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Ergonomic Applications To Dental Practice
Ergonomic Applications To Dental Practice
Ergonomic Applications To Dental Practice
Ergonomic Applications to
Dental Practice
Overview
What is Ergonomics?
What are the Consequences of Poor
Ergonomics?
What Policies/Standards Address
Ergonomics?
How can Ergonomic Principles Be
Applied to Dental Practice?
What is Ergonomics?
Job
Characteristics
Human
Capabilities
Ergonomics
Relationship between humans, the tasks
they perform, and the environment in which
tasks are performed.
Equipment-centered Ergonomics: Human
Adaptation to Requirements of Equipment.
Human-centered Ergonomics: Equipment is
adapted to Requirements of Humans.
Humans Do Dentistry
Not Equipment
Priority: Human Factors and the Way We Work
Number of Cases
20,000
16,000
12,000
8,000
4,000
FY89
FY90
FY91
FY92
FY93
FY94
FY95
FY96
FY97
?
?
WMSDs in Dentistry
75%
of dentists & hygienists suffer
from musculoskeletal disorders
that affect occupational health
& the quality of practice life
WMSDs in Dentistry
Reasons for Early Retirement Among Dentists
Musculoskeletal Disorders (29.5%)
Cardiovascular Disease (21.2%)
Neurotic Symptoms (16.5%)
Tumors (7.6%)
Diseases of the Nervous System (6.1%)
Source: Burke et al., 1997
% Reporting
Males
Females
Body Part
Dental Hygienists
Dental Assistants
80
70
60
50
40
30
20
10
0
* Diagnosed * Hand-wrist * Shoulder
CTS
pain
pain
* Neck pain
Low Back
pain
Imagine
Dental practice
without the compromise of your health,
the quality of care you provide,
& the quality of practice life you deserve.
Imagine
Dental practice
free from back, neck & shoulder pain
that afflict so many clinicians every workday.
Imagine
Reaching your peak performance potential
while you work comfortably,
with energy & enthusiasm left over
at the end of the day.
Ergonomics in Dentistry
Tool/Instrument Design
Goals: Reduce force exertion;
Maintain hand/wrist in neutral posture
Considerations:
Overall shape/size
Handle shape/size
Weight
Balance
Maneuverability
Ease of operation
Ease of maintenance
Ergonomics in Dentistry
Hand Instruments
Look for:
Hollow or resin
handles
Round, knurled or
compressible handles
Carbon steel
construction (for
instruments with sharp
edges)
Ergonomics in Dentistry
Automatic Handpieces
Look for:
Lightweight, balanced
models (cordless preferred)
Sufficient power
Built-in light sources
Angled vs. straight-shank
Pliable, lightweight hoses
Swivel mechanisms
Easy activation
Easy maintenance
Ergonomics in Dentistry
Syringes and Dispensers
Look for:
Adequate lumen
size
Ease in cleaning
Knurled handles
(no finger cut-outs)
Easy activation and
placement
Ergonomics in Dentistry
Magnification Systems
Goal: Improve neck posture; Provide clearer
vision
Consider:
Working distance
Depth of field
Declination angle
Convergence angle
Magnification factor
Lighting needs
Ergonomics in Dentistry
Workstation Layout
Ensure:
Instruments,
materials, medications,
etc. are accessible while
seated
Hoses are positioned
away from the body
Set-up can be adapted
for different operators
Ergonomics in Dentistry
Operator Chair
Goal: Promote mobility and patient access;
accommodate different body sizes
Look for:
Stability (5 legged base w/casters)
Lumbar support
Hands-free seat height adjustment
Adjustable foot rests
Adjustable, wrap-around body
support
Seamless upholstery
Ergonomics in Dentistry
Patient Chair
Goal: Promote patient comfort; maximize
patient access
Look for:
Stability
Pivoting or drop-down arm
rests (for patient ingress/egress)
Supplemental wrist/forearm
support (for operator)
Articulating head rests
Hands-free operation
Ergonomics in Dentistry
Posture/Positioning
Goal: Avoid static and/or awkward postures
Potential Strategies:
Position patient so that operators elbows are
elevated no more than 30 degrees.
Adjust patient chair when accessing different
quadrants
Alternate between standing and sitting
Ergonomics in Dentistry
Work Practices
Goal: Maintain neutral posture, reduce force
requirements
Potential Strategies:
Ensure tools are sharpened, well-maintained
Use automatic handpieces instead of manual
instruments where possible
Use full-arm strokes rather than wrist strokes
Ergonomics in Dentistry
Scheduling
Goal: Provide sufficient recovery time for staff
to avoid chronic muscular fatigue
Potential Strategies:
Increase treatment time for more difficult
patients
Alternate heavy and light calculus patients
within a flexible scheduling system
Vary procedures within the same appointment
Shorten patients recall interval
Ergonomics in Dentistry
Prosthetics Labs
Naval Station Rota Spain Clinic Case Study: Lab techs
mentioned chronic back, shoulder & neck discomfort / pain
during periodic Industrial Hygiene survey from working at nonadjustable bench in obviously stressful static postures -- with no
forearm support nor bench edge padding
Ergonomics in Dentistry
Prosthetics Labs
Naval Station Rota Spain Clinic Case Study -- Post intervention
improvements offered by Kavo ergonomic lab benches :
Lab techs affirm GREATLY increased comfort / decrease in back,
shoulder & neck discomfort / pain.
KAVO dental prosthesis lab benches offer ample forearm supports and workpiece
support centering prosthesis directly below technician which optimizes spinal / neck
/ head vertical alignment
Ergonomics in Dentistry
Prosthetics Labs
Naval Station Rota Spain Clinic Case Study: Lab technicians now
work in optimized ergonomic posture. In addition to forearm
supports and central workpiece support (locally-ventilated for air
contaminant removal !) , the table also has much improved overhead
lighting, a magnifying lens and a drill speed control operated by the
techs right knee
ERGONOMICS SUMMARY
Good ergonomic design of tools, processes
and furniture DOES improve personnel
comfort, health, morale, productivity and
readiness.
Individual effort as part of a workshop team
is the greatest means of identifying /
improving workplace ergonomic issues.
Its critical to seek prompt medical aid for
symptoms of ergonomic stress / CTDs
continued