Reducing Musculoskeletal Injuries with Technology

The use of proper ergonomics includes adjusting dental hygienists’ work environments to help them be more effective and efficient, while minimizing the risk of injury. New technology has entered the dental operatory that may provide ergonomic benefits to clinicians. Some technology advancements are quite common, such as loupes, lights, ergonomic seating, and earplugs to prevent hearing loss. Others have been introduced more recently and are slowly gaining a place in clinical settings. These technology advances include incorporating electronic dental/ health records, digital radiology, and use of photography for workplace evaluations.

ELECTRONIC HEALTH RECORDS

The advent of the electronic health record (EHR) may help clinicians maintain proper ergonomics. The design of EHRs should enhance clinical practice, as information is presented clearly and accurately and they are simple to navigate.¹ EHRs’ ease of use may help dental hygienists limit awkward postures and repetitive motions. The addition of foot-controlled charting and headsets can save clinicians time.

DIGITAL RADIOLOGY

Digital radiology can improve the safety and efficiency of the work environment in a variety of ways.² First, digital radiology eliminates the need to use chemicals to develop radiographs, improving safety. Digital radiology also reduces patient exposure and processing time, allows for efficient communication of electronic information, and provides portability.² The incorporation of digital radiology allows faster integration of radiographs into the patient record, enabling the ability to quickly share the data with other providers. All of these benefits improve efficiency.

DIGITAL IMPRESSIONS

Digital impressions are a new technology that reduce the need for repetitive procedures and save time. One advancement is the use of intraoral scanners to capture optical or digital dental impressions as an alternative to conventional alginate impressions. Although these computer-aided technologies are mainly used for dental procedures, studies have shown a time efficiency benefit, as well as increased patient comfort.³ One study found that taking computer-aided impressions was significantly faster than conventional impressions.³ Their use may reduce the need for repetitive procedures. A 2017 ­literature review showed optical impressions reduced patient ­discomfort, improved time efficiency, simplified the procedure, eliminated the plaster cast, and improved communication with the dental ­technician, as both have access to the impression in real-time.⁴

HEARING PROTECTION

Noise-induced hearing loss can be an occupational hazard.⁵ There are several sources of noise in the dental setting: handpieces, ultrasonic devices, heating/ air conditioning units, front office copy/ fax, and ­sterilization equipment. The wearing of earplugs by clinicians is becoming more popular, as more research about noise and hearing loss is conducted. Hearing protection options range from custom-made earplugs obtained from an audiologist or other hearing specialist to single-use or disposable earplugs. Hearing protection strategies should be incorporated to reduce the prevalence of occupational hearing loss in oral health professionals.⁶

WORKPLACE EVALUATIONS

Photography can be used to evaluate clinician working posture. These photos allow clinicians to actually see their posture so they can become more aware and, hopefully, maintain proper posture throughout the workday.⁷ Partido⁷ conducted a study with dental hygiene students who used photographs to conduct ergonomic self-evaluations. Results showed improvements in their ergonomic scores and increased accuracy of their self-assessment.⁷ Photography could be used in private practice settings for periodic workplace evaluations to self-assess and work to correct poor ergonomic positioning.

TRADITIONALLY ERGONOMIC INTERVENTIONS

Saddle stools correct the dental practitioner’s posture by facilitating a neutral spine position.⁸ Their use encourages the clinician to maintain an inward curve on the low back, which can help prevent back pain.⁸

Loupes may relieve pain in the hand, arm, and shoulders.⁸ The use of loupes and lights by both students and faculty in dental hygiene educational programs has been increasing as they improve vision, enhance ergonomics, and may prevent musculoskeletal disorders.⁹ The light, or coaxial illumination, augments the magnification and visibility in the field of vision.¹⁰

Cordless handpieces may help reduce the risk of injury caused by overuse. McCombs and Russell¹¹ compared one cordless coronal hand polisher to two corded coronal hand polishers to measure the muscle loads, duration of polishing, and the overall opinions of 30 dental hygienists. The study concluded that the weight of the cordless handpiece coronal polisher was significantly more comfortable, slightly reduced muscle load, decreased the duration of polishing, and made it easier for the dental hygienist to use. More research is needed on cordless coronal polishers.

Advances in technology could potentially improve efficiency and safety in the dental workplace. Ultimately, improved ergonomics could help promote health and career longevity by reducing the risk of MSDs and other occupational injuries.

REFERENCES

1. Wagner IV, Lex MacNeil MA, Esteves A, MacEntee MI. An electronic oral health record to document, plan, and educate. EuJ J Dent Educ. 2015;19:209–216.
2. van der Stelt PF. Filmless imaging: the uses of digital radiography in dental practice. J Am Dent Assoc. 2005;136:1379–1387.
3. Patzelt SB, Lamprinos C, Stampf S, Att W. The time efficiency of intraoral scanners: an in vitro comparative study. J Am Dent Assoc. 2014;145:542–551.
4. Mangano F, Gandolfi A, Luongo G, Logozzo S. Intraoral scanners in dentistry: a review of the current literature. BMC Oral Health. 2017;12;17:149.
5. da Cunha KF, Dos Santos RB, Klien CA Júnior. Assessment of noise intensity in a dental teaching clinic. BDJ Open. 2017;9;3:17010.
6. Theodoroff SM, Folmer RL. Hearing loss associated with long-term exposure to high-speed dental handpieces. Gen Dent. 2015; 63:71–76.
7. Partido BB. Dental hygiene students’ self-assessment of ergonomics utilizing photography. J Dent Educ. 2017;81:1194–1202.
8. Plessas A, Bernardes Delgado M. The role of ergonomic saddle seats and magnification loupes in the prevention of musculoskeletal disorders. A systematic review. Int J Dent Hyg. 2018;10:12327.
9. Arnett MC, Gwozdek AE, Ahmed S, Beaubien HD, Yaw KB, Eagle IT. Assessing the use of loupes and lights in dental hygiene education programs. J Dent Hyg. 2017;91:15–20.
10. Holt ER, Hoebeke R. Shine a Light. Dimensions of Dental Hygiene. 2012;10(9):25–27.
11. McCombs G, Russell DM. Comparison of corded and cordless handpieces on forearm muscle activity, procedure time and ease of use during simulated tooth polishing. J Dent Hyg. 2014;88:386–393.

From Dimensions of Dental Hygiene. April 2019;17(4):22,24.