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Ergonomics can be defined as ‘an applied science

concerned with designing and arranging things people use


so that the people and things interact most Efficiently and
safely’.
The nature of the work of a dentist involves continued sitting postures, standing postures, using
vibrating handheld equipment, repeated movements of hand and wrist sometimes accompanied
by the use of high force and bending the neck and the trunk.
Since the work area of the dentist is restricted to the narrow region of the oral cavity, dentist
resort to awkward and ergonomically poor postures to gain better access to the work site. This
renders dentists at high risk of musculoskeletal disorders(MSD).
Risk Factors:
 Force: The amount of physical effort required to maintain control of equipment or tools, or to
perform a task such as heavy lifting, pushing, pulling, or carrying.

 Repetition: Performing the same motion or series of motions continually or frequently, for an
extended period of time with little variation such as scaling and repetitive hand tool usage.

 Awkward postures: while performing job tasks such as working over-head, extended reaching,
twisting, squatting, or kneeling.

 Contact stress: Results from occasional, repeated, or continuous contact between sensitive body
tissues and hard or sharp objects like resting the wrist on the edge of a desk, or tool handles
pressing into the palms.

 Prolonged static posture: Dentists frequently assume static postures, which require more than 50
percent of the body’s muscles to contract to hold the body motionless
Age-related changes

a. Reaction time lengthens


b. Workload capacity decreases
c. Temperature related discomfort increases
d. Visual capabilities decreases
Prolonged static posture
Prolonged static posture:
 Dentists frequently assume static
postures, which require more than Muscle fatigue/ muscle imbalance
50 percent of the body’s muscles
to contract to hold the body
motionless while resisting gravity. pain

Protective muscle contraction

Joint hypomobility,
Nerve compression,
Spinal disc degeneration/herniation

Musculoskeletal Disorder
Sitting Posture: Poor postural alignment
accelerates wear and tear of vertebrae, discs,
muscles and ligaments; leading to pain syndromes.

• A straight back and respect for the body • Avoid rounding the back into "C" shape.
symmetry. • A greater forward inclination, the tilting to
• Forward inclination of the trunk of a a side and the trunk rotation are
maximum of 20°. contraindicated.
Muscle Imbalances:
During treatment, however, operators should strive
to maintain a neutral, balanced posture. Failing to
do so over time, the muscles responsible for rotating
the body to one side can become stronger and
shorter, while the opposing muscles become weaker
and elongated.

The stressed shortened muscles can become


ischemic and painful,
exerting asymmetrical forces on the spine

Misalignment of the spinal column and decreased


range of motion in one direction over
the other.

Muscle Imbalance Example of an awkward posture that


frequently is repeated in the same direction
which can lead to muscle imbalances.
Prevention of MSD
Follow operator chair ergonomic guidelines:
Goal: to promote mobility and patient access and to accommodate
different body sizes.
Look for:
1. Stability (5 legged base w/casters)
2. Adjustable lumbar support
3. Hands-free seat height adjustment
4. Adjustable foot rests
5. Hydraulic controls
6. Adjustable backrest
7. Tilting seat pan
8. Correct wheel type
9. Armrests (optional)
Selection of instruments:
 Tool/instrument design should be such that it reduces force exertion and
maintains hand/wrist in neutral posture.
Considerations to be kept in mind:
1. Overall shape/size
2. Handle shape/size
3. Weight
4. Balance
While buying Automatic hand pieces for your
operatory, look for:
1. Lightweight, balanced models (cordless
preferred)
2. Sufficient power
3. Built-in light sources
4. Pliable, lightweight hoses
5. Easy activation
6. Easy maintenance
Strategies to prevent MSD and lower back pain:

Stretches:
Stretches are a must. They can be easily performed,
by the chair side with gloves on and need minimum
amount of time (10-15 seconds).
1. The un-twister:
 Legs in tripod position; bend to
left side.
 Rest your left elbow on left knee.
 Stretch right arm overhead and
look towards the ceiling.
 Hold for 2-4 breath cycles
 Repeat
Trunk rotation
 Sit tall. Cross right leg over
left leg.
 Place left forearm on right
thigh and turn trunk to the
 right.
 Hold for 2-4 breath cycles.
 Repeat
The reversal

 Support wrists on hips and slowly lean


backward.
 Do not overextend the head.
 Hold for 2-4 breath cycles
Avoid twisting the trunk:

 Rear delivery systems encourage


extensive trunk twisting; can  Retrieve items with the closest hand
cause low back pain. and transfer it to the dominant hand.

 Rear delivery systems encourage extensive trunk twisting and can result in low back
pain. Try to retrieve items with the closest hand and then transfer them to the
dominant hand. Position patient so that operator’s elbows are elevated no more
than 30 degrees.
2. Dentist micro breaks

 Take frequent breaks to relax. A dentist can take a


break to do stretches’ while the assistant light
cures, while waiting for local anesthesia to act,
while the assistant mixes cements or applies
periodontal dressings etc.

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