Dentistry has come a long way over the last 150 years. The evolution of anesthesia, dental techniques, materials, equipment, and approaches has come a long way from standing up with a pair of pliers and a can of ether. Pain appears to be an accepted part of the dental profession, and its incidence is worsening. The patients are pain free but how about the dental staff? Our ultimate career goals are to be efficient and effective and healthy. However, these goals can be impacted by the presence of mechanical neck and low back pain. Daily discomfort continues to be tolerated day in and day out. Evidence from the Scandinavian literature as early as the 1950s reports complaints of neck, shoulder and low back pain within the dental profession (Seyffarth). Eccles and Powell reported in 1967 that the practice of dentistry leads to excessive fatigue and to certain occupational illnesses and disabilities. Although dental practice transitioned from standing postures to sitting postures for most patient care tasks in the mid-1960s, a decrease in the prevalence of reported discomfort has not been reported (Rundcrantz BL). Kilpatrick observed, “Whether in ancient times or today, one observes a common physical profile, an unnatural body form reflecting degrees of contortion & distortion which range from moderate to extreme … a great deal has changed & improved in the art & science of dentistry over the centuries, but little has changed in the manner of work” (Kilpatrick). Orthopedic research has shown that 70 to 80% of the population will experience transient neck or low back pain during the course of their lives (Spratt, Kelsey). Studies have found that 23% to 79% have symptoms that persist or recur (Toroptsova, Croft, Carey, van den Hoogen). A majority of dentists and hygienists have musculoskeletal complaints related to the back and neck (Oberg, Murphy). The prevalence of neck pain and lower back pain was reported at 52% and 58%, respectively, in the ADA News in June 2010, with similar findings reported in the ADA member survey in 2007. The work of dentistry relies a great deal on the upper body in the operatory, particularly the musculature of the shoulder. Shoulder muscles are largely responsible for the dynamic stability and joint motion of the glenohumeral joint. When the shoulder muscles fatigue, joint mechanics become altered, thus possibly leading to pathologies such as tendonitis, impingement, and even subluxations or dislocations (McQuade et al). According to Escamilla et al, if normal scapular movements are disrupted by abnormal scapular muscle firing patterns, weakness, fatigue, or injury, the shoulder complex functions less efficiency and injury risk increases (Escamilla et al). Prolonged sitting in a slouched seated position, also increases the intradiscal pressure of the lumbar spine increased significantly (Anderssen, et al).Pain in the dental practice can result from prolonged atypical posturing and further complicated by deconditioning. The cumulative effects of abnormal stresses and strains on the clinician have been well documented in the literature…. So, what can clinicians do? Is it possible for dental professionals to counteract the ill-effects of their profession on their bodies by participating in a regular exercise routine?
One option is dynamic sitting on the Evolution chair by Posture Perfect Solutions, which provides us with a unique alternative to typical sitting. The Evolution chair provides an opportunity to actively “participate” in the act of sitting, and while this may not be a good fit for all practitioners, it is yet another option to consider. Dynamic sitting allows us to avoid the habitual slouched sitting posture that our mothers always warned us about. We are continuously moving, adjusting and repositioning ourselves throughout the day thus counteracting our typical “holding patterns” of poor posture and perhaps saving our lives!
Efficiency, effectiveness and career longevity may be positively impacted by the fitness of the operator and their choice of seating. So when considering career longevity with the hope of making it to the end of your career in great shape, get on the ball!
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