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Strategies to Prevent Musculoskeletal Injuries for the New Dentist
Tammie Smeltz, RPLU, Content Marketing Manager
Work-related musculoskeletal disorders are common among dentists. This is due, in part, to the amount of standing, bending, leaning and twisting dentists perform while treating patients. According to a 2015 study in the British Dental Journal Team, injuries to the lumbar spine, shoulders and hands are a leading cause of illness-related early retirement for dentists.
Even though musculoskeletal disorders are a risk in the dental profession, there are ways to prevent or decrease the extent of these injuries.
Let’s look at some strategies to keep the physical body healthy during your dental career.
Posture: Improper body mechanics is one of the biggest contributing factors of musculoskeletal disorders in dentistry. Because of the complexity and extended length of time to complete dental procedures, dentists may be in a seated position while treating patients. A seated position can lead to twisting of the back and neck.
To decrease the risk of injury to the back and neck, the patient’s chair should be horizontal unless they have a medical condition that precludes them from lying flat. The vertical height should be at a level where the dentist has a good view of the patient’s oral cavity without having to bend too far forward.
When treating patients, it is best to keep the physical body in a neutral position which can be challenging at times. When the body is positioned neutrally, the ears, shoulders, hips and feet are in a straight line. You can practice neutral positioning by looking in a mirror. Also, dentists may want to incorporate ergonomic stools and chairs, keep their elbows close to the body when providing dental care and add stretch breaks into their workday.
Four-handed dentistry: Four-handed dentistry involves the dentist and dental assistant working in tandem. This allows the dentist to focus on the patient while the dental assistant organizes and hands instruments to the dentist. Using the four-handed approach decreases the risk of musculoskeletal injury to the dentist associated with twisting or reaching over the patient.
Exercise: Since the practice of dentistry is a sedentary occupation, it is imperative to engage in regular physical activity. Dentists are prone to muscle injury and imbalances in the cervical spine, lumbar spine, shoulders, hands and wrists because of their profession.
To prevent these types of injuries, it is recommended to take regular stretch breaks throughout the day.
Here are a few stretches that can be done easily in the dental office:
- Ear to Shoulder: This stretch can be done either standing or sitting in the office. To begin, gently tuck your chin to your chest and move your right ear towards your right shoulder. To increase the intensity of the stretch, place your right hand on your head and apply gentle pressure toward the right side. Hold the position for five breaths and repeat to the left. It may be beneficial to apply a heating pad to the neck prior to this stretch.
- Cat/Cow: Cat/Cow pose is an excellent way to stretch and mobilize the entire spine. Begin on your hands and knees with the shoulders directly above the wrists and the hips directly above the knees. With your spine in neutral, inhale and slowly allow the stomach to drop towards the ground. You will notice your lower back start to move, then the middle back with the shoulders and head moving last. At the end of the inhale, you will be gazing forward. This is cow pose. As you exhale, you will start to arch the back upwards coming into cat pose. The belly will move away from the ground. The shoulder blades will move away from each other, and the head will gently drop towards the floor. When performing cat/cow, the head is always the last to move.
- Cross-arm stretch: This stretch can be performed seated or standing. To begin, bring your right arm across your chest with the palm facing upwards. Place your left elbow crease under the right arm for support. Hold for five breaths and repeat on the other side.
- Hand/wrist: We often forget to stretch the muscles in our hands, wrists and forearms. These areas are prone to repetitive stress injuries in the dental practice. To stretch the hands, wrists and forearms, start on the hands and knees as you would when performing cat/cow. Keeping your shoulders over your wrists, externally rotate both arms so your fingertips are facing your knees, and your elbow creases are facing forward. In the beginning, this may feel like enough of a stretch. However, you can rock back and forth or side to side to feel more sensation. For a more intense stretch, start to peel the palms and thumbs off the ground and gently cross the thumb towards the pinkie finger while the knuckles and fingertips stay on the ground. Take five breaths and shake out the hands and wrists when complete.
Additional exercises for the neck, back and shoulders can be found here.
As you begin to practice dentistry, it is important to set aside time for self-care to prevent injuries down the road.
Dentists who are not already MLMIC insureds can apply for coverage here.
Sources
This document is for general purposes only and should not be construed as medical or legal advice. This document is not comprehensive and does not cover all possible factual circumstances. Because the facts applicable to your situation may vary, or the laws applicable in your jurisdiction may differ, please contact your attorney or other professional advisors for any questions related to legal, medical or professional obligations, the applicable state or federal laws or other professional questions.
