Career | Unraveling the 'ouch' factor

Career | Hands-On-Hygiene

Unraveling the “ouch” factor

The way you scale today can impact your ability to scale tomorrow.

By Renée Marchant-Turner, RDH


	photo: getty images

Whether it’s the hand, wrist, arm, neck, shoulder, hip or back, pain is something almost all hygienists will experience. In searching for a solution, it is important to remember that these disorders develop over a period of time, not after one hard day at the office. For this reason, we must become proactive—instead of reactive—to already occurring muscle and nerve pain. Proper equipment and posture are integral to a long, comfortable career, and ultrasonic scaling is a powerful tool in sustaining upper body health.

In A Pinch

Hand scaling requires a strong pinch grip to remove tenacious deposits, and, over time, these powerful pinch forces will negatively affect the muscles of the hands, wrist, and arms.1,2 A study comparing dental professionals found that hygienists had the highest risk of upper extremity cumulative traumatic disorders (CTDs), and that scaling and root debridement for many hours per day is one of the culprits.1,2 In fact, 75% of hygienists reported having hand problems, and 56% had classic signs of carpal tunnel syndrome (CTS).2,3



It’s helpful to know that manually tuned magneto-strictive machines allow the clinician to reduce the frequency of the insert, which creates a noticeably smoother vibration. The unit from Tony Riso Co. pictured here is available at www.tonyrisco.com.

Tabletop models are preferred for mobility and ease of reach for both right and left handed clinicians. The Symmetry from Hu-Friedy pictured here also features a lightweight ergonomic handpiece allowing for a relaxed grasp to maximize control while eliminating pressure points. For more info, visit www.hu-friedy.com.

If those are the statistics we are up against, small changes we make can go a long way in improving our longevity. For example, using a pen grasp with light pressure during ultrasonic scaling will significantly lessen operator hand fatigue. The stroke of an ultrasonic should be a light, gliding motion, and using extraoral finger rests rather than fulcrums will assure proper pressure for maximum deposit removal. Too much pressure against the tooth stops the vibration of the insert, resulting in less deposit removal.

Able to access complex areas such as interproximal, furcation, crowded and tilted, right and left curved inserts will reduce flexion and extension of the wrist during ultrasonic scaling, allowing for a neutral wrist position.

Not So Good Vibrations

Ultrasonics use vibration to accomplish debridement of hard and soft deposits, and, in spite of its many benefits, the vibration of the unit is a risk factor for CTDs.2, 5 This vibration can be significantly reduced by using slim inserts at low to medium power ranges; higher power should be reserved for very tenacious deposits since this also increases cementum removal.

In addition, the cord should be long and flexible enough so that it does not cause torque against the wrist, as torque and weight will force the clinician to grasp the handpiece tighter. Proper cord management—such as placing the cord behind the clinician’s neck and draping it down the dominant arm—also helps reduce wrist fatigue.

Hygienists have many obstacles that we must reduce before we become a disability statistic. Our bodies can only handle so much before they rebel. Take action, take ergonomic courses, and take care of yourself. No one else will.

Renée Marchant-Turner, RDH, is a contributing editor for Modern Hygienist.

References available upon request, click here.

Hands-On-Hygiene

Tips that make the day run smoothly and comfortably for you and your patients are the key to longevity in clinical practice. Hands-On Hygiene offers simple tips that Ms. Turner has learned from 28 years of full-time practice and from teaching beginning to advanced ultrasonic techniques and ergonomics. The small stuff matters, and this column will showcase the details that help make your day more comfortable and efficient.

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