Levin

Caylin Levin
ENC 1102-0M12
April 23, 2015
No Pain No Gain, Even in the Dental Field
From the first time I went to the orthodontist, with my buckteeth, I knew I wanted to have
that job. Every little girl dreams of being a princess or a ballerina at that age, but I wanted to play
with peoples teeth. My obsession with this became apparent when I was always trying to find
new and creative ways to pull out my little brothers teeth, even when they werent ready to be
yanked. My major here at the University of Central Florida only seems reasonable to be
Preclinical Health Sciences, going down the pre-dental route. I encountered many roadblocks as
I was researching. Whether the topic didnt interest me, for instance how not having dental
insurance works in favor of the patient, or if there wasnt enough research done, like how to
esthetically appeal an audience with themes and such, but then I remembered my dentist
mentioned the stress the job causes on your joints. So theres where I found my structure. Being
an aspiring orthodontist (or even a dentist) I thought I should get to know the risks and how to
prevent them in the best ways possible. According to Dr.Baheti and Dr. Toshniwal in their article
Ergonomics: A Pain Free Dentistry for Professionals it has been estimated that work related
musculoskeletal injuries occur in 54% to 93% of dental professionals, with the most frequent
injuries occurring in the spine (neck and back), shoulders, elbows and hands (Baheti and
Toshniwal) and although this percentage has a large range due to the fact that its an estimate it
just proves that at least over half of the dentists have reported they have felt pain in these areas
and with such high numbers something should be done. Dr.Baheti and Dr. Toshniwal also
expressed that in a specific study done on dental hygienists they reported neck pain associated

Levin

with working in a bent neck position, and neck symptoms [] by 72% of a sample of 94
experienced hygienists (mean age: 46 years) (Baheti and Toshniwal), which also just proves the
point stated before that something needs to be done to prevent such high percentages of dentists
and orthodontist with pain. The increasing number of work injury related dentists and
orthodontists prompts me to examine the issues that are related to how this happens, and how to
try and prevent it in the dental field, and to understand the best options as an orthodontist.
Recognize that there are several perspectives on having good ergonomics and how to help with
the pain dentists/ orthodontics face in their daily lives, but the three that are going to be talked
about are acquiring ergonomic furniture, taking more frequent breaks, and physical exercising
like yoga.
What Causes this Pain, and How Do We Effectively Prevent it?
Dentists and orthodontists have a high risk for musculoskeletal disorders due to the
nature of their profession, and to prevent this they have to practice good ergonomics. According
to the article Ergonomics, Posture and Exercises - Pain free, Prolong Orthodontic Career by
Sachan, Verma Panda, and Singh Ergonomics in orthodontics is the study of the relationship of
humans or clinicians to their working environment and the development of methods, tools, and
equipment to improve working conditions, increase efficiency, and reduce injury (Sachan,
Verma Panda, Singh). Theres a lot the evidence and precautions dentists and orthodontists have
with the ergonomics in their field. Its an everyday discipline to creating products and techniques
to assure safety and make sure the worker has full potential to work to their hardest. Figuring out
why this happens is one thing, but trying to find ways prevent it is another. With being an
aspiring orthodontist, knowing the ins and outs about how to better ones health in this field and
what proper procedures to take will only help people in the same situation. The effects and

Levin

precautions people in this field should take in order not to endure so much pain is something that
has been widely researched with surveys and experiments.
Musculoskeletal disorders are injuries or disorders that affect full body movements. In
professions such as doctors, nurses, and athletes MSDs have always been evident, but over the
years the amount of musculoskeletal disorders in dentists has been a great issue. Dentists and
orthodontists are exposed to several occupational hazards. Because of the improper posture when
sitting in a dentists chair the neck, shoulders, lower back, hand, and wrist pain is unfortunately
very common. The nature of this type of work and posture entails abnormal use of the lower
spine and causes tension in the ligaments. The earlier you can get ahold of the problem the easier
it is to fix and depending how quickly you can do this the treatment may range from pain relief
medications or end up having to get surgery.
In A Study on Job Postures and Musculoskeletal Illnesses in Dentists" by Ehsan
Rafeemanesh, Zahra Jafari, Farzad Omidi Kashani, and Farzaneh Rahimpour published in the
International Journal of Occupational Medicine and Environmental Health was a study among 65
dentists working in the Health Centers of Mashhad.. Their main argument is to relay back the
information the researchers found about Work-related Musculoskeletal Disorders (WMSDs) and
how in dentistry, due to the repetitive activities, long term working in static postures,
inappropriate working conditions as well as usage of inappropriate tools musculoskeletal
disorders are likely to occur (Rafeemanesh, Jafari, Kashani, Rahimpour). This study did a
survey of dentists (58 participated) in Iran to see which body part receives the most pain and this
is what they found:

Levin

As you can see the majority of dentists feel pain predominantly in their neck and then their
shoulders and back and we have to try and decrease that percentage.
Ergonomic Friendly Furniture
Your focus should be on the process of trying to better our nature because its to help
the common man or more like the common dentist to better their performance in their daily job.
The first way too look at increasing dentists work efficiency is replace all furniture with
ergonomic friendly equipment. The point of ergonomic furniture is to primarily improve ones
posture and that by itself is extremely important for dentists and orthodontists. Stated by
Dr.Baheti and Dr. Toshniwal in their article Ergonomics: A Pain Free Dentistry for Professionals
dentists and orthodontists practice an enormous amount of improper posture with things like:
Working with the neck in flexion and tilted to one side, shoulders elevate, side bending to
left or right, excessive twisting, forward bending/overreaching at waist, shoulders flexed
and abducted, elbows flexed greater than 90, wrists flexed/deviated in grasping, thumb
hyperextension, position maintained for 40+ minutes per patient (Baheti & Toshniwal).

Levin

With specifically designed chairs dentists and orthodontists could decrease the amount risks
caused by these things stated. The causes of MSDs include equipment that is poorly designed or
improperly used; the use of various types of force by parts of the body; awkward posture;
repetition; the use of vibrating tools; and other factors, including some that are not work related
(such as obesity, arthritis, autoimmune disorders, and smoking)(Sachan, Verma Panda, Singh)
so having the appropriate designed chairs and tools may not cause so many reports of MSDs
(musculoskeletal disorders). Because of the fact that dentists and orthodontists sit in such
awkward positions for such long periods of time they need some type of chair that supports their
uncomfortable setting. These specific chairs reduce the risk of back pain because research shows
that with the support maintaining the low back curve when sitting can reduce or prevent low
back pain. It will also cut back on the amount of neck problems because of the head rests, so
having these items in a profession that has a record of back and neck pain would be ideal.
Normal chairs tend to have a hard surface, so when sat upon there is an excess amount of
pressure on your hips, but with ergonomic chairs theres a seat depth that reduces the pressure on
your hips, and thats just another added indulgence. According to Bethany Valachi in Ergonomic
Positioning: A Few Degrees Add Years to Your Career:
With tight patient schedules, emergencies, and production goals to consider, it is easy to
overlook proper patient positioning. However, taking the time to position the patient,
dentist, assistant, and equipment properly can not only have positive ramifications for the
operators posture, comfort, and career longevityit can also lead to better treatment and
increased productivity (Valachi).
Not only does ergonomic furniture help with posture, but also, in general, its more comfortable
and being more comfortable results in an increase of productivity. With that being said it makes

Levin

working easier and overall youll feel better in the long run.
Taking Breaks Results in Longer Working Years
Kumar, Rathan, Mohan, Begum, Prasad, and Prasad in Exercise Prescriptions to Prevent
Musculoskeletal Disorders in Dentists claims that since the number of dental patients is
increasing day by day dentists are forced to spend longer times in dental chairs. This is
increasing the prevalence of musculoskeletal disorders in dentists (Kumar, Rathan, Mohan,
Begum, Prasad, Prasad). Another way to minimize the amount of pain dentists and orthodontists
face on a daily basis is to increase the amount of breaks; short mini breaks should be insinuated.
The numbers of patients are only increasing, which means the number of breaks dentists and
orthodontists get are diminishing, and that results in requiring longer times periods in
uncomfortable positions. In the article Musculoskeletal Symptoms Among dentists in Relation to
Work Posture, Ratzon, Yaros, and Mizlik describes how
dentists who work in the sitting position have more severe low back pain than do those
who alternate between sitting and standing despite the fact that those who sat at least 80%
of the time worked less hours and had less of a workload during their working hours
(Ratzon, Yaros, & Mizlik).
This implies that changing positions should be required for dentists and orthodontics and taking
pauses to walk around and stretch is highly recommended. Nearly 1/3 of the dentists and
orthodontists that retire early is due to musculoskeletal disorders, and in 2004, around $131
million in lost income was made out to MSDs treatment and relief according to Dentistry Today.
Dentists and orthodontists end up canceling millions of appointments a year due to pain
insinuated reasons because it makes them unable to fully perform their job with effectiveness.
We should minimize sustained effort by brief but frequent rest or pauses, which can minimize

Levin

fatigue and can enhance productivity. Try to incorporate variety of different activities to shift
musculoskeletal demands from one part of the body to another (Sachan, Verma Panda, Singh),
and in doing this take a breath and loosen up. Adding fifteen minute breaks through out the day
will increase the your productiveness in the long run, and you will be able to work for many
more years than if you didnt take these breaks.
Yoga: Not Only a Healthy Lifestyle, but an Injury Preventative Technique
On that note that leads to the last prospective: yoga. Yoga isnt only a way to stay fit, but
its also a healthy lifestyle that you can only benefit from. It is built to emphasize the your
strength in the core area and when worked out properly your posture is improved, which then
leads the alleviating back, shoulder, and neck pain. Dentists and orthodontists should partake in
this exercise to try and reduce their injuries or at least try to relive them. Yoga does many things
for your body. It increases flexibility, increases your muscle strength, tones your muscles,
improves your breathing as well as your energy and vitality, maintains a balanced metabolism,
reduces weight gain, improves ones athletic performance, and protects you from injury. As a
matter of fact it is also a great stress reliever. Being in the dental field is just as stressful as being
in the medical field, so having this yoga time cannot only help you physically but also mentally.
Doing this by your self would be effective, but it should be a requirement for all the employees
in your office because of how beneficial it is. Doing a team yoga class could be fun as well, but
the most important part is it will assist everyone in this field with a less stressful life and a more
productive work ethic.
Although yoga is a great idea, any form of exercise that strengthens and relieves your
pain is a good start. Yoga isnt everyones cup of tea but getting out and exercising so something
you should participate in. Staying healthy will also reduce MSDs because the more active and

Levin

healthier you are the more prone you are injury. Stretching and being active will increase your
muscle strength, core strength, and endurance level, reduce muscle tension, promote circulation,
and so much more. Never underestimate the power of being fit and healthy, it works wonders and
prevents injury.
Insight
Having these good habits from the start will definitely decrease the amount of pain that
would be found if you practice with out them. Understanding that once you become involved in
this field you should partake in these suggestions, so you dont end up retiring at the age of forty
due to some preventable musculoskeletal disorders. Orthodontists tend to make a lot of money so
help your bank account you may want to recognize your best options. Taking a pain pill or going
to the chiropractor every so often isnt going to help in the long run. From the beginning, when
you start up your business, find out which ergonomic furniture is right for you, require yourself
and your employees to take various short breaks through out their day, and do some yoga. These
suggestions will help you stay in business longer rather than cutting your time short because of
pain related symptoms. Practicing good ergonomics will only be used to your advantage, so
exercise it to its full potential to do your job comfortably and pain free.

Works Cited

Levin

Baheti, Mayuresh J., Dr., and Nandlal G. Toshniwal, Dr. "Ergonomics: A Pain Free Dentistry for
Professionals." Orthodontics (2014): 54-61. Your Guide on the Path of Dentistry. Web. 2
Mar. 2015.
Kumar, Dodda K., Neelima Rathan, Sreevalli Mohan, Mohammadi Begum, Bhanu Prasad, and
Eswar Prasad. "Exercise Prescriptions to Prevent Musculoskeletal Disorders in Dentists."
Journal of Clinical and Diagnostic Research (2014): 13-16. NCBI. Web. 2 Mar. 2015.
Rafeemanesh, Ehsan, Zahra Jafari, Farzad Omidi Kashani, and Farzaneh Rahimpour. "A Study
on Job Postures and Musculoskeletal Illnesses in Dentists." International Journal of
Occupational Medicine and Environmental Health 26.4 (2013): 615-20. Versita. Web. 2
Mar. 2015.
Ratzon NZ, Yaros T, Mizlik A, et al. Musculoskeletal Symptoms Among dentists in Relation to
Work Posture. Work. 2000;15:153-158.
Sachan, Avesh, Karuna Singh, Sujit Panda, and Vinaykumar Verma. "Ergonomics, Posture and
Exercises - Pain free, Prolong Orthodontic Career." Journal of Orthodontic Research 1.3
(2013): 89. Web. 2 Mar. 2015.
Valachi, Bethany. "Ergonomic Positioning: A Few Degrees Add Years to Your Career."
Ergonomic Positioning: A Few Degrees Add Years to Your Career. Dentistry Today, 10
Sept. 2010. Web. 01 Mar. 2015.