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    Demystifying pain among women in dentistry

    Why it's important to talk about pain in the dental practice.

    The percentage of women pulling up chairside in the operatory is increasing. And studies show that women in dentistry experience a higher frequency and severity of pain than their male counterparts, with the thumbs, hands, hips, neck, and shoulder being particularly problematic.

    When considering interventions for the female dental professional, there are dozens of gender-specific considerations: workplace ergonomics, specific exercise, daily activities, clothing, and much more.  Following are a just a few of the most important considerations. 

    Upper trapezius pain

    There are several causes of trapezius pain among women in dentistry. Perhaps the most common is due to the fact that many women tend to be shorter in stature than men, and therefore a common ergonomic position problem arises. Women with short torsos cannot position the patient low enough and are forced to raise the shoulders while working. This can cause rock hard shoulders and trigger points in the upper traps. A saddle stool is the easiest long-term solution to this problem. By opening the hip angle, it allows lower positioning of the patient with closer proximity.   

    Fourth and fifth finger pain

    Figure 1There are two common causes: thoracic outlet syndrome and cubital tunnel syndrome.

    Thoracic outlet syndrome has a higher prevalence rate among women than men and is frequently misdiagnosed as carpal tunnel syndrome. Thoracic outlet syndrome (TOS) is a neurovascular disorder caused by entrapment of the brachial plexus and subclavian artery (Figure 1), so in addition to the neurological symptoms of pain, numbness and tingling, one also experiences vascular changes such as coldness, discoloration, and swelling. Symptoms are most common in the medial forearm/hand and into the fourth and fifth fingers.

    Many MDs do not know the four diagnostic tests to differentiate thoracic outlet syndrome from carpal tunnel and end up referring TOS patients to a neurologist or surgeon. Ask your doctor for a referral to a certified hand therapist for accurate diagnosis of this syndrome and also the most conservative course of action. Because it is caused by forward head and rounded shoulder posture, ergonomic interventions are imperative to prevent and treat this syndrome, including loupes with a steep declination angle, correct patient positioning, and strengthening the proper stabilizing muscles.

     

    Dr. Bethany Valachi, PT, MS, CEAS
    Dr. Bethany Valachi, PT, MS, CEAS is DPR’s ergonomics editor and author of the book,“Practice Dentistry Pain-Free” and clinical ...

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