Ergonomics in the Dental Office. Susan S. Parker

information does not mean that the publisher and authors endorse the information or services the organization, website, or product may provide or recommendations it may make. This work is sold with the understanding that the publisher is not engaged in rendering professional services. The advice and strategies contained herein may not be suitable for your situation. You should consult with a specialist where appropriate. Further, readers should be aware that websites listed in this work may have changed or disappeared between when this work was written and when it is read. Neither the publisher nor authors shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.

      Library of Congress Cataloging‐in‐Publication Data applied for: ISBN: 9781119131373 (paperback)

      Cover Design: Wiley

      Cover Images: Courtesy of Susan S. Parker

      Preface

      Occupational musculoskeletal disorders (MSDs) are a significant health and safety problem facing most workforces today. The basic cause of these MSDs is exposure to risk factors to the worker. When a worker is exposed to MSD risk factors, their body begins to tire and thus becomes fatigued. When the fatigue outruns the body’s recovery system, a musculoskeletal imbalance happens to that body. Sometimes the worker has no indication that there is a problem developing. This sounds like it should be simple to change. However, the human body and the various styles of work that individuals do require some knowledge about the body and its various muscle groups to keep these musculoskeletal pains from developing.

      One such occupation that is really physically tough on the human body is dentistry. Dental health providers are at an increased risk of work‐related stress and musculoskeletal discomfort by the very nature of their daily work. In spite of different working patterns, there are parallel levels of symptoms in dentists and dental hygienists across nations. There are several links on the internet and journal articles addressing various ergonomic issues. However, there is a need for a more specific source of information for the entire dental health team that can be easily accessed and understood. Risk factors for MSDs are multifactorial. Therefore, the goal of this short book is to describe the causes of the musculoskeletal problems that might be occurring daily in the dental office and that we might have no idea are occurring, and to outline solutions to them. Symptoms appear very early in some dental careers, with a surprisingly higher prevalence of MSDs found in educational training.

The book aims to be easily accessible and to address specific ergonomic issues that might arise for dental practitioners in the operatory or working environment in the dental office. This information should be able to enlighten anyone who might need help in understanding how the body can be misused and the importance of ergonomics in most if not all walks of life. The desired outcome is a comprehensive strategy for mitigation and an integration of practices to reduce most ergonomic risks, in order to achieve amelioration in workplace ergonomics for employee health and safety. Efforts to address this problem for all dental professionals need to take an interdisciplinary, progressive approach. Prevention is better than treatment. Though no one can go back and make a brand new start, anyone can start from where they are and create a brand new ending. Let us begin now to appreciate our miraculous body and its human engineering.

      As Mahatma Gandhi said, “The future depends on what you do today.”

      Acknowledgments

      I would like to thank all of my wonderful dental students and many others who encouraged me in this endeavor. First, I would like to thank Wiley publishing and the many brilliant people there who worked with me on this publication Erica Judisch, Tanya McMullin, Susan Engelken, Bhavya Boopathi, Angela Cohen, and Dr. Sally Osborn. My gratitude to Mr. Rick Ames Blanchette for coming to New Orleans to meet me and to give me this opportunity.

      My dear family, colleagues and friends who helped me in every way and listened – Brandi Windham, Muscular Therapist, Dr. Frank Martello, Dr. Doug Dederich, Dr. Stephanie Noe, Shelly Zagor, Paul Caballero, Shelly Downs, Sharon Hearn, Curt Hearn, and the late Don Farnworth. Thank you all from the bottom of my heart.

1 What Is Ergonomics?

      Let’s start with some definitions of key terms. The terms “human‐factors engineering” and “ergonomics” are used interchangeably on the North American continent. In Europe, Japan, and most of the rest of the world, the prevalent term used is ergonomics. Merriam‐Webster (n.d.) defines ergonomics as “(1) an applied science concerned with designing and arranging things people use so that the people and things interact most efficiently and safely ‐ called the biotechnology, human engineering, human factors”; and “(2) the design characteristics of an object resulting especially from the application of the science of ergonomics.” The Britannica Online Encyclopedia defines human‐factors engineering as ergonomics or human engineering (Holstein & Chapanis, 2018). The term “human‐factors engineering” is used equally to designate a body of knowledge, a process, and a profession. Human engineering is a science dealing with the application of information on physical and psychological characteristics to the design of devices and systems for human use.

      The word “ergonomics” is derived from the ancient Greek ergon, which means work, and nomos, which means law. Ergonomics can also be seen as the science concerned with how to fit a job to a person’s anatomical, physiological, and psychological characteristics in a way that will enhance human efficiency and thus contribute to a safer working environment. The discipline of ergonomics was formalized after the end of World War II. The science of ergonomics looks for ways to make work easier on a worker’s body by using a combination of techniques and equipment that will prevent injuries while maintaining efficiency.

Human‐factors engineers have tried to show that with appropriate techniques it is possible to identify human‐made mismatches and thus to find workable solutions to these mismatches through the use of methods developed in the behavioral sciences. Design decisions and approaches cannot be reached without a lot of trial and error. The telephone and the typewriter keyboard are but two out of thousands of examples that might have been selected to show how human‐factors engineering has been consciously applied to solve technological problems. Today, we can just look at the many advances in the US space program, automotive industry, computer technology, and more. More broadly, in every sector globally there is a realization that physical problems occur because of workplace setups that can cause misalignment of the human anatomy, and thus physical pain and mental misery. The list continues to expand as the world moves at a faster and faster pace and there is a realization that ergonomics is essential in daily life.

      In the January 2021 edition of Costco Connection, there is a short article on how to prevent and recover from bad work habits. We are reminded to commit to healthy work habits such as sitting tall and getting up every hour to move that body. We must begin to listen to our bodies. Researchers have used a number of methods to measure these musculoskeletal disorders (MSDs) or imbalances, yet these are really just subjective. Gravity is the one force that affects all existence and behavior on earth. Defining and maintaining a steady center of gravity is therefore important and the most significant natural step in accomplishing any given task. Each individual has their own unique center of gravity. We can collaborate with other people and disciplines in order to achieve a better understanding of what needs to happen to avoid an MSD, but ultimately it is our individual responsibility to learn to treat our body with kindness.

The practice of dentistry today

      From the vantage point of the twenty‐first century we can see a continuous pattern of musculoskeletal strain and awkward postures among dental providers and their auxiliaries. A combination of unsupported postures, excessive movements,