The Science of Sitting
The right chair or stool can go a long way toward helping your customers feel good
Editor’s note: First Impressions would like to acknowledge the contribution of Pelton & Crane (Charlotte, N.C.).
Pain on the job reportedly is one of the biggest contributors to early retirement among dentists. At the very least, it has become a major health concern for practitioners and a common reason for canceling appointments with patients. Helping dentists select the right products, such as chairs and stools, and then training them to properly use this equipment, can transform the workstation from an epicenter of pain to a hub of productivity.
Ergonomics is the science of fitting the work environment to the worker. When the "fit" is off, dentists and hygienists typically experience a buildup of pain over time due to musculoskeletal dysfunction. The design of the workstation, together with the positioning of equipment, seating, lighting and other objects all play a role in creating an ergonomically sound work setting. Small spaces do not present an obstacle as long as the equipment and the patient’s oral cavity are positioned with the practitioner’s well being in mind. Even the position of the instrument tray can affect ergonomics. Distributor reps also should keep in mind that design characteristics that suit a large male dentist or hygienist will not be optimal for a smaller female practitioner.
Every time a dentist or hygienist twists or turns to pick up an instrument or examine a patient, he or she is fitting himself/herself to the environment, not vice versa. When the dentist places his or her body in an unnatural position for prolonged periods of time, it can lead to musculoskeletal dysfunction and ensuing neck and shoulder pain or tingling fingers and elbows.
Experts recommend that dentists and hygienists learn to work in the "home position," a balanced, seated position that helps prevent the buildup of pain. Home position requires the worker to sit with:
- Feet flat on the floor or foot ring.
- Knees shoulder-width apart and about an inch above the hips.
- Shoulders back.
- Neck in a neutral position.
- Upper arms hanging straight down along the side of the upper body.
- Work area mid-chest, with heart high.
The best seat
Chairs and stools today generally are designed to limit the dentist’s motions to shoulder rotation, thereby eliminating twisting or compressing of the torso. The base of the dentist’s chair/stool should permit him or her to sit comfortably, with full support on the buttocks and legs, according to experts. Ideally, there should be no pressure to the dentist’s hamstrings. Both the base and back support should be vertically adjustable, such that the chair back should provide lumbar support and promote good posture. The base should tilt and the back support should be able to move forward and backward with the practitioner.
Chairs and stools in and of themselves will not help reduce physical stress on the dentist unless they are adapted to a particular dentist’s work habits and style. For instance, an endodontist may prefer a chair with elbow supports if he or she frequently uses a microscope.
When helping a dentist select the best chair or stool, reps need to emphasize that access to the patient should be the primary consideration, according to experts. So, for instance, seat-tilt features on stools are designed to roll the dentist’s hips forward, reducing pressure on the lower spine and moving the center of gravity to the balls of the feet. This helps increase the dentist’s balance and range of motion in and around the oral cavity.
In the same fashion, if the patient chair is too thick to allow the operator to properly maneuver underneath it, or if the back is too wide and prevents the dentist from moving close enough to the oral cavity, the distributor rep should suggest a different style that is better-suited to the user. Some dentists may appreciate patient chairs with a double-articulating headrest, which can cost several hundred dollars but be priceless in the long run. It allows the dentist to properly position the patient’s oral cavity, enabling him or her to remain in the "home position."
Biggest objection
One of dentists’ biggest objections to replacing or upgrading their stools and chairs is price. (Stool prices range from $200 to $2,000, while patient chairs range from $2,500 to $12,500.) However, reps should remind their customers that potentially sacrificing their health in order to save money could prove to be a bad choice. Some less expensive chairs or stools that are designed less efficiently may be ineffective in an otherwise ergonomically designed office setting.
Reps should ask their customers:
- "Do you find your back hurts throughout the day?"
- "What impression does your equipment give your patients when they enter the operatory?"
Indeed, studies have shown that many patients have a negative perception of their dental visits. Placing them in an uncomfortable chair, particularly one that impedes the dentist’s access and prolongs the procedure, will not encourage them to return.
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