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Dental professionals can spend most of their working lives bending down, creating a multitude of back and neck problems. Here’s how to save your spine. By Lynne Testoni
If only mouths were designed differently—or located somewhere else on the body—then dentists, hygienists and assistants would be able to work with better posture, the way our bodies intended.
Unfortunately, dental work involves a lot of bending, stretching and peering into small mouths, doing procedures that require an attention to detail and minimal movement. No wonder dentists have difficulties with their backs. It’s a big problem within the profession.
Dentist and Pilates and movement therapy instructor, Dr Jean Wu, is currently completing her PhD, researching work-related musculoskeletal injuries among dentists. She is presenting some of her initial findings at SIDCON22 as one of the speakers.
“The research shows that work-related problems can affect between 64 to 93 per cent of dentists,” Dr Wu says. “It’s quite common. Within my own research, I have found that the spine is the most common area of concern.”
Dr Wu says that while all parts of the spine are affected, the most common problem area is the neck.
“The neck is the area where people are most likely to experience issues, as well as the lower back, with the upper back being a close third,” she explains. “Outside of the spine, dentists also have a lot of problems with hunching—rounded shoulders, poor shoulder positioning.
“Many postural issues and work-related pain issues arise from the fact that if you are undertaking dental treatment, it’s very static, where you are holding positions for a long time.
“In dentistry, luckily we don’t have to do much heavy lifting, but we do very focused, fine detail work which means that as a dental professional, you are in the exact same position with just your hands moving. Your head must stay almost perfectly still, otherwise you can’t see into the mouth, which is a very small area. Once you find a good area for vision, you often can’t move from that.”
Dr Wu says that surprisingly, younger dentists suffer from back issues more often than those who have been in the industry a long time.
“The research shows that the experience of work-related pain is much higher in younger dentists, rather than older dentists,” she explains. “However, I think the reason for this may be that dentists who have been in pain for long periods of time can often end up retiring early. They take themselves out of the equation, which is really quite sad.
“There’s a paper that shows that the number one cause of ill-health related, early retirement from dentistry is work-related musculoskeletal pain,” she adds. “They’re not retiring because they’re done with dentistry; it’s that their body has given out.”
Cathleen Dong’s story
Dentist Cathleen Dong understands the connection between dentistry and its effect on the spine. Dr Dong incurred a back injury, slipping a disc in her lower back while working in the public sector in 2019, which resulted in three months off work and a total reimagining of the way she operated.
“It happened with a patient who was difficult to treat,” she explains. “That was an eye-opening moment because you put yourself at risk and often the patient is unable to appreciate how demanding the job really is.”
Recovery involved a lot of physiotherapy and Dr Dong says she couldn’t sit for long periods of time after the injury, only standing or lying down for those months.
“So through quite a few months of physio, I managed to build up enough core strength to take the pain off my back,” she says. “Because COVID was happening I had reduced hours at work, and I wasn’t doing that many procedures that required a lot of sitting down.”
However, the injury did make her question many aspects of her dental career with Dr Dong adjusting the types of procedures that she did, in order to look after her back.
“I stopped seeing elderly patients who couldn’t be laid back the whole way,” she explains. “I paid more attention to my posture, and I stopped adjusting myself for the patient, instead making the patient adjust for me. I also got myself refractive loupes so that I could sit straight and work instead of bending my neck and back which made a world of difference.”
But the changes didn’t stop there. “I took up Pilates to try and strengthen my muscles as well. I stopped working full-time and cut down to part-time, which has really helped.
“All these changes altered the trajectory of my career,” she admits.
Prevention and recovery
Dr Wu says that it’s important that dental professionals make sure they are looking after their posture and spine—and she encourages all people in the industry to take the time to exercise and move their bodies regularly.
“Every person has their own individual situation, but as a general rule, the strengthening of deep postural muscles, rather than exercise focusing on surface muscles, is recommended,” she says.
“Another thing that really should be incorporated into any dental professional’s exercise regime is more back extension exercises. Pilates is a big one for me because you can create really targeted movements, but other forms of exercise such as swimming or even going for a walk on your lunch break, are all really good because they lengthen the body, introduce more space in between the joints and move the spine in a different way.”