Extracting Data: Ergonomics in Dentistry

The twisting and bending central to a dentist’s job can result in painful disorders of the neck, shoulders and back. Dr. Regina Pope-Ford’s research on musculoskeletal disorders among dentists aims to alleviate unnecessary discomfort.

Pope-Ford became aware of this issue because her sister is a dentist. Discussions between the siblings — including that many dental instruments are designed for use by men — prompted the assistant professor of industrial and manufacturing engineering and technology to study ergonomics in dentistry.

Using a motion-tracking system and electromyography, a diagnostic procedure in which electrodes record electrical activity in muscles, Pope-Ford evaluated 12 dentists as they worked on a patient simulator. Procedures measured included tooth extractions, mirror checks and cavity preparations with a handpiece. Eleven sensors monitored muscles in the dentists’ necks, backs and shoulders, and seven tracked motion.

She also is studying the differences between dentists sitting versus standing during procedures. “I looked at the correlation between standing and muscle activities,” Pope-Ford said.

Using electrodes to record the electrical activity in muscles, Dr. Regina Pope-Ford evaluated 12 dentists as they completed procedures such as tooth extractions, cavity preparations and mirror checks. Her research may lead to better ergonomics in dentistry.

Photo courtesy Dr. Regina Pope-Ford.

Her research revealed dentists stand less than 10 to 15 percent of the time with patients. While standing may cause back disorders, sitting may result in neck injuries. She said most of the dentists she studied exceeded recommended levels of muscle contraction for static postures. The key, Pope-Ford said, may be for dentists to “mix it up” and change positions throughout the day.

In addition to posture, Pope-Ford is studying muscle activity during procedures, grip types and lines of vision. Last summer, her research focused on the neck, while last semester, she looked at the impact on the back.

Her research began three years ago with her doctoral dissertation on ergonomics and human factors in dentistry, then she started researching the cognitive aspect. “I would note comments the dentists made about stresses and psychosocial factors in their work.

“At least three or four of the dentists I talked with said they don’t seek medical assistance when they experience discomfort or pain. Some take over-the-counter medicine or see a chiropractor, but they often feel that discomfort comes with the job,” Pope-Ford said.

The dentists evaluated had been practicing between two and 40 years. “I found no correlation between the number of years of practice and the number of pain areas. Even though there is a high prevalence of work-related musculoskeletal disorders, activities and hobbies away from work also have an effect. However, exercise, massages and adequate breaks during the workday can serve as interventions,” Pope-Ford explained. “Mental fatigue affects physical performance, too.”

Pope-Ford would like to expand her study to see if the initial findings hold true. She also intends to broaden her research to other health care providers, such as surgeons. Another area of interest is studying children’s posture while they use cell phones and tablets.

“I am interested in studying the flexion of the neck with the head down,” she said. “Dentists exceed the amount of neck flexion that is recommended, and the same is happening with children. I believe we will start to see more neck and back issues among them.”

Pope-Ford hopes her research will ultimately result in modifications to tools, chairs and other products dentists use. She will present her findings at the Conference for the American Academy of Pediatric Dentists in Seattle in May. She hopes networking with dentists and suppliers will present opportunities to seek volunteers for future studies and to discuss funding.

Her article “Neck and shoulder muscle activation pattern among dentists during common dental procedures” is scheduled for July publication in Work: A Journal of Prevention, Assessment, and Rehabilitation. The journal covers the entire scope of the occupation of work, with a major emphasis on preventing workplace injuries.

Pope-Ford commented, “I like doing research that has an impact on people. In industrial engineering, almost everything we do is tied to the individual. I hope to alleviate or prevent injuries, and I enjoy the opportunity to interface with people. Engineering involves a great deal of theoretical research, but I like applied research.”

By Nancy Ridgeway
Photography by Duane Zehr