An Effort to Reduce Physical Stress in Clinics, Labs, and Offices

Most members of the dental team know from personal – and painful – experience that musculoskeletal stress tends to come with the territory. Now, NYUCD has moved to take positive action to address this problem by introducing a new program that incorporates ergonomics training into the curriculum for all DDS students – more than 1,200 men and women. In addition, all preclinical and clinical faculty, hygiene faculty, postgraduate faculty, and clinical staff – nearly 1,000 individuals – will be invited to take part in training to identify and correct the performance of tasks in clinics and offices that may put them at risk for fatigue, discomfort, or musculoskeletal stress. The program represents a major expansion of NYUCD’s ergonomics education efforts, which previously were limited to lectures for first- and second-year students.

Directing the program is Dr. Denise C. Murphy, Clinical Associate Professor of General Dentistry and Management Science, and the author of an influential textbook on dental ergonomics, Ergonomics and the Dental Care Worker (American Public Health Association, 1998).

According to Dr. Murphy, studies have shown that dentists have a high incidence of musculoskeletal disorders in the neck, shoulders, upper extremities, and lower back, caused by biomechanical factors such as remaining in the same fixed posture for prolonged periods or bending, twisting and contorting the body in an attempt to get closer to patients. In fact, a study published in 1997 by the British Dental Journal found that musculoskeletal disorders were the most frequent cause of dentists’ early retirement. For Dr. Murphy, the lesson is clear: “Ergonomics, like infection control, is an important part of health and safety at the College.”

During the program’s initial phase, first-year students will get an overview of ergonomics principles, such as the need for variety in tasks and movements in order to avoid muscle tension caused by remaining in the same position for excessive amounts of time. In addition, students will be monitored and corrected as they practice simulated dentistry in a lab setting in their first two years. Second- and third-year students will learn about dealing with more specific situations encountered in patient care, such as choosing alternative grips for certain instruments to account for individual practitioners’ differences. A lecture for the senior class will focus on how private practitioners incorporate ergonomically-designed equipment into four-handed dentistry, a method for increasing productivity that emphasizes synergy between the dentist and the hygienist or dental assistant. All DDS students will be monitored annually in their clinical setting, and every clinic at NYUCD will be monitored three times a year through formal rounds.

“The earlier you can identify and correct biomechanical problems, the better it is,” says Dr. Andrew I. Spielman, Associate Dean for Academic Affairs. “By raising awareness of these problems among students, we will reduce the potential for injury and increase efficiency and productivity early in their careers. Indeed, there has been increasing attention to ergonomics issues affecting dentists since the ADA announced last April that it will cooperate with the U.S. Occupational Safety & Health Administration (OSHA) on voluntary ergonomics training and education for its members.”

Faculty will use an ergonomics checklist developed by Dr. Murphy to evaluate whether preclinical and clinical faculty and staff are using proper posture techniques and avoiding excessive repetitive movements and forceful exertions. If the information gathered reveals that certain tasks may create a risk for physical stress, the faculty, working in conjunction with Dr. Murphy, will develop written recommendations for correcting those tasks or replacing them with alternative procedures.