Levin

Caylin Levin
ENC 1102-0M12
April 14, 2015

Red, Thesis; Green, claims; Yellow, evidence; Blue, signal

phrases and in-text citations;
No Pain No Gain, Even in the Dental Field
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 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. The increasing number of work injury related dentists and orthodontists prompts
one 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

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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 in this paper
are acquiring ergonomic furniture, taking more frequent breaks, and physical exercising like
yoga.
Musculoskeletal disorders in professions like doctors, nurses, and athletes 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. Ehsan Rafeemanesh is in Occupational
Medicine, a faculty of medicine, with the Mashhad University of Medical Sciences, in Mashhad,
Iran. Zahra Jafari is in Occupational Medicine Department, a faculty of medicine, Pardis, Park
square, Mashhad, Iran. Farzad Omidi Kashani is in the Occupational & Environmental Health
Department, Torghabe-Shandiz Health Center, Mashhad University of Medical Sciences, and
Mashhad, Iran. Finally, Farzaneh Rahimpour is an orthopedic, a faculty of medicine at Mashhad
University of Medical Sciences in Mashhad, Iran. Their main argument is to relay back the
information the researchers found about Work-related Musculoskeletal Disorders (WMSDs) and

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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 58 dentists in Iran to see which body part receives the most pain and this is what they
found:

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.
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:

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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).
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

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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
working easier and overall youll feel better in the long run.
Kumar, Rathan, Mohan, Begum, Prasad, and Prasad in Exercise Prescriptions to Prevent
Musculoskeletal Disorders in Dentists express 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 lessen 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.
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 statement from the MusculoskeletalSymptomsAmongDentistsinRelationtoWorkPosture
byRatzon, Yaros, and Mizlik implies that changing positions should be required for dentists and
orthodontics and taking breaks 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

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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 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 stretch. 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.
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 not only 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, but it is a good 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. 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.
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

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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
Baheti, Mayuresh J., Dr., and Nandlal G. Toshniwal, Dr. "Ergonomics: A Pain Free Dentistry for

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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.
RatzonNZ,YarosT,MizlikA,etal.Musculoskeletalsymptomsamongdentistsinrelationto
workposture.Work.2000;15:153158.
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.