SELF AWARENESS INCREASES THE LONGEVITY OF PRACTICE

1. POSTUREDONTICS
SELF AWARENESS
INCREASES LONGEVITY OF
PRACTICE
DR NISHAVERLIANEY
M.D.S
PERIODONTIA

2. DENTAL
PRACTICE
POST
GRADUATION
GRADUATION
• 27-60YEARS
• ACADEMICS &
/CLINICAL PRACTICE
• 26-28 years
• SPECIALITY DENTAL
EDUCATION
• 23-25 years
• BASIC DENTAL
EDUCATION
LIFESPANOFDENTIST

3. DENTAL
PRACTICE
HEALTH
SKILL
UPGRADATION
DISCIPLINE
LONGEVITYOFPRACTICE

4. POSITIONAND HEIGHT OFTHE PATIENTS CHAIR
DOCTORS STOOL --- LUMBAR ,THORACIC ,ARM SUPPORT
INSTRUMENTS
LIGHTING
POSITIONOF INSTRUMENTTABLE
PLEASANT TEMPERATURE
AMENDINGTOTHE PRINCIPLES
OF ERGONOMICS
IDEALWORKSTATION

5. ERGONOMICS
an applied science concerned with designing and
arranging things people use so that the people and things
interact most efficiently and safely
— called also biotechnology, human engineering

7. OPERATOR
POSITION
VISIBILITY
ACCESSIBILITY
COMFORT
CONTROL
FACTORS

8. HORIZONTAL PATIENT POSITIONING
CLEARANCE AROUNDTHE PATIENT HEAD SHOULD
ALLOW UNIMPEDED OPERATOR
ACCESS FROMTHE 7 O’CLOCKTO 12.30 O’CLOCK
POSITION FOR RIGHT HANDED
OPERATORS
NARROW BACKREST ALLOW ASSISTANTTO BE
CLOSERTOTHE DENTIST
OPERATORPOSITION

9. WITHTILTING SEATS AND BACKREST
TILT SEATS ONLY 5-10 DEGREE FOREWARD
SOTHAT THIGHS ARE HIGHER LEVEL
THANTHE KNEE
STOOL

13. INSTRUMENTS
ROUND HANDLE
SHALLOW CIRCUMFERENTIAL GROOVES
HOLLOW /RESIN HANDLES
COMPRESSIBLE HANDLES
COLOR CODED
SHARP
MICRO SURGICAL
MAGNIFICATION
LIGHT WEIGHT

16. LIGHTING
OVERHEAD LIGHTING SHOULD
PROVIDE
EVEN
SHADOW FREE COLOR CORRECTED
ILLUMINATION

17. NO PROLOGNED STATIC POSTURES
NO LONG APPOINTMENTS
ALTERNATE BETWEEN SITTING SND
STANDING DENTISTRY
STANDING DENTISTRY FOR EXTRACTIONS
IMPRESSIONS
ALTERNATE BETWEEN DIFFERENT DIAMETER
SIZES OF INSTRUMENTS
REDUCETHE PINCH FORCE AND DURATION
OF PROLONGED PINCH GRIPPING
PRACTICALTIPS

18. FORCEFUL EXERTIONS
↓
HIGH LOADSON MUCLES,TENDONS,LIGAMENTS,JOINTS
↓
REPITITIVE RECURRENT PROBLEMS
MSD'S

19. WORLD HEALTH ORGANISATION
defines MUSCULO SKELETAL DISORDER
as
“A disorder of the muscles, peripheral nerves or vascular system
NOT directly resulting
from an acute or instantaneous event “
Insufficient or inappropriate equipment,
inappropriate work area design,
direct injuries,
repetitive movements from working with dental instruments,
sitting for extended times with a flexed and twisted back

20. MUSCULOSKELETAL DISORDERS
HAND AND WRIST
DISORDERS
CARPELTUNNEL
SYNDROME
GUYONS SYNDROME
TENDONITIS
NECK AND
SHOULDERS
DISORDERS
MYOFACIAL PAIN
DYSFUNCTION
SYNDROME
ROTATORY CUFF
TENDINITIS
CERVICAL
SPONDYLOSIS
BACK
DISORDERS
SCIATICA
BACK PAIN
HAYES 2010,CONRAD 1990, HAWN 2006, SIMMER BACK 2006

21. WRIST ANATOMY

22. HEALTH vs DISEASE

23. HAND ANATOMY

24. ENTRAPMENT OFTHE ULNAR NERVE INTHE GUYON
CANAL as its passes through the wrist
Symptoms --a feeling of pins and needles in the ring and
little fingers
before progressing to a loss of sensation
and/or impaired motor function of the
intrinsic muscles of the hand which are
innervated by the ULNAR NERVE.
GUYONSCANAL
SYNDROME

25. TENDINITIS

26. MYOFASCIALPAIN
DYSFUNCTIONSYNDROME

27. SCIATICA

28. Pressure to the sciatic nerve
Worsened with prolonged bending,
excessive sitting or bending
Pain from the lower back or hips radiating
to the buttocks and legs
Leg weakness, numbness, tingling

29. CERVICALSPONDYLOSIS

30. PAINFUL
MOVEMENT
CHRONIC
PAIN
RESTRICTED
MOVEMENT
STIFFNESS
WEAKNESS

31. GENDER
AGE
WEIGHT
HABITS
STRESS
EQUIPMENTS
SETUP
POSTURE
ASSISTANTS
WORKING HOURS
WORKINGYEARS
WORKING
INTENSITY
SYSTEMIC CONDITION
PHYSICAL FITNESS
WORK REST CYCLE
Kierklo 2011; Morse 2010;
Valachi 2003;Yamalik 2007

32. Sufferers ofWMSDs may experience numbness,
tingling, pain, decreased strength, or swelling of the
affected area (Michalak‐Turcotte 2000).
Work‐related musculoskeletal disorders (WMSDs)
have been identified as
a significant occupational health problem among
dental professionals (Hayes 2010; Leggat 2007)
The prevalence of non‐specificWMSDs among dental
professionals is estimated to be between 49% and
92% (Moodley 2018).

33. CONCLUSIONS
HEALTHY
LIFESTYLE
MUSCLE
STRENGTHENING
STRESS FREE
LIVING
• NUTRITION
• WORK BALANCE
• YOGA
• STRECHING
• MEDITATION

34. REFERENCES
1. INTERNATIONAL JOURNALOF CLINICAL PEDIATRIC DENTISTRY 2014
JAN-APR;7(1):30-34
2. CONSTRAINED POSTURE I N DENTISTRY—A KINEMATICANALYSIS OF
DENTISTRY
OHLENDORF ET AL.BMC MUSCULOSKELETAL DISORDERS (2017)18:291
3. MUSCULOSKELETAL DISORDERS IN DENTISTRY-A REVIEW. (2014) JSM
Dent 2(3): 1032
4. GUPTAA, BHAT M, MOHAMMEDT, BANSAL N, GUPTA G. ERGONOMICS IN
DENTISTRY. INT J CLIN PEDIATR DENT 2014;7(1):30-34.

35. 5 PREVENTING MUSCULOSKELETAL DISORDERS IN CLINICAL DENTISTRY:
STRATEGIESTO ADDRESSTHE MECHANISMS
LEADINGTO MUSCULOSKELETAL DISORDERS.
VALACHI B,VALACHI K 2003 Dec;134(12):1604-12
6 DENTAL ERGONOMICSTO COMBAT MUSCULOSKELETAL DISORDERS:A
REVIEW GUPTA A, ANKOLAAV, HEBBAL M.
Int JOURNALOF OCC SAF ERG 2013;19(4):561-71
7 Ergonomic risk and preventive measures of musculoskeletal disorders in the
dentistry environment: an umbrella review SimoneDe Sio,Veronica
Traversini Francesca Rinaldo , Clasant ,Giuseppe Buomprisco,Roberto Perri
Federi ca Mormone, Giuseppe LaTorre, Fa brizio Guerra.PeerJ. 2018; 6: e4154