Align for Success: How Ergonomics Will Help Your Practice and Your Life

You're listening to The Dr. Phil Klein Dental Podcast from Viva Learning.com. Welcome to the show. I'm Dr. Phil Klein. Learning how to sit and stand should be natural. But when you're operating in a field of vision that is smaller than a tennis ball, and that field is often not in a perfect position, we need to look at instruments, equipment, and body mechanics that will help us maintain our body's health for practice longevity. To tell us more about this is our guest, Dr. Sheri Doniger. She's a respected dental clinician, author, educator, and a consultant who currently practices dentistry in Lincolnwood, Illinois. Before we get started, I would like to let our audience know that Dr. Doniger's webinar titled Align for Success, How Ergonomics Will Help Your Practice and Your Life is now available as an on-demand webinar on VivaLearning.com. Simply type in the search field Doniger, D-O-N-I-G-E-R, and you'll find the webinar. It's an excellent class for every dental team member to watch. Also, I would like to thank our sponsor, DentalEase. DentalEase is a dental supply company committed to providing state-of-the-art dental practice solutions for unlimited interconnectivity, choice, and control. A true dental pioneer, the company stands as an indispensable industry staple with over 100 years of experience in dental equipment. So thank you, DentalEase, for sponsoring this podcast. Dr. Doniger, it's a pleasure to have you on Dental Talk. Phil, it's an honor to be here. I'm so excited to talk about one of my favorite topics. Yeah, we're happy to have you. So to begin, why should clinicians be concerned about ergonomics? Well, we should because we were taught it in school and we all forgot. And what will happen is because we pretty much are in a profession that turns our body into a pretzel on almost a daily basis. If we don't consider how our body functions and ergonomics and what our instruments weigh and all sorts of other things, we're going to be all hunched over by the end of our practice career. And I'm here to say after, shall I say it out loud, Phil, 50 years of being in the dental profession that my posture isn't that bad. And except for a few aches and pains, I'm doing okay because I've been following some pretty serious ergonomic rules during the course of my run from assistant to hygienist to dentist. Yeah. And I could be a testament to poor ergonomics as an endodontist. I had to retire earlier than I would have liked. Our generation didn't have the endodontic microscope. I used a lot of direct vision and it just really jacked my back really badly. So I had herniated discs and I practiced for a couple of years past the point where I was very uncomfortable. Luckily, I found a new career with Viva Learning. So that worked out very well. I've been doing this for 22 years. But yeah, I did not pay enough attention in dental school when they taught four-handed dentistry and ergonomics. And I wish they stressed it even more. So what is the best posture for clinicians? Well, it's probably not how anybody is sitting right now. Because when you're sitting and standing and walking, your ear really should be above your clavicle. And if your head is further forward than your chin is further forward, then you're really straining your upper back and you talk about disc injuries and you're... getting yourself into a really bad habit and as you said you know the the posture the the direct vision that we're doing um is not right um i i know um my friend tim caruso always talks about peeking and perching and that's pretty much what you were saying you know we want to get on the edge of the chair and we want to look so The best posture for clinicians is really to try to keep your back as straight as possible. When you're sitting in the dental chair, your hips should be higher than your knees and your feet should be flat on the floor. And that seems kind of counterintuitive, but you want your feet to be flat on the floor for a couple of reasons. First of all, it helps balance you. Second of all, if your feet are up on the rung of the chair, you can... Lean too far forward and not even think about it. So it's just best to be sitting in a proper position with proper posture and also asking the patient to move towards you. Patients are in the chair for anywhere from, you know, 15 minutes to a couple of hours, and we're doing this all day long. And if they're uncomfortable for a couple of seconds, well, you know, just say, I want to do my... excellent dentistry on you and i can't if i can't see it's very difficult for me to work on you if i can't see so asking the patients to move towards you to help you maintain a posture and you maintain your steady field of vision is really important when a doctor is or a staff member is trying to correct their posture okay so they haven't been doing that great over the years they heard your podcast they watched your great webinar or they have a health advisor that's saying, listen, you know, a chiropractor, whatever, you need to change your posture. What is that period like as far as time and difficulty to make that behavioral change? Is that something where they're really aware of it for the first month or two and then it becomes more natural? How long does that take and what's that process? I agree. It's, you know, you're really aware of it in the beginning and being aware of it is a good thing because then you know you're doing something incorrect. um because all of a sudden you start doing the pegging and perching thing and you go oh wait i'm not supposed to be doing that i'm really supposed to be doing more indirect vision as you were saying you know we were doing more direct vision and i resemble that too i've done that i've done a lot of you know in uh direct vision as opposed to the indirect vision But I think if you take some time and breaks between patients and can actually either stand against the wall and make sure so you could feel what it feels like for your back to be straight, your spine to be straight. If you do that a little bit more than once or twice a day. then it's a lot easier to transition into a better posture because you know where your shoulders are supposed to go. You know where your spine is supposed to be. And it's better for you to recall, you know, muscle memory is the best thing. It's better for you to recall after practicing. And even practicing in the office is a great idea. Once you're at the point, though, where you have some symptoms, that's not too late, of course, because you could change your ergonomic habits and get in better position so that these symptoms go away. But you really want to... start this process of improving ergonomics when the symptoms appear, right? You want to get that before that happens. There should be some handbook or something every dentist has to read, right? I mean, you got to read. It's like the California Dental Practice Act or some crazy laws they make you read. Ergonomics is really critical to longevity. Absolutely. Yeah. Have you written anything on this? I've written articles, yes. I've written articles on ergonomics and how important it is to actually, we want to practice for a long time. We want to practice for as long as we want to practice. And I'm sure your practice life was cut short because of you. injuring yourself and the last thing we want to do is injure ourselves after you know we've put whatever debt we did you know to get it get ourselves through dental school and all the education um i think it's it's good if it's good to work on ergonomics before you get injured it's good to work on ergonomics when you just start to be injured and of course it's good to work on ergonomics after you were injured and um in my podcast i mentioned if you're in discomfort seek medical help. One of the things that I had done to me was called dry needling. And what they did is they, because I just had such acute pain in my upper back that I couldn't move. I just couldn't function correctly. And lifting anything was a pain and in more ways than one. And they do this dry needling technique where they take a needle and they literally go into a tight bunch of muscles and know how to manipulate it. And after a period of time, it does relax and it does. it does work but you also have to be doing the right things and i think one of the things you had mentioned was seeking out professionals be it an exercise specialist that knows about ergonomics somebody that specializes in dental ergonomics there's several people that are out there that do yoga for dentists that's great and again i think i think if we all would focus a little bit on spending a few minutes of each day, even after between the patient, stretching, stretching in our chair just to get in our dental stool, just to be able to get our spine back in alignment and get the blood moving. And the other good part about that, and I mentioned this and it's a little off your topic, but when we do do these stretches in our office, it gives us a couple of seconds to be just, you know, to not be stressed, not to think about something, just to kind of get our back and our body back into, you know, into shape. Some companies, some manufacturers are very focused on ergonomics more than others. So dental equipment and hand pieces, small equipment, large equipment, play a role in this. Tell us about what we should be looking for in dental equipment to support good ergonomics. My biggest suggestion about dental equipment is you really need to go try things. You need to feel them. You need to feel them in your hands. You need to see how something feels, how your body sits in the chair. It's kind of like Goldilocks going and checking out all the chairs in the house to see what fits, what's the most comfortable. A couple things that I think are very important are illumination and magnification. Both of them will help with sitting in a straighter posture and being able to see at the proper angle and the proper distance away from the oral cavity. Very key, very important. When we look at lighting in the operatory, I'm a huge fan of LED lights. I know Forrest has a great one. I used the one that was before that when Dentalese had their initial LED lights. That was the best addition to my operatory. It was lightweight. It was easily moved. It didn't make the patients crazy and the bulbs last forever thinking about instrumentation you really should try different instruments to see how they feel in your hands some are a little heavier than others some are back heavy some are you know some are too wide some are you know some are just are not wide enough when I was in dental hygiene school one of the things that they the instructors came by and sort of as we were scaling and we stopped they came by and kind of hold on the instrument and they want you know they want to make sure that you're not gripping any instrument with a death grip and that's something that i think clinicians need to be aware of um hand pieces they've got all sorts of phenomenal cordless preventive hand pieces now that aren't tethered with a cord so you're not constantly fighting the cord um a a hand piece i think we should be looking at lightweight very hand-friendly, balanced, stable in your hand, minimum effort to, you know. prep the tooth so you're not having any fatigue. Illumination, of course. There's this awesome handpiece, again, by Dentalys. It's called the Ares 500, and it's got this really amazing RAFD technology. When you use it with a compatible reader, it will track the handpiece. In addition to all these great things of being lightweight, and it has a swivel that's like a dream. Believe me, the swivel is like a dream. But it'll tell you where, how many times it's been sterilized, when the last time it was sterilized, and actually where it was in your office, if you have this little reader. But that's, you know, I've been using Star handpieces since dental school. So I have evolved through, you know, their creation of handpieces. That's exactly the same company and brand that we used back. Right. You know, well, I think we probably went to dental school at a similar time, but Star was in our kit. That was part of our kit. But Dental Lease has evolved over the years, and they really do focus on ergonomic products. They also have an interesting line of dental equipment as well. But as I said, I've been a fan of their LED lights and obviously using their hand pieces for a very long time. The other thing that you need to consider going back to equipment is electric hand pieces. They're not as heavy as they used to be. And there's some great electric hand pieces out there. Don't be afraid of electric hand pieces. But the most important thing for any of these things, hair polishers or intraoral cameras or anything is you really need to feel what they feel like in your hand. Because, Bill, honestly, something that feels great in your hand may not feel good in my hand because, you know, of the years of practice differential or how I hold an instrument or how I'm sitting or even left-handed and right-handed. I think it's so important that everybody tries before they buy or at least have the ability to try and see what it feels, see what the instruments feel like. Absolutely. I think that's really important. In fact, with consumable products like bonding agents and flowables, the companies often send out samples and say, hey, you want to try something that we think is going to work really well for you? And a lot of these manufacturers don't expect a dentist to buy a product like a consumable material before they try it. Now, with a handpiece, it's a little bit different because the company just can't be sending out sample handpieces. So what's the best way to try a piece of equipment like that? Well, you know, dental meetings are coming back. They're not roaring back, but they're coming back. And I think it's wise if you are in need of any of these products that you get to go to one of the local dental meetings, like the state level or, you know, the national level or any of the regional meetings that are available. A lot of times dental reps from companies will come out to your office and let you sample a product and sample hand pieces. I have done this on numerous occasions. I wanted to see what it feels like. And I was able to try a handpiece for a month or so, get the feel of it, see what it feels like. And then, you know, it's if I like it, I like it. If I didn't like it, I'd try another handpiece in their line or somebody else's line. But I think, again, I think it would behoove us considering how expensive things cost. clinicians to be able to try something before they buy it and you know your practice life is basically at risk if you're using something that's too heavy you know you're gripping it too hard and it's it you know you're twisting too hard to to to see something so it's just so important to be able to to evaluate it in your own hands. Yeah, no, very, very insightful information, Dr. Doniger. We appreciate your time. We certainly appreciate how important it is to get ahead of ergonomic problems before they begin, because trying to fix things once they start to break down is always more difficult. And since we've started this podcast, I've adjusted my posture with my microphone. So I already feel better. I think I'm moving in the right direction here. Thank you so much. Yeah, we hope to see you on more stuff with Viva Learning. You're a great KOL, great speaker. We enjoyed your time. Thank you, Dr. Doniger. Thank you. Have a great rest of your week.