The science of ergonomics

Oct. 1, 2005
Improving performance and preventing injury

Improving performance and preventing injury

Lisa Broering, OTR/CHT

The utensils in your kitchen, the chairs in your dining room, the pens in your office ... all of these items are being marketed as “ergonomically correct.” After decades of research on ergonomics and its benefits, the concept of ergonomics has become mainstream. In fact, ergonomics is so hot right now that the term is even being used to describe a picnic plate that has a holder for a beer and a burger.

Manufacturers are prudently marketing the ergonomic benefits of their products, citing clinical studies showing that ergonomic products and workplace configurations both drastically improve job performance and prevent injury. This is also true in the dental industry, where 40 percent of the early retirements of all dentists have been attributed to poor ergonomics. As a group, women specifically suffer from dental workplace injuries - injuries that could be prevented or diminished by the implementation of proper ergonomics.

What ergonomics means for dental professionals

Ergonomics is an applied science that studies how a job or task fits an individual’s body. Poor work design, poor body positioning, and physical and emotional stressors can all impact a worker’s ability to be productive in her place of work. The result is typically a work-related injury, commonly referred to as a “musculoskeletal disorder.” The term musculoskeletal disorder describes health problems associated with the muscles, nerves, spinal discs, joints, cartilage, tendons, and ligaments. Many of these injuries occur in the lower back and upper extremities.

Musculoskeletal disorders are occurring with increasing frequency in the dental workforce. Notably, more than half of these reported injuries are suffered by women. By employing proper ergonomic techniques, however, many of these injuries can be prevented.

The process of prevention begins by recognizing the primary causes of workplace injury: sitting for extended periods of time, awkward postures, and job stress. The bad news is that all of the above risks are present in the dental operatory. The good news is that they can be minimized or prevented, reducing the chance of a musculoskeletal disorder. The process of minimizing these risks involves incorporating proper ergonomic practices. Implementing simple ergonomic changes can extend your ability to work productively and comfortably in your dental practice.

Ergonomic changes you can implement today

There are dozens of ergonomically correct products and product configurations that you can use to increase your quality of practice and overall health. The most effective approach is for an ergonomist to assist you in identifying the most important modifications for your particular practice. Three simple modifications that you can make today to drastically improve your practice involve: proper selection and adjustment of an ergonomic stool, use of surgical loupes and proper patient positioning.

Choose a proper stool and adjust it correctly

Standard stools are tailored to fit a 5’10” male. Most women fall significantly out of that range and have difficulty finding a stool that fits them properly. Additionally, many of the stools on the market do not provide adequate back support, and a large number of them do not have arm supports. Look at your current chair configuration. When working on a patient, do you lean forward and sit on the front edge of the chair? If so, then you are not properly using the stool, or it is not adjusted correctly.

A chair such as the Alleviate stool is designed to accommodate full body positioning. Forward tilt options are available, allowing you to work at a closer angle to your patient, thereby reducing the chance for injury. Articulating arm supports are also available to provide a resting position for the elbows without interfering with the flow of the office. The seat is contoured to support the hips and legs, and the backrest has a built-in lumbar support. All of these components are needed to minimize a chance of injury when sitting for an extended period of time.

To further prevent injury, make sure the stool you select is adjusted correctly. For example, place the seat height at an angle slightly above the resting position of the knee. This allows for better weight distribution when working in a forward tilt mode.

Use surgical loupes

Are you wearing loupes? Many dental professionals believe that if they have 20/20 vision, they do not need loupes. Unfortunately, this is not true. Dental work is performed in a small, confined space. Magnifying the space will allow for a better view angle, resulting in a more upright position. If your neck is bending forward more than 20 degrees, you are placing yourself at a greater risk for injury. Using surgical loupes and setting a proper focal distance and declination angle is imperative for maintaining a proper neck position.

Properly position your patient

Patient placement should be slightly below the resting position of the elbows when placed at a 90-degree angle. Unfortunately, many dental professionals compensate with their patient position to place them at a working angle closer to their line of vision. This causes an awkward posture, and you may notice yourself doing an “arm winging” position throughout most of your procedures. This is usually the result of poor positioning and difficulty accessing the quadrant, which may lead to significant injury over time.

Many manufacturers have incorporated an articulating headrest on the patient chair. This allows you to maneuver the headrest in a proper position for both the upper and lower quadrant. Also, a quick release button is now available that allows for ease in use and minimizes the strain on the hand. By choosing ergonomically correct products, you can better position your patient and reduce risk of injury.

Maximize the benefits of ergonomics

Implementation of the three ergonomic practices described above has changed high-risk injury environments into places that are productive, safe, and allow for an efficiently run practice. If you are unaware of the correct adjustments for your particular body type and practice, contact your representative or consult with an ergonomist who specializes in dental practices. By taking proactive steps to maximize the benefits of ergonomics, you will improve your performance, prevent injury, and better enjoy your practice.

Lisa Broering, OTR/CHT
Ms. Broering is president and CEO of Ergo Links, Inc., a company that specializes in implementing proper ergonomics in dental workplaces to achieve an optimal, safe work environment. She can be reached at (954) 931-7415, or visit for more information.