Back to Balance - The wider concept of dental ergonomics

Short version of the presentation by Prof.Dr.drs.drs. Jerome Rotgans

In the past the design of dental treatment chairs forced dentists to a permanently crooked posture. As a result many dentists suffered after many years of professional activity on skeletal and muscular deformations. The modern treatment chairs are more ergonomic, but many dentists are still plagued with work-related back pain. An equipment of the dental practices according to ergonomic principles and further measures should make the dental profession "painless".

Workplace of a dentist

Typische Haltung bei der praktischen Ausübung des Zahnarztberufs
Figure 1: Typical working posture of dentists, Wouters 2007 (Click to enlarge)

The suffering of Dentists

The complaints concentrate in head, neck, shoulder and back: 64% back- and 42% headache. (from: Rohmert W, Mainzer J, Zipp P (1986) Der Zahnarzt im Blickfeld der Ergonomie. Eine Analyse zahnärztlicher Arbeitshaltungen)

Since 2006 there are the "Ergonomic requirements for dental equipment"

Still ... should work chair, headrest, operating light and treatment chair to be developed urgently ergonomically.

There is no ergonomically correct dental unit available! Example: No appropriate dental unit is available for female dentists shorter as 155,7 cm and male dentists taller as 195,8 cm

Zahnärztlicher Behandlungsplatz
Figure 2: Hokwerda 2005 (Click to enlarge)

Workplaces for dentists from the last century

Zahnarztstuhl bis 1950/1960
Figure 3: Status until ca. 1950/1960 (Click to enlarge)

Previously, the dentists were forced by the design of treatment chairs to a very non-ergonomic working posture. Though design changed in time, not the working position!

Enwicklungsrevolution in den Sechzigern: Turbine mit Spraykühlung
Figure 4: In the Sixtees: Developmental Revolution: turbine with spray coolant KaVo 2014 (Click to enlarge)

In the Sixtees: Developmental Revolution

Development of the turbine with spray coolant: From „gas pump“ to a unit with tablet and spittoon, turbine incorporated; with the results:

The new treatment chair

ergonomischer Zahnarztstuhl
Figure 5: The „Golden Solution“: To work sitting on the laying patient (Click to enlarge)
In der Praxsis wird die korrekte Arbeitshaltung oft nicht eingehalten
Figure 6: New and modern equipment does not automatically improve working posture. (Click to enlarge)

Work stress with „clear“ posture problems

Beyond this all, since the Eighties (in Germany)

What hardware developments occurred?

until today, technical, colour and design „only“

Neueste Hardware-Entwicklungen
Figure 7: What hardware developments occurred? (Click to enlarge)

FOCUS „Working Position“ is too narrow-minded!

Figure 8: PHD project: Occupational loads and demands in the dental profession
(Studie zur Erfassung arbeitsbezogener ergonomischer und psychosozialer Stressoren in Bezug auf das psychische Wohlbefinden und Beschwerden im Muskel-Skelett System, Neuhaus, 2014)
Picture by (Straul c.s. 2010) (Click to enlarge)

A broader concept seems necessary! „Health and Wellness“ to avoid occupational diseases ..... with conscious inclusion

Pentagon Partnership

German Society of Dental, Oral and Craniomandibular Sciences, German Academy of Dental Ergonomics
(Arbeitsgemeinschaft „Arbeitswissenschaft und Zahnheilkunde“ der Deutschen Gesellschaft für Zahn-, Mund- und Kieferheilkunde (AGAZ))
The Network for Unity in Dental Ergonomics (TNUDE)
Figure 9: The Network for Unity in Dental Ergonomics (TNUDE) (Click to enlarge)

FOCUS on "good working posture" almost automatically — biopsychosocial measures for the prevention of occupational risks based by work