Dental professionals are constantly worried about injuries occurring that could affect their ability to practice long-term. Whether an injury occurs on the job, such as an occupational injury, or from an outside source, such as an accident, the strain placed on one’s body when practicing dentistry can lead to further injury or the end of a career altogether.
The question is, how do dental professionals prevent injuries or further injuries while promoting the healing process?
Work-related Musculoskeletal Disorders
Musculoskeletal disorders involve conditions affecting bones, joints, muscles, and connective tissues. Dental professionals sit for long periods of time with awkward positions, increasing risks for work-related musculoskeletal disorders (WMSD). A recent survey of 151 dental professionals was completed to determine the prevalence of WMSD. The survey reported 58.3% had experienced WMSD within the last 12 months, 66.7% had experienced neck pain, and 33.11% had experienced pain in multiple sites.1
Ergonomics is Essential in Dentistry
All dental professionals learn how important ergonomics is to the prevention of WMSD and occupational injuries, practicing proper posture, proper patient positioning, and proper instrumentation. To ensure proper posture, dental professionals are taught to maintain an upright posture and not lean over their patients, work as closely to the patient as possible to minimize the need to overextend arms and back, keep feet flat on the floor, have ideal lighting, and consider utilizing loupes to increase visibility and maintain ideal positioning.
Ideally, patients should be placed within a supine position for clinical procedures. Dental professionals are taught to keep instruments sharp and use appropriate instrumentation techniques.
However, this is not a perfect world with perfect operatories, patients, or instruments. Therefore, the bodies of dental professionals suffer on a daily basis.
My Story
I remember sitting in our dental hygiene clinic on day four of the Indiana University Northwest Dental Hygiene Program. One of our full-time faculty members began our first clinic discussing WMSD immediately. She reviewed how important proper ergonomics would be to ensure the longevity of our health, well-being, and career. Due to WMSD, her career in private practice was cut short, resulting in the transition to dental education. Her story encouraged me to focus on ergonomics and pursue further education in case injury of any sort would halt my dental hygiene career.
Six years into private practice, I worked four days in private practice (accelerated hygiene) and instructed as a clinical lecturer adjunct faculty within the dental hygiene clinic at the Indiana University School of Dentistry (IUSD) one day a week. At this point, like many dental professionals, I had neck stiffness, shoulder tightness, and headaches at times. However, I was still able to practice without any chronic pain when cognizant of proper posture, patient positioning, lighting, and instrumentation while also wearing my loupes every day and having regular massages.
However, on February 14, 2014, I was on my way to IUSD to teach when I was in a car accident that resulted in a concussion, a fractured nose requiring surgery, and chronic post-traumatic headache. From that day forward, due to the injuries sustained within my car accident and the constant ergonomic strain from private practice, I would come home every night with severe migraines.
After a year of continual treatment (chiropractic care, trigger point injections, acupuncture, dry needling, and physical therapy), I was still in chronic pain and was told this would be my new normal if I did not allow my body time to heal by not practicing dental hygiene. Thankfully, I was able to transition out of dentistry for the time being.
The longer I was out of private practice, the less frequent my migraines became. I started focusing on my diet when my mother was diagnosed with lupus, decreasing foods that encourage inflammation, such as gluten and dairy, and began increasing my intake of fruits and vegetables. Not long into this journey, I was introduced to concentrated plant-based nutrition, which drastically decreased inflammation within my body.
Giving my body time to rest and fueling it with proper nutrition allowed my body to heal. Seven years later, I have returned to private practice and am also a group exercise instructor and personal trainer, having the ability to share my passion for both oral and overall health with those around me. I have learned the importance of incorporating stretching into my days as well as workouts. Cycling and strength training with lighter weights and high repetitions have helped strengthen my upper body rather than prevent further injuries.
Importance of Stretching
Stretching throughout the day is essential to balance your work/rest ratio and relieve stress and tension from the body. Dental professionals sit for long periods of time throughout the day, which places strain on the body. Strain or poor posture in dentistry can lead to spinal and pelvic misalignment. Most often, lordosis or curvature of the spine occurs, which is typically accompanied by an anterior pelvic tilt. The erector spinae and hip flexor muscle groups become tight while the core weakens. Therefore, dental professionals should regularly complete back and hip flexor stretches while also strengthening their core.2
- Neck circles – gently bring chin to chest, roll next towards each side
- Neck/trapezius stretch – gently bring your head towards your shoulder; opposite arm out straight, feeling a gentle stretch towards your fingertips
- Shoulder rolls – gently rotate shoulders up and back
- Supported backbend – stand straight and place hands on lower back while gently leaning back and looking up
- Standing shoulder/chest stretch – clasp hands behind, feeling the stretch within the chest and releasing the shoulders
- Forearm stretch – straighten elbow and bend palm toward the floor
- Hip flexor stretch – kneel on your left knee and place your right foot flat on the floor in front of you, knee bent; lean forward, stretching your left hip toward the floor; switch sides
- Planks – place your feet on the floor and your elbows directly under your shoulders, holding a straight line from your ankles to your head; this exercise can be completed anywhere to help strengthen your core
Importance of Regular Exercise
Choosing a type of exercise you enjoy will ensure you stay motivated and continue to work out. Also, dental professionals must choose a type of exercise to strengthen your core. A strong core will help you maintain good posture.
- Cycling – a great combination of low-impact cardio and core strengthening, which is ideal for dental professionals
- Yoga – an excellent form of exercise to destress, improve flexibility, and loosen muscles
- Pilates – an excellent form of exercise to increase prober breathing and core strength
- Barre– an excellent form of exercise to improve flexibility and balance while strengthening your core and other major muscle groups
- Strength training
- Any form of strength training for dental professionals should incorporate low weights and high repetitions, allowing for muscle conditioning with a decreased chance of injury
- Strengthening the shoulders, arms, and core through strength training can decrease chances of injuries or further injuries seen in dentistry
- If lifting too heavy of weights or not having proper form prior to adding weight, injury can occur
- If pain occurs, reduce exercise intensity, frequency, and/or duration
Conclusion
All roles within the dental profession are physically demanding. Practicing proper ergonomics is essential, but not always enough to prevent occupational injuries or allow you to keep practicing after injuries outside of the operatory. However, focusing on proper nutrition and regular stretching and strengthening exercises might just extend the longevity of your dental career.
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References
- Kumar, M., Pai, K.M., Vineetha, R. Occupation-related musculoskeletal disorders among dental professionals. Medicine and Pharmacy Reports. 2020; 93(4), 405–409. https://doi.org/10.15386/mpr-1581
- Crespo, M. NETA’s The Fitness Professional’s Manual, 5th Edition. 2018; 156.
