There are multiple factors involved in the development of favorable or unfavorable outcomes from our repetitive routines. Anyone involved in dentistry is aware of the potential for stress to become a negative factor. There is a growing body of scientific evidence that directly links long term stress to physical problems often with a strong inflammatory component. Quite apart from stress itself, long held static postures can lead to pain, tightness and myofascial related trouble.
In order to try and get a glimpse of what our fellow dental workers are experiencing, a survey entitled “Pain and Strain in the Dental Profession” was distributed to many dental offices in Vancouver, Victoria, Duncan, Kelowna, Nanaimo and a few other locations within British Columbia. A cover letter was attached to the survey explaining the purpose of the survey to get a better understanding of our common problems and solutions. A total of 160 completed surveys were returned to the author by prepaid envelopes. Of the respondents, 61 were dental assistants, 30 hygienists, 34 dentists and 35 receptionists.
The survey asked the following questions; what is your role; dentist, dental assistant, hygienist, or receptionist? What is your gender? What is your age? How many years of experience? Is there work related pain or limitation of movement? Location of the pain, or weakness with key locations offered; e.g. neck, back, shoulder, wrist, fingers, etc.
Underlying preexisting conditions, e.g. arthritis, fibromyalgia, diabetes, auto or sports injuries, or other? What is the degree of seriousness of the condition, not serious, somewhat or very serious?
What has been the source of help sought? Example; doctors, chiropractor, physiotherapy, and massage. What is the effectiveness of treatments: not at all, a little bit, somewhat or very helpful? Respondents were also asked if they felt that they received adequate training regarding posture and body positioning during their education. Does the stress at work affect your mental and/or emotional well-being mildly, moderate, extremely? Are your remedies for stress adequate? What are your remedies? Athletics, TV, alcohol, prescription drugs, nonprescription drugs, massage, yoga? The final question of the survey asked whether any of the conditions described, physical or other, were perceived as leading to a possible disability.
The following are the results of the survey. Age of respondents ranged from 20-60 years. Experience ranged from less than 5 years to over 25 years.
Work related pain or limitation of movement:
All respondents: 114 of 160 yes 71%
Assistants (greatest) 45 of 61 yes 74%
Dentists (least) 21 of 34 yes 62%
Weakness of grip:
Assistants 41%
Assistants with 15 years’ experience 56%
Hygienists 40%
Location of body problems:
All responders:
Back 59%
neck 58%
wrist 32%
fingers 24%
hips 18%
Neck problems:
Receptionists 77%
Assistants 57%
Dentists 50%
Hygienists 47%
Assistants with 15 years’ experience 78%
Hygienists with 15 years’ experience 62%
So it seems that with more time, our chosen career in dental practice, comes also a greater likelihood of musculoskeletal trouble, especially in vulnerable locations such as the neck.
In fact of all respondents in various roles for 15 years or more those reporting pain or limitation of movement were:
receptionists 94% (16 of 17)
hygienists 90% (9 of 10)
assistants 85% (23 of 27)
dentists 67% (14 of 21)
The perception of the seriousness of our problems is also very interesting:
Problems not too serious:
dentists 68%
assistants 62%
hygienists 53%
receptionists 41%
Conversely problems somewhat to very serious:
dentists 32%
assistants 38%
hygienists 47%
receptionists 49%
As for perception of efficacy of treatment sought to combat these musculoskeletal problems:
Very effective:
dentists 50%
receptionists 33%
hygienists 27%
assistants 23%
Most popular professional help:
massage therapy 49%
chiropractic 40%
yoga 30%
physiotherapy 16%
medical doctor 12%
In addition 31% of respondents take anti-inflammatory drugs for their conditions.
Future disability anticipated (work related):
hygienists 30%
assistants 27%
dentists 16%
receptionists 14%
said yes (entire study group 24%)
Does stress affect you are work?
dentists 85%
receptionists 66%
assistants 59%
hygienists 57%
said yes (66% of all respondents).
Do your stress remedies work for you?
dentists 85%
receptionists 74%
assistants 72%
hygienists 67%
said yes (74% of all respondents).
Popular remedies for stress were:
athletics/exercise 68%
television 61%
massage 46%
yoga 32%
alcohol 25%
Of the 108(of 160) who use athletics/exercise 72 or 67% are stressed by work, and of these, 27 or 25% have ineffective stress remedies. Furthermore, in this exercise group, 38% have somewhat or very serious pain/range of motion problems with 23% ineffective remedies and 24% headed towards disability (in their opinion).
Among the yoga practicing 65% (36 of 55) are stressed at work, 29% with ineffective pain/ range of motion remedies. 14 or 25% headed for perceived disability.
When we looked at the people (38) using both yoga and exercise the results are almost identical to the above 2 groups (that are themselves virtually identical). Furthermore, stress incidence is the same as the overall group, and so is the effectiveness of stress remedies. (70 to 75%)
What is also identical is the proportion of those who fear impending disability, about 25% for everyone. That is, the total of all respondents, the yoga people , the yoga/ exercise people all have the same sense of impending disability.
Although the sample size is relatively small at 160 respondents spread among dentists, hygienists, assistants and receptionists, the results may be pointing to some significant problems that stem from our work. Further study conducted on a larger scale is called for here.
My own personal history, dentist for over 25 years, long term exercise and athletics devotee, yoga student for 10 years and yoga teacher for 3 years gives me a special interest in the problems of work related somatic and stress nature. I confess to having been a little surprised at the seeming lack of advantage from exercise, athletics, or yoga to help out, until I thought about it.
In my personal experience, until I found yoga, I suffered from ongoing musculoskeletal trouble in my shoulder and neck with a lot of myofascial discomfort. In retrospect, until I found some particularly gifted therapeutic yoga teachers, I did not develop a daily routine that really worked well for me. Having attended some dental conference lectures given by certain physiotherapy experts and also looking at therapeutic/ preventive exercises recommended by some chiropractors, I believe that there are many well designed and intelligent series of remedial stretches and poses (involving the use of controlled breathing) from many sources (physios, chiropractors, therapeutic yoga teachers, etc. ). As for relieving stress; there are also a great many sources available, and we can look at that in greater detail in a further study as well. From my own personal experience in successfully combating somatic (body) and psychological stresses and strains from work as a dentist I have found this: find things that you can do on a consistent (near daily) basis that seem to work for you and stick to them! They must, however, be designed to deal specifically for you and your particular problems.
If your hot yoga class or other work out routine you may do is not helping to relieve your stress and strain you may very well find what you need elsewhere. Practitioners of somatics, physiotherapy, therapeutic yoga, etc. can be found and are of enormous help. Having found for myself a daily routine of therapeutic yoga techniques that have solved and continue to solve my own neck and shoulder strains, I know similar solutions await you.
As for stress relief there are so many excellent choices, for example community involvement and volunteerism, are proven to relieve stress. If you find sitting and meditating is not for you, try walking calmly in a place and setting you enjoy while breathing slowly, fully, and calmly. You may be surprised at how well this “walking meditation” will work for you.
Gordon Levin is a dentist in general private practice and a certified yoga teacher.
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