Importance of Exercise to Reduce Muscularskeletal Disorders

Work-Related Muscularskeletal Disorders in Dentistry:

A survey of WMSDs in dental professionals found neck symptoms in 17‐73% of dentists, 54‐83% of dental hygienists, and shoulder symptoms in 38‐62% of dental assistants, and 20‐65% of dentists, 27‐76% of dental hygienists, 62% of dental assistants, and 6% of dental and dental hygiene students (Morse 2010). A high prevalence of lower back pain among 55 and 59% dental practitioners has also been noted (Kierklo 2011; Ratzon 2000). In addition, it has been reported that WMSDs are a determining factor in transitioning from the profession altogether for 18‐30% of practitioners (Burke 1997; Miller 1991).

Ergonomics Is Essential in Dentistry:

All dental professionals learn how important ergonomics is to the prevention of WMSDs and work-related injuries, practicing proper posture, proper patient positioning, and proper instrumentation. To ensure proper posture, dental professionals are taught to maintain an upright posture and not lean over their patients, work as closely to the patient as possible to minimize the need to overextend arms and back, keep feet flat on the floor, have ideal lighting, and consider utilizing loupes to increase visibility and maintain ideal positioning. Ideally, patients should be placed within a supine position for clinical procedures. Dental professionals are taught to keep instruments sharp and use appropriate techniques. However, this is not a perfect world with perfect operatories, patients, or instruments. Therefore, bodies suffer a daily basis.

My Story:

I remember sitting in our dental hygiene clinic on day four within the IUN Dental Hygiene program. One of our full-time faculty members began our first clinic discussing work-related musculoskeletal disorders (WMSDs). She reviewed how important proper ergonomics would be to ensure the longevity of our health, well-being, and career. Due to WMSDs, her career in private practice was cut short, resulting in the transition to dental education. During my last year within our Dental Hygiene program, I knew that I would continue my education and obtain my master’s degree. My plan was to eventually transition into dental education or dental sales, but also wanted to ensure I had alternative options in case I could no longer practice dental hygiene.

Six years into private practice, I was working four days in private practice (accelerated hygiene) and instructing as a Clinical Lecturer Adjunct Faculty at IUSD one day a week. On February 14, 2014, I was on my way to IUSD to teach when I was in a car accident that resulted in a concussion, fractured nose requiring surgery, and chronic post-traumatic headache (CPTHA). Due to my injuries sustained within the car accident and the strain from private practice, I would come home every night from private practice with severe migraines. It was a year of continual treatment (chiropractic care, trigger point injections, acupuncture, dry needling, and physical therapy), before I realized this was my new normal if I didn't give up my career in dentistry and allow my body time to heal. My current position opened at that point in time, and I am happy to have had this opportunity to transition out of private practice and allow my body the chance to heal.

The longer I was out of private practice, the less frequent my migraines became. I started focusing on my diet when my mother was diagnosed with Lupus. I began decreasing foods that encourage inflammation, such as gluten and dairy, and began increasing my intake of fruits and vegetables. Not long into this journey, I was introduced to Juice Plus+, which has decreased inflammation drastically.

Giving my body time to rest and fueling it with proper nutrition, has allowed my body to heal. Now that my focus has shifted to proper nutrition and practicing exercises to strengthen my upper body, back, and core, I am the strongest I have been since playing high school sports. I have learned the importance of incorporating stretching into my days as well as workouts. Cycling and strength training with lighter weights and high repetitions have helped strengthen my upper body rather than prevent further injuries. Next on my list is to continue to strength my core and flexibility by becoming more proficient in Yoga, Pilates, and Barre. My passion now is not only oral health, but also overall health and wellness, which includes fitness and nutrition. If only I knew then what I know now, I could have prevented such pain while in private practice.

Importance of Stretching:

Stretching throughout the day is essential to balance your work/rest ratio, relieving stress and tension on the upper body, core, and back.

Neck Circles – gently bring chin to chest, roll next towards each side

Shoulder Rolls – gently rotate shoulders up and back

Supported Back Bend – stand straight and place hands on lower back while gently leaning back and looking up

Standing Front Deltoid/Chest Stretch – clasp hands behind, feeling the in the chest and release the shoulders

Forearm Stretch – straighten elbow and bend palm toward the floor

Hip Flexor Stretch – kneel on your left knee and place your right foot flat on the floor in front of you, knee bent; lean forward, stretching your left hip toward the floor; switch sides

Planks – placing your feet on the floor and your elbows directly under your shoulders, holding a straight line from your ankles to your head

Importance of Regular Exercise and Working Out:

Dental professionals must choose the right type of exercise, aiming to build a strong core that will help you maintain good posture and focus on gradually strengthening those stabilizing muscles through gentle stretching and exercise.

Cycling – a great combination of low-impact cardio and core strengthening, which is ideal for dental professionals

Yoga – an excellent form of exercise to distress, improve flexibility, and loosen muscles

Pilates – an excellent form of exercise to increase prober breathing and core strength

Barre – an excellent form of exercise to improve flexibility and balance, while strengthen your core, glutes, legs, arms, and back

Strength Training – any form of strength training for dental professionals should incorporate low weights and high repetitions, allowing for muscle conditioning with a decreased chance of injury; workouts, such as CrossFit, can increase chances of injury to the upper body and back

References:

Burke FJ, Main JR, Freeman R. The practice of dentistry: an assessment of reasons for premature retirement. British Dental Journal 1997;182(7):250‐4.

Kierklo A, Kobus A, Jaworska M, Botulinski B. Work‐related musculoskeletal disorders among dentists ‐ a questionnaire survey. Annals of Agricultural and Environmental Medicine 2011;18(1):79‐84.

Miller DL. An investigation into attrition of dental hygienists from the work force. Journal of Dental Hygiene 1991;65(1):25‐31.

Morse T, Bruneau H, Dussetschleger J. Musculoskeletal disorders of the neck and shoulder in the dental professions. Work 2010;35(4):419‐29.

Ratzon N, Yaros M, Mizlik A, Kanner T. Musculoskeletal symptoms among dentists in relation to work posture. Work 2000;15:153‐8.