I did it. I passed all the exams and completed all the competencies. Finally, after four years of relentless pursuit and sleepless nights, I have that license number in hand. That first day on the job will be one that I will never forget.
Many hygienists I have spoken with have commented similar feelings. That pervasive and persuasive self-talk that goes something like this: “Am I ready for this? What if I forget something? Will I even know where to start? Will my patients know I am a new grad? If they ask me, what do I say? What if I forget how to use a probe?”
A sense of delight and accomplishment quickly calmed those first-day jitters after the first real-life patient experience. And, the funny thing was, my first week as a dental hygienist couldn’t have been more packed with memorable encounters and reminders that what I do matters.
Two days into my new career, I had sent a patient to the ER for a hypertensive crisis, had to educate a very tenured patient at the practice about their chronic and very active periodontal condition, and had someone give me dirty looks and walk out on me in the waiting room because I wasn’t “their” hygienist.
Despite these noteworthy conversations, I found my job more fulfilling than ever. I was elated that I had the pleasure of seeing six to eight patients daily without stopping for faculty approval (insert sigh of relief here). I knew I was where I needed to be and doing what I was meant to do.
However, just two weeks later, I began to experience very new and quite painful lower back pain at the end of my workdays. I noticed the tension building up in my nondominant hand, and I became acutely aware of just how emotionally draining my job was.
I loved being a dental hygienist, but how was it that I was feeling so much pain in such a short time? I mean, I had just started my career two weeks ago.
Countering the Burden of Dental Hygienists
According to a 2020 study published in the International Journal of Dental Hygiene, the prevalence of musculoskeletal disorders (MSD) reported by dentists and dental hygienists ranged from 64% to 93%. It was stated that “MSDs represent a significant burden for dental professionals.”1
Furthermore, out of the 205 female experienced dental hygienists and dental hygiene students surveyed, almost all (89% and 88%, respectively) reported musculoskeletal disorders within the last year that affected at least one body part.1 It seems that very few practitioners leave this profession free from pain.
As a seasoned yoga instructor, I began to speak to myself the way I would coach any of my clients, and I started by taking a personal inventory. Was I using proper ergonomics in the operatory? Where could I improve during the day as I worked so as not to come home mentally and emotionally drained and physically aching? How long has it been since I’ve gotten on my mat to work out the stress and body tightness after a long day? (Truthfully, it had been a hot minute.) Was I still incorporating those wrist and neck yoga stretches between patients like I was doing in school?
According to Kumar et al., yoga postures and exercises were shown to increase parasympathetic activity, decrease serum cortisol levels, and increase study participants’ sense of well-being and overall relaxation.2 In this study, medical students participated in a 12-week yoga and meditation program where they practiced yoga for 60 minutes daily, six days per week. At the end of the 12-week study, researchers found only a mild increase in serum cortisol levels in the yoga group, resulting in an overall reduction in stress and anxiety.2
A little yoga is just what I needed.
In excruciating pain and with much reluctance and, frankly, quite a bit of skepticism for a yoga teacher, I crawled onto my mat and told myself to take it slow. I proceeded to do two simple movements as slowly as possible while focusing on my breath and my body. Downward-facing dog, roll to plank, roll back up to downward-facing dog, roll slowly back to plank and child’s pose.
I completed these simple movements as much as possible for as long as possible with sporadic breaks in child’s pose. It was wild, but my back pain began to melt away. I had a good night’s rest, and by morning, I was back at work without any pain. This yoga stuff works.
3 Tips to Prioritize Self-Care
As a new grad, there was so much that I was balancing those first few days and months on the job that the last thing on my mind was my ergonomics or doing some yoga poses at the end of a very long and full day. However, if I had known that my sacrifices in ergonomics were going to cause me such horrible pain, then I might not have bent my head that way to see the distal lingual of #7. If I had realized that just two simple movements could have provided me with some early prevention of aches and pains, I probably would have taken the five minutes to do them.
It did feel a little bit like an “I told you so” moment as I heard the voices of my instructors in my head reminding me to prioritize my body positions during treatment.
Below is my humble advice for all those recent graduates and the fresh new grads to come.
1) Take your time
Take a deep breath or two before grabbing your patient from the waiting room. Take your time bringing them back to the operatory. I know that you may feel the need to go 100 miles per hour, but these moments will help you appear calm and collected even if you don’t feel that way.
When you put your focus into exactly what you are doing at that moment, you stay present, make fewer mistakes, and can perform better instrumentation. When I slowed down, I received lovely compliments about how gentle I was.
As a side note, not one patient ever asked if I was “new,” and they still haven’t. They all assumed I had been doing this for years.
2) Microbreaks, microbreaks, microbreaks
Stretch your neck behind the patient while taking vitals. Stretch your wrists when the doctor comes in for an exam as you step out and around the operatory. Perform a quick heart opener stretch, such as a standing cactus arm pose, when you return to your op after the appointment is complete and after you flip your room. Any one of these moments will benefit you tremendously.
If you can manage to fit all three of them in, you are a rockstar. I am still a work in progress, but who isn’t? And remember, no one is perfect.
The fact that injuries like carpal tunnel syndrome are ten times more likely in dental hygienists than in any other career field is just one more reason to prioritize self-care.1
3) Be the mindful clinician, not just a “tooth cleaner”
I do these three things during treatment to help me maintain proper ergonomics to the best of my ability. At least once during patient care with every patient, I will:
- Assess my grip on my nondominant hand and soften it.
- Pause and check the position of my head in relation to my spine.
- Double-check the fulcrum of my dominant hand and look to see if there is a more supportive option that will lessen the amount of effort I need to complete the work.
In Closing
When we sacrifice our bodies and minds to save a few minutes or get a patient out earlier, we send the message that we are easily replaceable. A study conducted on compassion fatigue and burnout in dental hygienists reported that more than two-thirds of the respondents thought about leaving the profession.3 This is alarmingly high. Yet, our specific skillset is in demand now more than ever.
After working just a few short months, I can already see how I am positively impacting patients’ oral health and overall well-being. We are one of the few medical professionals specializing in disease prevention, and we are trained to recognize early signs and symptoms of numerous systemic diseases. We are special.
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References
- Netanely, S., Luria, S., Langer, D. Musculoskeletal Disorders Among Dental Hygienist and Students of Dental Hygiene. International Journal of Dental Hygiene. 2020; 18(2): 210-216. https://pubmed.ncbi.nlm.nih.gov/32012436/
- Kumar, K., Singh, V., Kumar, D., et al. Effect of Yoga and Meditation on Serum Cortisol Level in First-Year Medical Students. International Journal of Research in Medical Sciences. 2018; 6(5): 1699-1703. https://www.msjonline.org/index.php/ijrms/article/view/4755
- Knutt, A., Boyd, L.D., Adams, J.L., Vineyard, J. Compassion Satisfaction, Compassion Fatigue, and Burnout Among Dental Hygienists in the United States. Journal of Dental Hygiene. 2022; 96(1): 34-32. https://jdh.adha.org/content/96/1/34.short
