Back pain was not in the job description, how to minimize risks?

Back pain among dental staff is common, it cannot always be prevented and most of us know what to do to in regard to posture.
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Regardless of how far modern technology and equipment has come, 70% of dentists still report suffering from back pain. Suffering physical pain on a daily basis can quickly escalate into the inability to perform certain tasks, followed by the unavoidable need to take time off work to recover. If things get really bad, you or your dental staff could even have to undergo surgery to fix severe posture issues.

In a 2010 study by Brown et al. it was revealed that the most common cause of ill health retirement amongst 189 dentists was musculoskeletal disorders. Similar results became apparent among dental nurses, hygienists and therapists, too. So you can avoid unwanted early retirement and help take care of your body, here’s everything you need to know about back pain in the dental practice and how best to prevent it. 

Why do dental staff suffer?

Almost all dental professionals suffer from back pain because of the unnatural position they’re forced into while treating patients. In fact, physical pain is so common in dental professionals that we list it as one of the top 5 challenges dental assistants must overcome. It’s all down to torque (also known as rotational force) which occurs when your body becomes unbalanced as you lean forward and angle your head to get a clear view of the oral cavity.

The human head makes up 8% of our bodyweight. The average weight of a man’s head is 14lbs and the average weight of a woman’s head is 11lb. This essentially means we all have a bowling ball attached to the top of our spine. While this isn’t a problem when we’re sat or stood upright, it becomes a significant physical burden as soon as we angle our bodies. 

To have a direct line of vision into the oral cavity, you’re forced to tilt your body forward, even if you’re using a mouth mirror and loupes. For every second you lean your head 45° forward, you’ve got to resist 6.56 foot pounds of torque to prevent your face from falling into your chest. If you keep your head in this position for 10 minutes, that’s the muscle exertion equivalent of lifting a 20lb dumbbell 92 times.

It’s worse for dental staff with a tendency to lean their entire body forward and not just their head. When you lean your torso forward at the pelvis at a 30° angle to gain a clear view into the oral cavity, you’re forcing the lumbar region of your body to resist 18.62 foot pounds of torque. Keep your body in this position for 10 minutes and that’s the muscle exertion equivalent of lifting a 20lb dumbbell 266 times. 

When you think about the excessive stress you put onto your body while practicing dentistry in the form of weightlifting, it’s easy to understand why you’re in so much pain at the end of the week. Thankfully, if you take appropriate action now, you can lessen the aches you experience at the end of each working day and escape the debilitating back pain which many dental professionals endure after retirement. 

How to prevent back problems in the dental practice

The ideal way to prevent back problems in the dental office would be to practice in a consistently neutral or balanced operator position. However, providing optimal patient care is impossible with this physical restriction, regardless of how proficient you are at using a surgical microscope.

Since maintaining a neutral or balanced position and providing patients with excellent care aren’t both possible, it’s important you take other steps to minimize the damaging health consequences of prolonged periods of torque resistance. 

Maintain good posture

Avoid back problems by assuming a neutral or balanced posture whenever you’re not required to have a direct line of vision into the oral cavity. This is every moment you’re not directly treating a patient, such as when you’re waiting for the anesthesia to take effect. Take these opportunities to find a comfortable position and stretch your neck and back muscles to give them a break.

Take a break whenever you can

Take the above advice one step further and let your body relax whenever you’re not carrying out a procedure. In between patient appointments, take the time to relax your muscles however feels best. Whether you sit upright on a chair, take a stroll around the room or roll your neck and shoulders around to loosen them up, whenever you’re not treating patients, take the time to look after yourself. 

Hire more staff

If an increased workload means you and your staff are forced to work overtime, resulting in severe physical pain, consider expanding your team. If you don’t want to commit to hiring new employees full-time, think about using an online cloud-based platform like Cloud Dentistry which specializes in matching the right dental staff with the right dental practices. 

When you hire dental professionals this way, you only pay for the specific times and days you require them. For example, if your appointment schedule is packed on Monday and Friday afternoon on one week, you can hire an extra dentist, dental hygienist or dental assistant on those afternoons to help lower everyone’s workload and the physical pain that comes with it. 

Consider new operator stools

Having the proper operator stools can take the pressure off your legs, feet and lower back while treating patients. From the moment you lean forward in your stool, you create torque and your entire body is subject to rotational force. If you find yourself in this leaning position often, you’ll develop pressure points on the underside of your thighs, resulting in pain and numbness in your lower legs and feet. If this sounds familiar, invest in an operator stool with a seat that tilts forward to evenly distribute the force along your hamstrings. 

If you suffer from intense lower back pain, consider an operator stool with an armrest for your non-dominant hand. This helps transfer a percentage of the leaning torque force from the lumbar region of your body into the elbow cup of the stool. 

Sadly, there’s no magical solve-all operator stool that fixes every ache and pain. Try discussing your problems with a physical therapist and ask them for recommendations on the best type of chair to accommodate your needs.

Re-think patient chairs

The type of patient chair you have in your practice dictates how far you’ve got to lean to gain a good view into the oral cavity. The traditional chair style reminiscent of a flat ironing board is ideal for being able to slide close to the patient and minimize how far you’ve got to lean forward and tilt your body.

By contrast, the thicker-backed chairs that most patients find visually appealing push you further away from the patient, forcing you to lean forward more or tilt further to get a better look. Try to find a patient chair that has a little bit of both — attractiveness for your patients and comfort for you.

Try exercise or physical therapy

Exercise is something you should prioritize in order to achieve work-life balance. Not only can going for a run, doing a pilates class or practicing yoga at home make you feel relaxed, happy and healthy, but including little workouts into your life can really help with back pain, too.

If you don’t like the idea of hitting the gym or signing up for a group class, you can start simple at home. Begin by searching for “Workouts/exercises/stretches for back pain” and work from there. Try and find advice for your specific type of back pain. If you struggle, just try different techniques until you find one that works for you. 

Written By Sandie