CDA Presents: Mind your body to avoid back, neck problems

SAN FRANCISCO - Dental professionals should make regular exercise and good posture part of their daily routines to avoid back and neck problems, according to a presentation at the California Dental Association's CDA Presents conference.

Juli Kagan, RDH, a certified pilates and yoga teacher, noted that dentists, hygienists, and assistants spend much of their day leaning over, making them extremely prone to back and neck soreness and pain.

"I really believe that what we do as dental professionals -- the way we take care of patients -- is an athletic event," Kagan told a well-attended session that attracted more than 200 people.

The concept of "four-handed" dentistry (dentist and assistant) began in the late 1960s in some of the more progressive dental schools, because dental professionals were complaining about back strain, Kagan explained. Equipment designers began making chairs for "sit-down" dentistry.

Sit-down, four-handed dentistry may have increased production, but it did not reduce the number of problems that dental professionals faced regarding musculoskeletal disorders, she noted. In fact, it may have had an inverse effect, Kagan said.

She encouraged everyone to find some type of exercise and do it at least four times a week. "Sprinkle exercises for good posture throughout the day," Kagan suggested, and she led the group through a series of simple exercises to reduce hand, neck, and back pain.

Some 62% of dental professionals complain of neck pain, and 81% said they had shoulder problems during the previous 12 months, according to Kagan.

Studies show that physical exercise could act as a prophylaxis against musculoskeletal illness and stress for dentists of a wide range of ages, she said.

Because dental professionals spend most of their day in a forward flexion position, most of their abdominal muscles are relatively stronger, compared with their back muscles, Kagan noted. To strengthen back muscles, she advised lying on your stomach and lifting your arms and legs.

Lifting weights and swimming also are good to keep muscles flexible and strong, she said. Massages help stiff and sore necks and backs as well.

And rather than twisting your body around the patient, Kagan recommended first getting comfortably seated, then move the patient toward you.

"Contort your patient, not yourself," she suggested. "Sit for the maxilla, stand for the mandible," Kagan advised.

Although a variety of chair designs, ranging from balls to saddle types, claim to be ergonomic and improve posture, she offered this simple advice: "Get one that fits your butt." Crown Seating makes custom-fitted chairs that she prefers, she said, adding that the company doesn't pay for the endorsement.

Kagan also offered these helpful hints:

• Use loupes to avoid bending over too much. "Your diagnoses will go up 100%, and it helps spot calculus and caries," she said.
• Use sharp instruments to avoid straining fingers and hands.
• Do finger and wrist exercises to increase circulation from gripping instruments tightly.
• Computer monitors should be at eye level to avoid slouching and keep the neck in a neutral position.
• While sitting, the hips should be higher than the knees, not at 90° angles.
• For obese patients, she suggested standing during treatment to maintain better posture.
• Rather than sitting on the edge of your chair, Kagan advised sitting in the center, with your knees wider than your hips, and leaning forward rather than bending over.

She also recommended having someone take your photo while you're working so that you can see how to correct your posture during treatments and at your desk.