quiz 1. Ergonomic factors include which of the following? a) Positioning b) Instrument c) Exercise d) a and c only e) b and c only f) a, b, and c 2. Using instruments with different dimensions puts a strain on your fingers and wrist? True False

17. 3. Bursitis, Cervical Spondylosis, and Cushing’s Syndrome, are all associated with poor ergonomics. True False 4. What is the proper positioning of the client when scaling the maxillary teeth? a) 20˚angle with the floor b) 15˚angle with the floor c) Supine d) It’s the client’s choice, not yours.

18. 5. Some examples of performance factors include: holding your instrument properly, using proper strokes, and using a proper fulcrum. True False

19. Answers 1. f 2. False 3. False 4. c 5. True

20. References 1. Adams, C. (n.d.). What is Ergonomics - Ergonomic Basics. Retrieved from http://ergonomics.about.com/od/ergonomicbasics/a/ergo101.htm 2. In Darby, M. L., & In Walsh, M. M. (2015). Ergonomics. In Dental hygiene: Theory and practice (4th ed., pp. 144-52). St. Louis, MO: Elsevier. 3. Nunn, P. (2004, March). Dimensions of Dental Hygiene. Retrieved from http://www.dimensionsofdentalhygiene.com/2004/03_March/Features/P REVENTIVE_POSITIONING.aspx http://www.dimensionsofdentalhygiene.com/2004/03_March/Features/P REVENTIVE_POSITIONING.aspx 4. Wilkins, E. M., & Williams, L. (2014). Patient Reception and Ergonomic Practice. InClinical practice of the dental hygienist (11th ed., pp. 88-99). Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins.