Standing on the job offers many favorable benefits

by Juli Kagan, RDH, MEd, and Lynn Pencek, RDH, MS

When you were a little kid, did you ever get scolded for tipping forward in your chair, or worse, tipping backward and teetering on two hind legs?

At the time you didn't think about your posture or biomechanics. Fortunately, your body knew it needed to be in a neutral spine-opening position with the hip joint while leaning forward, and needed to lengthen the spine while hinging back. You were forced to sit in those hard wooden chairs and consequently, you often squirmed, daydreamed, or became inattentive. But mostly your body wasn't happy. To counteract this frustration, you fidgeted.

Sitting for long periods of time while leaning forward toward patients and performing repetitive motions (e.g., scaling), builds the front of the body, making these muscles short and tight while the opposing back muscles overstretch, making them long and weak. More importantly, a slumped spine and upper body impairs breathing by closing down the chest, lungs, and diaphragm.

We live in a seated society. But here's the question: Why do you sit to do clinical hygiene? Take a moment and think about it. Is it because someone told you to? Is it because that's what others do? How many of us never even give it a thought? Well, now is the time to consider taking a stand, literally.

Standing has two very important and favorable features. First, when you sit, the intervertebral disc pressure is twice as high compared to standing. This is because, even when sitting up, the vulnerable lumbar region loses its protective natural curve. Secondly, when you move from standing to sitting, the pelvis actually rotates backward, posteriorly, flattening the lower lumbar spine by at least 30 degrees.

Standing takes more muscular energy (a great thing for burning more calories) but can reduce blood supply to the loaded muscles (not such a good thing if you have weak leg veins). To combat this potential problem, keep moving! Try to sit for the maxilla and stand for the mandible. Consider root planing for 45 minutes while standing, then sitting for the next patient. Vary your movements and avoid extreme bending, stretching, and twisting, just as you would while seated.

Standing while working often provides an opportunity to employ direct vision, thus preventing unnecessary leaning and twisting. In addition, the use of extraoral fulcrums can sometimes be used, which provides added stability and leverage.

What is vitally important about standing is that your neck and spine are not compromised. You should NOT lean over the patient to obtain a better view. This can strain the neck as well as upper back muscles. On top of that (pun intended), your shoulders should be in alignment with your body and your forearms should be parallel with the floor, allowing the elbows to rest close to or on your body for support.

Even while seated, it is common for an operator, who has an innate desire to perform the best work possible, to involuntarily lean forward to bring the eyes closer to the viewing area to gain visual acuity. Loupes provide a longer working distance, thus preventing the practitioner from having to lean forward and get into awkward postures.

Whether standing or sitting, the operator's working distance should be the same when a patient is positioned correctly. Dental loupes help maintain this proper posture. Properly fitted dental loupes should have a working distance long enough for the operator to sit up straight, with the shoulders and neck in a healthy posture, while providing enough depth of field to see both maxillary and mandibular teeth without readjusting posture to accommodate for better vision.

Read the complete article on the RDH Magazine's website.

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