The 3 Keys to Preserving A Dentist's Health

For all of you that were able to attend the Dentist Health & Ergonomics presentation last month at the Englewood Henry Schein office, it was great catching up again.

Just a quick follow up on what we discussed-


Most of you were already well aware that your ergonomics in the operatory could certainly improve.  By it quickly became apparent that it seemed the biggest issue was how to implement the suggested ergonomic changes- without in turn affecting your patient’s overall comfort.

So in this article there are some follow up thoughts on that very topic...



The biggest challenge discussed was certainly- 
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How to tilt the chair back for healthier dentist positioning- without making the patient uncomfortable & unhappy?



Well often times, especially with older patients, these patients don’t tolerate neck and spinal extension as comfortably as they did when they were younger.  Time and gravity has tended to lock their bodies into more kyphotic or rounded postures.  So how to best respect their bodies and yours while treating their teeth.  

One of the best ways of ensuring that the patient is comfortable, even when tilting them back, is to support their spine with supportive cushions.  As you can see from the picture, the supportive cushions will often allow the patient to be much more comfortable while also allowing a more horizontal posture.

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When placing a supportive cushion under your patient's neck to clean the upper arch, prepare them for their new more extended neck position  You might say something like- “I’m just going to help support your head with this cushion and tilt your head back for a few minutes so that I can reach that decay and really clean these top teeth thoroughly.  And then I’ll we’ll come right back to this position again.”  Just a few words like this to reassure them can help reduce any additional anxiety and tension that might arise from being in the position.

Similarly, here is another strategy to reduce any prolonged patient tension or anxiety.  As busy as things get throughout your day, 


An occasional patient “mini-break” helps to reassure the patient


The biggest disappointment I think I’ve ever had at my dentist’s office was…  the day he got rid of his “sippy cup and spit” beside the chair!  I was admittedly in love with that contraption!  Whenever things got a little too intense, I could always look forward to that little break and sip of water that I knew was just a few moments of displeasure away. Ok, the sip cup and spit fountain beside the patient chair may be gone forever.  But the occasional promised patient mini-break doesn’t have to be.  You’d be surprised at how much even just a few brief mini-breaks during a treatment would decrease patient tension and anxiety.  And by helping to reduce any sustained emotional tension, you’ll quickly discover that it will likely also reduce most complaints of physical tension and discomfort as well.  

And as an aside- it would also reduce the likelihood of patient TMJ issues.  Trismus and other jaw pain issues that arise occasionally in the dental office most often occur with prolonged patient TMJ opening in the presence of higher amounts of jaw tension/anxiety.  Many of these might be avoided by decreasing prolonged jaw opening and measures of reassurance to reduce their anxiety and tension.

If there is an area of the upper arch that requires prolonged work, remember that the patient’s head is in an extended position that for many can be slightly more uncomfortable.  Perhaps after working on that area for a while you might consider giving the patient a mini-break from that neck position to work on another area of the mouth. Then, of course after a respite come back to the upper arch again later and continue.


One of the endodontists at the presentation has an excellent ergonomic set-up in his office and he offered this strategy.  To ensure that he remains in a comfortable and healthy posture throughout the day, he will

Very gradually tilt the patient’s chair backwards throughout the treatment.

By gradually lowering the patient, the patient typically isn’t even aware that their position has changed.


And finally, just a reminder, even if you still struggle to lower your patient as they just don’t seem to tolerate lowering the tilt of the chair...  


You can still focus on 2 other things to improve your daily body mechanics and long-term health.


1.  Your elbows, which should be located along side of your body with your arms relaxed, should be at the same level of your patient’s mouth.  When in this correct position, your forearms will be parallel to the floor.


As a reminder, keep in mind that ideally your dental stool should be at a height where your hips are higher than your knees.


2.  You should also consider a stool which allows you to be closer to your patient.  A saddle stool will allow you to open your legs to position yourself closer to your patient.  This will allow you to see in the mouth without hunching your spine and allows less strain and reaching toward the patient.

Best of luck with all these tips!  And I'm sure many of you have suggestions of your own.   Please feel free to help others by sharing them in the comments below.