Overcoming back and neck pain

Understanding, recovery and prevention of work-related musculoskeletal disorders in the dental profession was the fascinating topic of a presentation in the main scientific programme at this year's Australian Dental Congress (ADC15) in Brisbane, sponsored by A-dec.

The presentation by Dr Aniko Ball revealed the alarming incidence of musculoskeletal disorders among dental professionals. Worldwide research shows 87% of dentists and up to 96% of dental hygienists suffer chronic pain.

Having experienced debilitating pain in the neck, back and shoulder for over 30 years and at times, the loss of feeling in her hand, Dr Ball's mission is helping other dental professionals identify the causes of work-related injuries and provide preventive and recovery strategies.

Occupational musculoskeletal disorders begin early in dental careers, with studies showing 70% of dental students are already experiencing chronic pain by their third year of study!

Work posture - the prolonged bending and twisting actions performed in daily clinical practice - is the main cause of the shocking rate of chronic pain in the dental profession. Dr Ball explained that work postures which are contrary to the body's biomechanical design begin as cumulative trauma on a daily basis, resulting in musculoskeletal disorders most commonly in the neck, back and shoulder.

International studies show that 25% of dentists worldwide suffer severe chronic pain, forcing many to take extended time off work or into early retirement. Dr Ball is currently conducting a survey into the incidence and impact of pain and discomfort among Australian dentists, allied health professionals and dental assistants.

Dr Ball explained why she did not find long-term relief after receiving 30 years of medical and physical therapies (her experience is in line with worldwide studies). Doctors and physical therapists were treating her symptoms, not the cause. As long as she continued faulty work posture and movement habits during clinical dentistry, she was never going to recover. Luckily, on the verge of forced early retirement, she discovered the Alexander Technique, an-evidence based, cause oriented kinesthetic method for overcoming musculoskeletal disorders. After identifying and releasing faulty posture and movement patterns and learning how to co-operate with her biomechanical design during clinical dentistry, she recovered.

Dr Ball is passionate about the transformative impact of the Alexander Technique in the recovery and prevention of work-related injuries in the dental profession. Out of a desire to make a difference, she has undertaken a 1600 hour part-time course at the Melbourne Alexander School. Dr Ball founded "Optimum Dental Posture" with the intention of addressing chronic work related pain issues in the dental profession.

In her presentation, Dr Ball stressed the importance of "internal" and "external" ergonomics, with internal ergonomics relating to the operator's efficiency in posture and movement and external ergonomics relating to the correct use and adjustment of dental equipment.

Dr Ball said it was important to invest in ergonomically-designed equipment including the dentist's and assistant's stools, patient chair, delivery system and surgery layout. uuu

"Bulky dental chairs, lack of proper stool adjustability and poorly designed delivery systems are costly and damaging to practitioners' health and careers. I lost sensation in my left hand for months when I could not get my knees underneath a bulky dental chair and compensated by extra twisting," Dr Ball said.

"The way you sit on a stool and bend over the chair is just as important as the stool and chair design. Good ergonomics is the marriage of the right equipment used properly and the operator knowing how to activate inner posture and movement patterns. You can have the best and most expensive equipment and still twist and damage your body."

In her presentation, Dr Ball highlighted the importance of a well-designed stool. "The dentist's stool must be adjustable for height and angle of the backrest and the seat. The seat should have a slight downward tilt so that the knees are lower than the hip joint. Sitting this way on the 'sit bones' of the pelvis and feet on the ground helps to maintain the proper curvature of the spine".

In an interview after her presentation at the A-dec stand, Dr Ball said A-dec had designed dental equipment in a way which could help avoid back and neck issues. She was especially impressed with the patient chairs, which have very thin, flexible, sculpted backrests, allowing the operator to get their knees underneath.

"It's a matter of taking advantage of intelligent mechanical equipment design and combine it with our own natural biomechanical design, ensuring the two work together to keep the body in balance to avoid back, neck and shoulder pain," she said.

Dr Ball's presentation "Overcoming Back and Neck Pain in the Dental Surgery" in the main scientific program at this year's Australian Dental Congress was sponsored by A-dec; she also presented "Well-Being and Ergonomics for the Dental Team" in the allied personnel program. She plans to take her message internationally in the hope of helping dental professionals around the world overcome and prevent work-related pain and enjoy long productive careers in comfort.