A pain in the neck and the back is not the way you want to perform in the dental profession.
But let's step off the treadmill and re-evaluate the situation. Let's look at the operator, the performer, in fact you! Now let's look at that nagging neck and back. Years of poor posture, various accumulations of musculoskeletal injuries seem to tire and cause pain on the least minor task. If you are reading this and start to realise why I you can no longer get out of the chair or reverse the car without being 100% dependant on mirrors, then read on.
Core Skills
Lifelong education and skill acquisition from postgraduate learning keeps you one step ahead in running a successful practice. The following is the secret to delivering quality primary dental care:
- Good financial planning
- Good time management -"Work expands to fill the time available...." Parkinsonâs Law)
- Good communication skills
- Work performance - integral part of team, delegation, job description, positive reinforcements
- Keeping the patient happy - your business asset. Does this practitioner have my interests first or their financial priorities first?
- Learn how to enhance the practice by reducing your stress and improve your physical and emotional well-being.
Finally, the interaction of the clinician and their work system. If you learn how to be 'practice smart' and work within your capacities then you will your reduce your stress. In fact this is the basis of ergonomics.
Back injury mechanisms
If you are limited by musculoskeletal symptoms, there will be impairment in your ability to deliver your professional skills. This will slowly lead to a reduction in confidence and burn out sets in. The MRI scan shows a middle aged dentist who has significant cervical disc degeneration affecting the C567 region resulting in upper limb neuropathy. The practise of dentistry is completely impaired as the practitioner cannot work without the symptoms of pain and altered dexterity occurring. Fig 1
The tissue bio-mechanics of tissue creep from poor posture (postural, work related) will finally result in the spinal tissues failing at the segment where they have been subjected to this level of strain. In dentistry, one vulnerable area is the neck region where poor posture has occurred due to the operator concentrating on performing with direct vision. Fig 2
The implementation of correct ergonomic equipment, training and awareness in all members of the dental team will hopefully reduce this musculoskeletal disorder that has commonly affected the dental profession. As a health care professional, we have a duty of care towards our patients and also ensure that we have a livelihood. Looking after ones health has to be the cornerstone of your practising strategy.
To learn more about the 'Happybacks' course, please email [email protected] for details.
Dr Richard Pilkington
BDS,MBBS,FDSRCS
References and Further Reading
Freeman R, Main J, Burke F. Occupational stress and dentistry: theory and practice. Part 1-recognition. British Dental Journal. 1995;178:214-217
Freeman R, Main J, Burke F. Occupational stress and dentistry: theory and practice. Part 11 - assessment and control. British Dental Journal. 1995;178:218-222
Burke FJ, Main JR, Freeman R. The practice of dentistry: an assessment of reasons for premature retirement. British Dental Journal. 1997; 182(7):250-254
Rundcrantz BL, Johnsson B, Moritz U. Pain and discomfort in the musculoskeletal system among dentists - a prospective study. Swedish Dental Journal. 1991a; 15(5):219-228
Rundcrantz BL, Johnsson B, Moritz U. Occupational cervicobrachial disorders among dentists: analysis of ergonomics and locomotor functions. Swedish Dental Journal. 1991; 15(3):105-115
Marklin RW, Cherney K Working Posture of dentists and dental hygienists J Calif Dent Assoc 2005; 33,133-136
Murphy DC, Ergonomics and the dental worker. American Public Health Association, 1998
Michael Adams, Nikolai Bogduk, Kim Burton, Patricia Dolan "The biomechanics of back pain"
Churchill Livingstone, second edition 2006 Checked by ME on 15.2.11 Image: 'happy backs 1' 'happy backs 2'