Fourteen percent of Americans experience chronic neck pain, while 67% of dentists do. Twenty-seven percent of Americans report experiencing chronic lower back pain, while 65% of dentists do.
So why do dentists experience chronic pain at rates that are WAY higher than the average population? Click here to hear more.
The average dentist spends 60,000 hours in awkward stances throughout their lifetime.
That’s more than six years in extremely uncomfortable positions! These are the average chairside docs statistics. I don’t know the rates for house-call dentists. There are just so few of us.
But my personal experience leads me to believe that house-call dentists could experience even more awkward positioning and the subsequent consequences just because of the nature of the job. I would say ergonomics is one of the biggest challenges I face as a house-call dentist.
At home, patients are usually medically complex
Our patients are usually staying in their hospital bed, wheelchair or recliner. They can’t move to accommodate you. You want them to be comfortable, so you’re moving to accommodate them.
In addition to moving to accommodate patients, you’re bending to carry, unpack, and repack the equipment after each visit and doing it all over again.
Limit your daily visits
The obvious physical toll of being a house-call dentist should not be underestimated. This is why I limit how many visits I do each day and consider my week carefully.
If you’re curious about how to schedule your day so that you can sustainably offer care, grab my free scheduling template called called "A Day in the Life of a House Call Dentist."
My top 3 ergonomic considerations for house-call dentists:
Maintain a neutral position while you’re working.
As a house-call dentist, you’ll spend a lot of time standing. Stand as upright as possible. Stand with legs at least shoulder width apart to provide a stable base. If a patient is in a hospital bed, see if you can raise the bed to avoid bending. If a patient is in a recliner, let them recline as far back as they comfortably can. The more reclined the patient is, the easier the appointment will be. If the patient is in a wheelchair but is somewhat mobile, ask if they’d be willing to lie on their couch and place their neck up on the side arm. This is more like a traditional dental chair position. So when a patient is in this position, grab a seat and sit upright while you treat them.
Finally, during extractions - keep your forearm perpendicular to your torso. Don’t take your elbow off of your body, because that’s not a neutral position.
Use appropriate instruments.
Pull out your mirror and use indirect vision when possible to avoid having to bend. Use a headlight and loupes. The light following you throughout the procedure stops you from having to reach for another light source. Reaching is not a neutral, controlled position. At a certain distance, the magnification of the loupes can aid your posture by alleviating the need to bend for a magnified view.
Be thoughtful about case selection.
Just because you can offer a particular service, doesn’t mean every patient is a candidate for each service. If the patient has to sit upright and has a very limited opening, you might not be able to safely perform a posterior op. Electing to refer this procedure or offer an alternative like SDF, is not only safer and more comfortable for the patient, it’s safer for you and your back, too.
Four things that you can do outside of work to prevent injuries that come from poor ergonomics.
1. Stretch before and after work.
The same is true for any exercise. Stretch at the beginning and end of your very physical workday. Some useful stretches include moving your chin back to your chest to relieve your neck from the feeling like your face is being pulled forward. I recommend that you find some free youtube videos about dental stretches.
2. Sleep well.
For me, this is WAY easier said than done. I struggle with getting enough sleep. Sometimes, I'm up late working, and only get five or six hours of sleep. I know that this is terrible and irresponsible. Our bodies need time to rest and recharge so that we can perform at the highest level. If you can, get in a full eight hours in a proper resting position because lack of sleep will catch up, eventually.
3. Exercise regularly.
You don’t need to be a professional athlete or bodybuilder to be a house-call dentist, but a basic level of fitness will help prevent you from a work-related injury. I’m a big fan of running, yoga, and skiing. I just took my first gymnastics class, too. These exercises help me with balance and core strength, which are great for helping me maintain good posture during the workday.
You don’t have to do those exercises, do whatever you enjoy doing! You’ve got to find an activity you love.
4. Visit a massage therapist.
I’ve been getting massages for the past few months and I’ve found it to be incredibly helpful. Not only do I feel more relaxed afterward, but the massage therapist usually has super helpful feedback. Their feedback can give you great insight into what you should be stretching every day. Plus, if you are experiencing pain and your doctor recommends massages, you can write them off!
Hopefully, you feel armed with some information about the physicality of house-call dentistry and some things you can do to stay strong for your patients. I hope you’ll use this info to take care of yourself so that you can continue to provide the best dental home care possible to your patients.
If you aren’t interested in pursuing dental home care yet but want to support the cause, consider donating to the Home Smile Care foundation. This is an organization founded by myself and my loved ones to increase access to dental home care. Your contributions will help patients who are best served at home, but who cannot afford the home dental visit. Visit homesmilecarefoundation.org.