Occupational health and Safety in Dentistry

Occupational Health and Safety in Dentistry

Michael Streicher

In the inaugural blog post in this series, my colleague identified some concerning dental practices which increase the risk for the development of a musculoskeletal disorder (MSD) among dental practitioners. In this blog post, I will cover the specific risk factors that increase the risks of developing an MSD, some prevention strategies, and briefly touch on how practices can begin to implement these improvements incrementally and systematically into their practices.  

Ergonomics is more than just posture. It is a methodological approach to work that considers every aspect of the work environment. From the administrative and organizational workflow to the technology, furniture, and procedures you use daily, ergonomics can help you design a workspace that works for and with you instead of against you.  

Four key risk factors influence the likelihood of developing musculoskeletal disorders (Ortiz Hugues, 2023). It is essential to address these factors to create a safer, healthier, and more sustainable work environment: 

  1. Individual Factors: Individual characteristics and habits can contribute to the risk of MSDs. Factors such as poor posture, lack of physical fitness, and improper body mechanics during procedures can increase the likelihood of developing discomfort or injury.
  2. Organizational Factors: The organization and layout of the dental practice play a significant role in ergonomic health. Factors like inadequate workspace design, insufficient equipment adjustability, and lack of proper ergonomic training and education can impact dental professionals’ well-being.
  3. Financial Factors: Financial constraints can sometimes limit the implementation of ergonomic practices. Investing in ergonomic equipment, furniture, and workstations may incur costs. However, it is essential to consider the long-term benefits and cost-effectiveness of preventing MSDs and promoting the well-being of dental professionals.
  4. Physical Factors: The physical demands of dental procedures contribute to the risk of MSDs. Prolonged static postures, repetitive motions, and forceful exertions can strain muscles, joints, and other structures in the body. Identifying and mitigating these physical factors is crucial for reducing the risk of developing MSDs.

Dental work can be physically demanding, particularly on the musculoskeletal system. However, several ways exist to reduce the risk of developing musculoskeletal disorders (MSDs) and promote a healthier work environment. 

To combat the onset of musculoskeletal disorders, there are various new trends in ergonomics being practiced in combating musculoskeletal disorders (MSDs) in dentistry: 

  1. Four-Handed Dentistry: This technique is critical for efficient workflow and involves an assistant working alongside the dentist, helping with tasks, and reducing strain on the dentist. Maintaining a horizontal reach distance of 14-25 inches between frequently used instruments and the dentist is crucial. This shortened distance also ensures that the assistant can carry out short, bio-mechanically efficient movements when handing any instruments to the dentist. Sharing the workload promotes efficiency and reduces the risk of overexertion on tendons and ligaments, which can, over time, lead to musculoskeletal disorders.
  2. Alternating Sitting and Standing Positions: Regularly switching between sitting and standing can help reduce the strain on the body. Adjustable dental chairs or standing desks allow dental professionals to change their posture throughout the day, promoting better blood circulation and reducing the risk of developing MSDs.
  3. Pressure Relieving Mats: Using ergonomic mat surfaces in dental sub-specialties, such as oral maxillofacial surgery, is essential. Most procedures in these sub-specialties are performed while standing. Using ergonomic mat surfaces can help reduce the impact on the feet, legs, and lower back. This reduces discomfort and fatigue during lengthy procedures. Additionally, it can also minimize the loading on the lower spine, which in turn reduces the rates of lower back pain. According to a recent study, 53.6% of oral surgeons experience lower back pain (Kiran Uppada et al., 2020).
  4. Proper Cord Management: Organizing and managing cords and cables in the dental operatory can prevent tripping hazards and minimize unwanted tension or strain on the body while working.
  5. Maintaining Proper Ambient Temperatures: Maintaining a comfortable ambient temperature of around 25°C in the dental operatory helps prevent muscle stiffness and keeps the body relaxed during long working hours. Regulation 67/93 requires that any healthcare setting maintain a temperature of 18 degrees Celsius or higher during all working times.  
  6. Taking Rest Periods: Incorporating regular rest periods during lengthy procedures allows dental professionals to rejuvenate their muscles and prevent fatigue. Short breaks can help relieve tension and reduce the risk of developing MSDs.
  7. Scheduling Appointments Strategically: Managing the schedule effectively can help prevent overexertion, allowing for adequate breaks and reducing the strain on the body. Proper time management can contribute to a healthier and more sustainable work environment.

In addition to these trends, incorporating stretches into the work routine can help relieve muscle tightness. These stretches are cumulative information obtained from various studies in the literature and can be beneficial in alleviating pain and preventing MSDs. 

A practice can begin building momentum toward implementing these changes by creating an ergonomics checklist. IPAC Consulting can undoubtedly assist in developing this helpful tool and getting your practice on the right track toward ergonomic greatness and reduced risk of developing musculoskeletal disorders.

 

References 

Harris, M. L., Sentner, S. M., Doucette, H. J., & Brillant, M. G. S. (2020). Musculoskeletal disorders among dental hygienists in Canada. Canadian journal of dental hygiene : CJDH = Journal canadien de l’hygiene dentaire : JCHD, 54(2), 61–67. 

Ortiz Hugues, J. C. (2023). The Importance of Ergonomics In Dentistry. Decisions in Dentistry, 9(1), 34-36–39. https://decisionsindentistry.com/article/importance-ergonomics-dentistry/  

Poorni, S., Srinivasan, M. R., & Priyanka, B. (2020). Ergonomics and its impact on musculoskeletal disorder among Dental Surgeons: A literature review. Journal of Operative Dentistry & Endodontics, 5(1), 12–17. https://doi.org/10.5005/jp-journals-10047-0089. 

Uppada, U. K., Sinha, R., Madishetti, S., Pampana, S. G., Kumar, S., & Chidagam, P. R. (2020). Ergonomics among Oral and Maxillofacial Surgeons in the Indian States of Telangana and Andhra Pradesh – An Evaluative Study. Annals of maxillofacial surgery, 10(2), 325–329. https://doi.org/10.4103/ams.ams_39_20