How Can We Improve Ergonomics in the Operatory? Why is it so Critical?

You're listening to The Dr. Phil Klein Dental Podcast from Viva Learning.com. Thanks for joining us on the show. I'm Dr. Phil Klein. Dental professionals are particularly at risk of musculoskeletal problems that are often accompanied by pain. Today, we'll be discussing the five key areas where you can improve your ergonomic positions to protect your health. In addition to proper positioning for doctors, hygienists, and assistants, we'll be talking about dental equipment. that aids in clinician and patient positioning, as well as tips and tricks to promote overall health and safety. Our guest is Stephanie Botts. She is a clinical dental hygienist for over 14 years. She's a certified ergonomics assessment specialist, providing both in-office and virtual ergonomics consulting and coaching to dental professionals. Before we get started, I would like to mention that Stephanie will be presenting a live webinar on VivaLearning.com titled Addressing the Top 5 Ergonomic Mistakes in the Dental Operatory. It is scheduled for Monday, December 5th at 8.30 p.m. Eastern Time. If you're on the West Coast, 5.30 p.m. Pacific. Simply visit VivaLearning.com to register. The webinar is free and you can earn live interactive CE credit. Stephanie, it's a pleasure to have you on Dental Talk. Thank you so much for having me. So ergonomics is certainly a very important topic for all of us who practice dentistry. First hand, I can say I've lost part of my career as an endodontist due to ergonomic issues. And I went into another direction with my career, which turned out to be okay because I started Viva Learning. But for many dentists and hygienists and so forth, assistants too, it's a really important topic because everybody spends so much. time and money on their career to get it started. And you certainly don't want to cut it short due to back pain or something that's unbearable to live with. So I know this is kind of a loaded question because we're talking about ergonomics. I'll ask it anyway. What's the number one thing clinicians need to have in mind when practicing dentistry? Yeah, that's a great question. And I appreciate you saying your experience because I hear that a lot. And a lot of clinicians either have to drastically cut down their hours or leave the field altogether. And we did not go to school and invest that time and money just to have our career cut short. But I think the most important thing people need to keep in mind is that they are important too. It's more of a mindset. I think us as. dental clinicians, most of us are caretakers and we tend to put the needs of others before ourselves, which makes us great clinicians. It makes us really good at what we do, but then our body and our minds start to fall apart. And so I just really try to encourage people to put themselves first as counterintuitive as that may be, because if they don't, they will start to fall apart in more ways than one. The concept is very similar to OSHA, for example, whose entire existence is focused on the well-being of the employee, from safety to infection control and everything else. So I don't see why we can't look at it from the same perspective when it comes to ergonomics. We should be very concerned about ourselves and our team members. So ergonomics is a broad term that covers a lot. So if you can narrow it down a bit, what is the most important aspect of ergonomics that pertains to the dental clinician? Yeah. Yes. Ergonomic. There is a lot that fits under that word ergonomics. But the most important thing for us in the operatory is to focus on neutral posture. And there's a lot of aspects. It's not just sitting up straight. There's a lot of aspects to neutral posture. But once the clinician really wraps their head around that concept, that's their foundation. They can start a neutral posture. They can return to neutral posture as much as they can. And that'll help train them. And also. It helps them realize what unhealthy body movements are once they realize what healthy body movements are. So I think that's the most important part is neutral. So how does a dental clinician that doesn't really know very much about ergonomics, there was some training in dental school, not a lot. I missed most of those classes when I was in dental school for whatever reason. But how does somebody identify that they're going down the wrong path? you know, we don't want to wait for the symptoms to start coming up where they start to become uncomfortable practicing. What's the neutral position mean to the average clinician that doesn't know a lot about the science of ergonomics? Yeah. So neutral posture really is, it's just the position of the spine where it's the healthiest. And so if you're trying to establish neutral, I'll just give you some basic guidelines. You want the ear in line with the shoulder, which, and we're talking about profile view. So for most of us, Because we're hunched forward, we need to move our head back to get it in line with the shoulder. That should be aligned with the hip. So there should be one straight line there. We also need to have our feet flat on the floor. A lot of people cross legs or up on their tippy toes and do some crazy things with the feet. So we want them flat on the floor. And then our arms. We need to have our arms close to our sides with the elbows bent at about 90 degrees. So when someone gets themselves into that posture, then they can start realizing, oh my gosh, I'm leaning forward all the time, or I'm reaching a hundred times a day to grab my instruments. And ergonomics really, it's not rocket science. Like there's no genius to it at all, but it takes a lot of body awareness. So once someone feels what neutral is, they can really start to realize how much they're not in neutral and they can start to organize things like their equipment, their operatory to support. them in that neutral. Yeah. And I want to get into asking you about equipment in a second, but before I go there, in your experience, how much have you seen out there in the field where these clinicians are kind of violating that neutral position and leading themselves down a path where they're heading towards problems ergonomically? It's consistently every day. And I think that, and I don't know, sometimes it's just a lack of education. or it's they've developed these habits over time and they know that they're bad, but they don't know how to get out of them. It's like we start to be, we start to get comfortable in our discomfort, if that makes sense. Like we know that it's not good for us, but that's what we know. And I do think ergonomics equipment plays a big role in that. But it's not just equipment. It's also behavior. So it's a mixture of the two. And there's a lot of really good ergonomic equipment out there. Like Midmark, for example, has some very good large equipment and their systems. Like they have organizational systems that can really help us. But if we're not using that great equipment correctly with our behavior, then we're not really seeing the full picture. So you really need both. You need behavioral changes that are... and I don't use the term aligned as a pun, but you need behavioral changes that are aligned with good ergonomic practice. And then you need equipment, obviously, to support that. Because if you don't have good equipment, then you're kind of compromising, right? And you're changing things that you know aren't really correct to accommodate equipment that's not designed for good ergonomics. What is it about Mintmark stuff that is so in alignment with good ergonomics? One of their main focuses is ergonomics. They put a lot of attention in their engineering and their research on what's going to be good for the dental clinician. One of their things that I love is one of their patient chairs. It is highly adjustable. it's got a swivel base which i recommend i recommend sitting at 12 o'clock as much as you can sometimes it's hard to access 12 o'clock because of the um operatory layout and you have to swivel the chair a little bit so you can access 12 o'clock and they've got a really good system for that so they've got a lot in their headrest this the size and contour of the headrest on the chair really It cradles the patient's head, but then it's adjustable so we can control the occlusal planes. And that's just, I mean, they've got a lot of equipment that's really good for us. But if we don't know how to use it and maximize the efficiency, so that's where the behavior modification comes into. So patient comfort is, of course, a concern when you... a dental chair but the way the chair is ergonomically designed and manufactured is so that the clinician can get into a position and treat that patient where they're not compromising based on providing more comfort to the patient like a real thick headrest for instance whatever would put the patient's head in a certain position where the doctor would have to compromise to get in there you're saying that they look at both sides They do, yeah. And I would say that they engineer their equipment with the clinician in mind, which is great for us. Also, the backrest on their chairs. I have a problem with really thick backrests. That's great for the patient. It's comfortable, but it's very difficult for us. And so they take all of that into consideration when developing their products. So what would you say would be the biggest? mistake that dentists are making consistently with their posture when they're in the operatory? Let's talk about the operatory. Is it something that's related to leaning over all the time, direct vision? Is it working with the assistant? And if you want to speak on behalf of the staff as well, the assistant who's forehanded dentistry is obviously a big part of it. What are your feelings over the years that you've seen that doctors and staff could look for? quickly to try to rectify some of the issues that they're having? I would say probably the most common mistake that I see is improper patient positioning. Because if their position dictates ours, and so we have to make sure that we're really being deliberate, especially if you're working on the lower arch versus the upper arch, those are two completely different positions. And I would say across the board, dentists, assistants, and hygienists all. most of the time have issues with patient positioning. And so if we can just start with that and get our patient in the optimal position, it's going to make our appointment go so much better. Yeah, very good point. So does Midmark have a training program or some way they communicate with the dentists and the team members about incorporating some of this ergonomic equipment into their practice so that they can work towards? eliminating some of the issues they're having? Yeah. So from what I know, the sales team is very educated on ergonomics and they are educating their clients when they're talking about equipment. So they're not just selling them chairs and throwing equipment at them. They're actually discussing what's going to be best for their model of practice. Maybe this chair is going to be good for a restorative room, but maybe not so much for a hygiene room. And so they're... They're really tailoring what they recommend to what the client needs. Yeah, that sounds outstanding. So tell us about your training. You do some virtual ergonomic training online. You have your own company, training company, or how does that work? Yeah, so I started my company in 2021, last year, and it's called Posture Pros. And so what I'm doing is I do virtual, but I also do in-person assessments and coaching. My aim is to give the most practical advice to people. I can tell people to sit up straight all day, but how do they do that with the equipment that they have? How do they do that with the patients that they have? And so I'm working with people. as they're working on patients in real time so that I can really give them some usable advice based off of their procedure and their operatory design. And it's all different. It's not cookie cutter at all. So it's actually been really fun for me to figure out what's going to work for different people. It's not the same recommendations across the board. And can you do that effectively virtually without always going into the practice? Yes. And I'm really happy that I can. Actually, Zoom has worked out quite well for these virtual assessments. We log on. I help the clinician position their phone. I usually do. I'll have them position it towards the foot of the patient so that I can see them more straight on. And then I have them. put it off to the side so I can see the clinician's profile. And then I also am looking at their operatory design. And so it's been a really nice, convenient way to offer the service. I do have some companies or some larger, I would say like DSOs and corporate dental that will fly me out to do assessments, but most of the time that's not in the budget for a lot of people. So virtual has been really nice. That's phenomenal. It's really, really. entrepreneurial of you to do something like this. Do you find that dental teams are reaching out to you after the fact, like they've already experienced some issues and they go, wow, you know, I'm starting to feel like I'm doing things incorrectly and I'm not very comfortable doing the routine things that I did two years ago. Or do you think they're getting to you earlier more as a prevention path? I would say most of the time, and I'm hoping this will change, but most of the time it's after they're in quite a bit of pain, which is tough. It's just like when a patient comes in, it's much easier to treat a demineralized area or even a small carious lesion versus. a crown or a root canal. We wish that they would have come in sooner. So it's the same. I'm hoping that people will start to think more preventively for themselves and just get this foundation as early in their career as possible so that they don't end up with issues. It's tough when people are already in quite a bit of pain when I start to work with them because typically they need other services too. They need to see, you know, chiropractor or physical therapist or posture therapist as well. So the earlier, the better. And it's funny because it's just what we tell our patients. Like we understand the prevention model with our patients, but when it comes to us, sometimes we don't quite see it that way. Yeah, that's very typical. So what's the best way for a dental team to reach out to you? I would probably say my website. It's posturepros.net. I'm also, and on my website, it obviously has links where you can contact me. I'm pretty active on social media as well. That's probably where I get most of my clients and my leads from. And so I'm pretty active on Facebook and Instagram too. But all of those links are on my website. Yeah. Hats off to you, Stephanie, for a great new company that you've launched. And it's really exciting to see. what you can offer dental practitioners who are so busy with so many other things in their practice, they just don't really focus on the ergonomics because it's not, if it's not broken, why fix it? You know, that kind of mentality. And that's really something that they have to think differently about because a career in dentistry could be what, 40 years? I don't know. Mine didn't last that long. Yeah, right. Hopefully. If you're enjoying it, right? You don't want to do 40 years of something you don't enjoy, but based on the dentist I'm talking to, most of them really love their work. in many ways but it's a challenging profession and having someone like you guide them through these kinds of challenges and keep them in in the right path is really important and it's nice that you're working with a company like midmark who makes different types of equipment in the operatory that are perfectly designed in many ways to maintain good ergonomic posture and so forth so we really appreciate having you on the podcast thank you so much and we're looking forward to you as i mentioned in the introduction your webinar on Monday, December 5th, 8.30 Eastern Time. For those of you on the West Coast, 5.30 Pacific. Thank you so much, Stephanie, and look forward to hearing from you again. Thank you so much for having me. I appreciate it.