POSTURE OF THE DENTIST I. Introduction The dentist must maintain a single posture for many hours a day.

Poor postural habits may cause fatigue, tension, muscle spasms, numbness in lower limbs, joint discomfort, and circulatory problems. Correct posture will reward the dentist with increased comfort and productivity. This program presents a seated working posture that is effortless and easy to maintain over an extended period of time. Based on principles of anatomy and physiology incorporated into a set of postural criteria, the program describes a posture in which the upright spine makes fewer demands on muscles and minimizes pressure on body cavities. Sitting erectly places less stress on the intervertebral discs, and the ligaments anterior and posterior to them. Benefits and Anatomical Elements of Correct Posture A. Correct posture will reward dentists with increased comfort and productivity B. Poor postural may habits lead to fatigue, tension, muscle spasms, numbness in lower limbs, joint discomfort, and circulatory problems C. The seated operator conserves energy and has a longer life expectancy D. Three principles of anatomy and physiology related to ideal posture: 1. spine erect, correct position of spine is a most important consideration 2. muscle activity conserved; an upright spine makes fewer demands on muscles) 3. body cavities follow proper form; an upright spine minimizes pressure on body cavities Sitting Erect A. a basic key to maintaining a comfortable position over the course of a work day 1. ensures proper relationship of vertebrae and discs forming curves of spine (cervical, thoracic, lumbar, and pelvic) 2. all four curves should coincide with the midline center of gravity B. places less stress on intervertebral discs and ligiments anterior and posterior to them

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the recommended position for arm placement allows greater muscle relaxation and promotes maximal performance within minimal range of motion V. sitting erect is a more balanced position for the muscular system 1. The Body Cavities A. the relationship of discs and ligaments helps to stabilize the spinal column and maximizes stability when vertebrae are stacked upright 6. discs are insensitive to pain 4. the upright spine exerts less pressure on the discs than poor posture D. balanced position minimizes uneven muscle pull 3. improper posture (bending forward) displaces the center of gravity. discs are shock absorbers for the body 3.C. excessive pressure on discs may weaken the discs and cause herniation of the soft central part of the disc (this condition is mistakenly referred to as a “slipped disc” I. At this location. head and trunk should be balanced on spinal column and legs by pull of opposing muscle groups 2. sitting erect minimizes pressure on the discs and distributes body weight more evenly over load-bearing surfaces F. the pressure on discs in greater when sitting than when standing or reclining E. anatomical structures 1. the disc between the last lumbar and first sacral vertebrae is the site of greatest stress – 70% of disc herniations occur here. The Muscular System A. the posterior longitudinal ligament measures only half the original width IV. following skeletal and muscular guidelines maintains correct body cavity alignment . herniated discs can irritate spinal roots and nerves J. and pain-sensitive ligaments securing discs may fatigue or stretch H. G. the anterior and posterior longitudinal ligaments secure the discs between the vertebrae and are sensitive to pain 5. improper posture causes body weight shifts to a portion of weight-bearing area of discs and vertebrae – resulting stress may jeopardize longitudinal ligaments and discs. involving the abdominal muscles helps support the back and lessens fatigue B. intervertebral disc (fibro-elastic mesh with a soft gelatinous center) between each vertebra 2.

maintains proper form of thoracic. sitting erect 1. allow the spine to contact the back of the chair 4 to 6 inches above the seat) 2. legs 3. avoids undue pressure to internal organs (lungs respire at normal capacity and intestinal passages are not compressed) 3. and misalignment of the vertebral column E. support and straighten the back (choose a chair with a firm seat and back. maintain 12 to 16 inch distance between your eyes and the patient’s mouth to allow for adequate illumination and room to place the forearms correctly 2. hold the elbows at sides about 2 inches lower than the patient’s mouth 3. keep feet flat on floor G. lower the chair height and keep the thighs parallel to the floor 3. and restrict muscular function inside and around the body cavities VI. the postural criteria for the dentist to maintain good working posture are grouped into three areas 1. avoids pressure that may pinch blood vessels and nerves. abdominal. flat chair back permits lumbar spine to be erect and prevents flexed position causing strain and fatigue C. adjust the chair height to meet guidelines for legs 1. trunk and head 2. recommendations for the trunk and head 1. adjust chair height so that the hips are slightly higher than the knees – if this is not possible. A bent back can cause increased muscle pull in the back. for good visualization – bend neck forward slightly and direct eyes downward F. arms B. Posture of the Dentist A. hold shoulders parallel to the floor D. decreasing the pull in the arm and shoulder muscles . keep forearms basically parallel to the floor.B. compression of the internal organs. place both feet flat on the floor 2. suggestion for arms 1. minimize stress on the lower back and pressure on posterior thighs 4. and pelvic cavities 2. lean forward as seldom as possible (lean only from the hip and never bend the back. hold the lower legs perpendicular to the floor allowing adequate blood circulation to the lower extremities 5. firm.

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