Benefits of Rubberdam Isolation in Ergonomics

Introduction

Dentistry requires the operator to spend long hours working in static postures. When ergonomics is applied in dentistry, one of the most discussed theme is the working posture of the dentist. The special attention on this topic is because of the widely recognized and accepted fact that posture is the key to preventing musculoskeletal disorders. In dentistry, the working position represented by the spatial arrangement of the dentist’s entire body around the patient must be distinguished. This differentiation is useful to understand the working conditions. The ideal posture of a dentist gives him -

• optimal working conditions (access, visibility and control in the mouth) and
• physical and psychological comfort throughout the execution of the clinical acts.

A good posture provides the dentist more working energy, a reduced stress level, increased comfort, lack of pain/muscular tension, and a lower risk for therapeutical errors. A bad posture induces premature fatigue, pain, stress and a negative attitude to work, high-risk for musculoskeletal disorders and a poor quality of work. 1

Our unavoidable ‘Static Posture’ - Problems & Solutions

Prolonged static postures are strongly incriminated in the etiology of musculoskeletal disorders and therefore they deserve a special attention. Sitting on the chair for a long time involves the activation of paravertebral muscles and a substantial ‘charging’ of the lumbar curvature of spine higher than standing . To maintain a posture for a long time, including a balanced posture, predominantly involves a static muscular effort. The static work is more tiring than the dynamic work though it requires lower oxygen consumption. During static work , a large number of impulses from proprioceptors of muscles and tendons reach the same place, meaning a continuous long time excitation of cerebral cortex nerve centers. This mechanism explains why the static work is more tiring than the dynamic work . Although we cannot avoid the static posture we can try and reduce the stress by reducing the time spent in the static posture . This can be achieved by -

• Creating an ergonomic working environment
• Using specialised chairs meant for ergonomic benefits
• Incorporating the classes of motion
• Including the nine essential elements for a good ergonomic operatory design
• The use of magnification especially the dental operating microscope along with rubberdam isolation

This article focuses on the role of rubber dam isolation in ergonomics both with and without magnification. First let us understand -

How magnification helps in ergonomics

Any device that enhances or improves a clinician’s resolving power is extremely beneficial in producing precision dentistry. Restorative dentists, periodontists, and endodontists routinely perform procedures requiring resolution well beyond the 0.2- mm limit of human sight. Crown margins, scaling procedures, incisions, root canal orifice location, caries removal, furcation and perforation repair, post placement or removal, and bone/soft tissue grafting procedures are only a few of the procedures that demand resolution well beyond the 0.2-mm limit. Hence without enhanced vision, the operator has a natural tendency of a head tilt for better visibility of the area of work. 2