Module 1—Ergonomics and.pdf

Module 1—Ergonomics and Periodontal Instrumentation Section 1 Ergonomic Risk Factors Associated with Periodontal Instrumentation What is Ergonomics? 2 Copyright © 2016 by...

Module 1—Ergonomics and Periodontal Instrumentation Section 1 Ergonomic Risk Factors Associated with Periodontal Instrumentation What is Ergonomics? 2 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Ergonomics -Ergonomics is an applied science concerned with the “fit” between people and technological tools and environment -Focuses on making tasks comfortable and efficient for user -Equipment should fit the user instead of forcing user to fit equipment -Efficiency makes tasks easier to do 3 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Poor Ergonomic Working Conditions -Worker comfort, productivity, and workplace safety can suffer -For the dental hygienist the work environment includes the dental office layout, dental equipment, and instruments -Dentists and dental hygienists are exposed to ergonomic risk factors that can lead to discomfort, pain, and possible disability 4 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Musculoskeletal Disorders 5 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Common Musculoskeletal Disorders in Dental Healthcare Providers 6 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Musculoskeletal Disorder (MSD) -MSD is a condition where parts of the musculoskeletal system (muscles, tendons, nerves) are injured over time 7 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Causes of Musculoskeletal Injuries 8 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Forceful or Awkward Movements Periodontal instrumentation involves forceful movements combined with awkward postures. Injuries occur with overuse of small muscles and tight grips. Injury to the musculoskeletal system can cause loss of strength, impairment of motor control, tingling, numbness, or pain. 9 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Poor Posture A twisted torso or uneven shoulders for an extended period of time can increase the risk of musculoskeletal injury. 10 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Repetitive Movements The human body was not designed to make the same movements hour after hour, day after day. Dental work requires repeated use of arms and hands in a fixed work position. 11 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Ergonomic Hazards for Dental Hygienists 12 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Ergonomic Hazards -Awkward postures -Ideal is neutral posture, that means the joint is being used near the middle of the full range of motion -Further from neutral posture puts more strain on the joint (e.g., outstretched arms for a long time) 13 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Poor Positioning of Wrist Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company 14  Ergonomic Hazards (cont.) -Static postures -Maintaining the body in one fixed position for an extended period of time -Human body is not designed for static positions -Static gripping of instrument handles is common during periodontal instrumentation 15 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Ergonomic Hazards (cont.) -Force -Refers to the amount of effort created by the muscles, and the amount of pressure placed on body part -“Pinch gripping” is undesirable while holding an instrument 16 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Ergonomic Hazards (cont.) -Repetitive movements -A task that involves the same fundamental movement for more than 50% of the work cycle -Periodontal instrumentation would be categorized as a repetitive task -Consider the frequency, the duration, and the recovery time during work tasks 17 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Thoracic Outlet Syndrome A painful disorder of the fingers, hand, and/or wrist caused by compression of the brachial nerve plexus and vessels 18 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Causes of Thoracic Outlet Syndrome -Tilting the head forward -Hunching the shoulders forward -Continuously reaching overhead 19 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Rotator Cuff Tendinitis A painful inflammation of the muscle tendons in the shoulder region 20 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Causes of Rotator Cuff Tendinitis -Holding the elbow above waist level -Holding the upper arm away from the body 21 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Pronator Syndrome A painful disorder of the wrist and hand caused by compression of the median nerve by the pronator muscle 22 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Causes of Pronator Syndrome -Holding the lower arm away from the torso of the body 23 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Extensor Wad Strain A painful disorder of the fingers as a result of injury to the extensor muscles 24 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Causes of Extensor Wad Strain -Extending the fingers independently of each other 25 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Carpal Tunnel Syndrome A painful disorder of the wrist and hand caused by compression of the median nerve in the wrist 26 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Causes of Carpal Tunnel Syndrome -Repeatedly bending the hand up, down, or from side to side at the wrist -Pinch-gripping an instrument without resting the muscles 27 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Ulnar Nerve Entrapment A painful disorder of the lower arm and wrist caused by compression of the ulnar nerve at the wrist 28 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Causes of Ulnar Nerve Entrapment -Repeatedly bending the hand up, down, or from side to side at the wrist -Holding the little finger a full span away from the hand 29 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Tenosynovitis A painful inflammation of the tendons on the side of the wrist and base of the thumb 30 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Causes of Tenosynovitis -Hand twisting -Forceful gripping -Bending the hand back or to the side 31 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Tendinitis A painful inflammation of the tendons of the wrist 32 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Causes of Tendinitis -Repeatedly extending the hand up or down at the wrist 33 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Musculoskeletal Injuries A high risk for musculoskeletal injury occurs when repetitive motions are combined with forceful movements, awkward postures, and insufficient recovery time. 34 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Section 2 Foundational Skills for Periodontal Instrumentation  Foundational Skills for Periodontal Instrumentation -Periodontal instrumentation is a complex psychomotor skill -Requires the proper position, instrument grasp, mirror use, finger rests, and stroke production -For successful instrumentation, must have mastery of individual skill components…these skills are mastered one-by-one 36 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Building Blocks for Periodontal Instrumentation 37 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Ergonomic Do’s and Don’ts -Don’t alter posture positions just to get the job done -Do assume a neutral, balanced body position -Do make adjustments to patient’s chair and dental equipment to complete periodontal instrumentation 38 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Neutral Positioning -Refers to ideal positioning of the body in a balanced position -Results in a decreased risk of musculoskeletal injury 39 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Neutral Position for the Clinician 40 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Neutral Neck Position Goal: Head tilt of 0 to 15 degrees AVOID: – Head tipped too far forward – Head tilted to one side 41 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Neutral Back Position Goal: Leaning forward slightly from the waist or hips AVOID: Curved back 42 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Neutral Torso Position Goal: Torso in line with long axis AVOID: Leaning or twisting torso 43 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Neutral Shoulder Position Goal: Shoulders even AVOID: Shoulders hunched up toward ears 44 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Neutral Upper Arm Position Goal: Elbows at waist level held slightly away from the body AVOID: Elbows held above waist level 45 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Neutral Forearm Position Goal: Forearm parallel to the floor AVOID: Angle between forearm and upper arm of less than 60 degrees 46 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Neutral Hand Position Goal: Little finger-side of palm slightly lower than the thumb-side of palm AVOID: Palm parallel to floor 47 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company The spine has three healthy curves: 1. Cervical (inward curve) 2. Lumbar (inward curve) 3. Thoracic (slight outward curve) 48 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Neutral Clinician Posture – Step 1 -Position buttocks all the way back in the chair 49 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Neutral Clinician Posture – Step 2 Adjust seat height so feet are flat on the floor 50 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Neutral Clinician Posture – Step 3 -Weight evenly distributed -Seat back about 1 in higher than front of seat -Hips slightly higher than knees 51 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Selecting Clinician Stool -Each clinician should adjust stool height and seat back to his or her own body proportions and height -Adjust seat tilt and lumbar height of backrest -All three normal back curves should be present while sitting 52 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Neutral Position for the Patient 53 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Supine Patient Position Maxillary Treatment Areas 54 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Characteristics of Neutral Patient Position Patient’s feet even with, or slightly higher than the tip of nose 55 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Characteristics of Neutral Patient Position (cont.) Chair back nearly parallel to the floor for maxillary treatment areas 56 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Characteristics of Neutral Patient Position (cont.) Top of patient’s head even with the upper edge of the headrest 57 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Characteristics of Neutral Patient Position (cont.) Chair back raised slightly for mandibular treatment areas 58 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Patient Head Adjustment -Once chair is in position, ask patient to adjust head for optimum visibility of treatment area 59 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Patient Head Tilt for Maxillary Arch (Chin-up position) -Angle the headrest up into the back of patient’s head so nose and chin are level 60 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Patient Head Tilt for Mandibular Arch (Chin-down position) -Angle the headrest forward and down so that the chin is lower than the nose level 61 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Neutral Positioning of Equipment 62 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Light Position for Mandibular Arch -position light directly over the oral cavity -position at arm’s length 63 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Light Position for Maxillary Arch -position will vary from being over the oral cavity to being positioned over the neck -position at arm’s length 64 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Clinician Position Relative to the Patient 65 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  -upper arms parallel to torso -arms are not raised -shoulders relaxed 66 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  -elbows are raised up in a stressful position -patient chair is too high 67 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  -patient positioned too high for clinician -clinician’s chair is raised so she can reach the mouth -her feet are not flat on the floor 68 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Easy Neutral Position 1. Sit alongside the patient. 2. Position your arm against your side. 3. Position your arm crossed at your waist. 69 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Easy Neutral Position (cont.) 4. Lower the patient’s chair until the patient’s open mouth is below the point of your elbow. 70 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Easy Neutral Position (cont.) 5. Make sure that your shoulders are not raised up toward your ears! 71 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Patient Head Position -Ask patient to adjust his or her head to have access to treatment area -Maxillary arch: patient in chin-up position -Mandibular arch: patient in chin-down position 72 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Ancillary Equipment Ancillary equipment helpful during periodontal instrumentation: -Coaxial illumination -Magnification loupes 73 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Coaxial Illumination -Spectacle-mounted or headband-mounted lights (dental headlights) -Light beam parallel to clinician’s line of vision 74 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Magnification Loupes -Magnifies treatment area -Improves visual sharpness -Reduces strain to clinician’s back and shoulders -Decreases eyestrain 75 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Field of Vision Without Loupes -When learning the skills of positioning, mirror use, and finger rests, the clinician needs a normal field of vision -Permits self-evaluation of skills 76 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Neutral Positioning -The ideal positioning of the body -Results in a decreased risk of musculoskeletal injury 77 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Summary: Neutral Position Comprised of: -Neutral, balanced clinician position -Neutral patient position -Neutral clinician position in relation to the patient and to dental equipment 78 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company