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Dr. Bethany Valachi, PT, DPT, MS, CEAS is DPR’s ergonomics editor and author of the book,“Practice Dentistry Pain-Free” and clinical instructor of ergonomics at OHSU School of Dentistry in Portland, Ore. She is also the author of the evidence-based "Online Dental Ergonomic & Wellness System for Dental Professionals." A physical therapist who has worked exclusively with dental professionals for more than 15 years, she is recognized internationally as an expert in dental ergonomics, and has been invited to lecture at more than 300 conferences worldwide. She has published more than 50 articles in peer-reviewed dental journals and has developed patient positioning and exercise DVDs specifically for dental professionals. Bethany offers free newsletters, articles, videos and product reviews on her website at www.posturedontics.com and can be reached at email@example.com.
Should dentists use a chair with armrests? Our ergonomics expert says yes and explains how to adjust them.
Question: Should dentists have armrests on their chairs?
This is a great question and one I’m quite passionate about.
Studies support the use of armrests in the prevention of neck, shoulder and low back pain. Armrests have been shown to decrease muscle activity in the neck and shoulders of dentists, especially in the upper trapezius on the handpiece, or dominant side-areas where dentists tend to report a high incidence of pain!
Armrests will be more effective in resolving neck pain for some dentists than for others, depending on the etiology of the pain. However, in my live lectures, I perform a test on audience volunteers to determine if armrests would be helpful in decreasing neck pain. From the lecture test results, approximately 75 percent of dentists report decreased or eliminated neck pain when the arms are properly supported.
Choosing the best armrest type
Because the incidence of neck and back pain are so high among GPs, I consider armrests mandatory for them.
There are several styles of armrests on the market today: fixed, movable, swiveling, pivoting and telescoping. The style I’ve found that works best for most GPs is the 2D telescoping armrest (also called the “Relax” armrests by some vendors). This style of armrest moves in two planes: in/out and forward/backward with the operator, and it can be set at a specific height and resistance. Pictured above are 2D telescoping armrests, an example of a popular armrest style for general dentists.
Making correct adjustments
Proper adjustment of the armrests is essential in preventing neck/shoulder problems. Adjusting the armrests too high can actually worsen neck pain, as it puts the levator scapulae muscle on slack and can cause neck stiffness and pain at the crook of the neck and shoulder. Muscle activity is lowest when the elbow rests are set slightly low.
Proper width adjustment (between armrests) also is important because armrests set too far apart will cause abduction of your arms. Positioning the armrests too far forward can encourage the dentist to lean forward, compromising operator posture.
Most companies will offer a two-week trial of armrests with your chair, so there’s no reason not to give them a try. Some companies, such as Crown Seating, can retrofit armrests to your existing stool. However you choose to do it, it pays to give your muscles a rest!