¶ Welcome to Season Three
Well, welcome back to Season Three of the Level Up Infection Prevention Podcast. I'm Michelle Strange. And I'm so excited to have you join me as we dive deeper into the nuances of infection prevention and patient safety.
¶ Introducing Ergonomics in Dentistry
Today, we are tackling, uh,
ergonomics, which might, you be like, I don't know. I don't understand why that's in an infection control podcast but we will talk about that a little bit more. Uh, it's a topic that is so important in creating safe dental visits.
¶ Guest Introduction: Caitlin, The Ergonomics Guru
And I'm thrilled to be joined by Caitlin, who brings a wealth of knowledge and practical insights to the table. Uh, Thank you so much. Welcome to my podcast
Thank you. I'm excited to be here.
and you actually have your own podcast. Um, the aligned hygienist, is that correct? And so you are an ergo ergo, a guru.
Yes,
can I give you
I go for ergo.
So I'm curious, like.
¶ Ergonomics and Infection Control: The Connection
When I asked you to come on this podcast, did you feel like it was a reach for an infection control podcast to be talking about ergonomics?
No, I mean, first of all, pain and dentistry is so high and safety is one of the most important things how we set up our room. And yeah, I think it goes right in line with it.
And when we look at OSHA stuff too, like we talk about occupational hazards as one of the things, like we talk about biological hazards and chemical hazards, but occupational hazards. is how our room is set up. It is how our behaviors day in and day out. It is, are we wearing our eyewear and our PPE, even though that's a little crossover with biological, but it's all very important.
¶ Common Ergonomic Issues in Dental Practices
And so I'm curious when you go and evaluate offices, are there just some things that are just repetitive? So redundant. You're seeing them seeing us all do those same things over and over again.
I think there's some habits that many of us have, right? Like the chicken wing or leaning or twisting when we're in the operatory, but some other things that You go into an office and I'm almost flabbergasted that no one has changed or these long cords that are in the walkway either for our patient or practitioners to trip over and I don't know about you, but I know multiple people that have gotten their foot caught on a cord and fallen and tripped.
I believe Susan Cotton actually got injured that way.
she did.
Yeah, and then it's also like the setup of the operatory. So, if there's rear delivery and we constantly have to twist over and over again, that is a huge issue when it comes to our ergonomics, our overall well being.
It's true. And you talk about the chicken wing and, where I see ergo ergonomics, really crosses over with our engineering controls that we talk so much about. especially when we look at our hierarchy of controls and the things that are the most effective and the things that are least effective when we are talking about, uh, patient safety, disease, transmission, all of that. And in the middle bucket is engineering controls, which.
I think, well, one of the ones that I think are, has changed that chicken wing for me the most is, um, the aerosol assist high volume evacuator because your HPE is an engineering control and I tried so hard to implement it back in like 2017, but, oh my gosh, that chicken wing and that shoulder discomfort do you have any other suggestions for that chicken wing issue?
A lot of it. I mean, some of it's our equipment that we're using, right? If you're using an HVE is there a way that you can still position yourself appropriately while getting in there? But I mean, there's some, there's a lot of great technology out there that can assist you or can hold that high evacuation suction for you that, Would prevent again that random reaching and then it's also how are you positioned around the patient? Where is that cord coming from? Are you having to pull it?
And that's the reason you have the chicken wing So yeah, it's kind of hard to break down without seeing because there's so many things that you see
I so agree.
¶ The Role of Ergonomic Tools and Equipment
one thing that I wanted to bring up with you, because I think you and I both use the Andau Ergo Loops. And first I'd love to start with what your thoughts are on ergo loops, loops in general, wireless headlights. And then I'd love to throw in my thoughts about that from an infection control standpoint.
Oh, I'm curious to hear that. I am a huge fan of ergo loops for anyone that can or loops in general, but then ergo loops are kind of the high-end new standard for anyone that can actually tolerate it, which I would say is the majority of us. If we give ourselves that time and consistency of learning and training ourselves, because it is, there is a learning curve.
But ergonomic loops are the only way that as a practitioner, we can actually sit upright with our head aligned over our shoulders over the spine and to practice in a neutral posture. And when we're not in that neutral posture, that is what leads to pain and injury, right? So whether we're talking about just looking down at our patient all day, it might seem really insignificant, but that is like, 20 pounds of pressure on our spine instead of if we had ergo loops and our head is aligned.
So I'm a big fan of them. And then when it comes to headlight, either cordless or corded, I actually just got the cordless headlight and I love it. And now, as I'm saying it, I'm wondering what your infection control.
No, actually, that's exactly what I would say is, well I was curious about if there is more weight with a wireless, is there more drag with a wired, is that going to factor into that straight posture that you were talking about, that neutral posture?
So I really think that cordless or corded, it's, you know, really personal preference. I was getting sick of getting my cord caught on doorways and knobs and all of that. I will say that if you're getting a head or a corded cordless headlight, It is going to add more weight than a corded light will be,
battery pack
That is just, yeah, what we know. Um, however, if you're in ergo loops, because your spine is aligned, you're not feeling that weight quite as much as if your head was leaning forward and it's pulling your head down. Does that make sense?
That makes sense. Yeah, totally. So, I . like a wireless because I do believe you should not be wearing your loops around your neck
Mm hmm
because if you think about where is the spatter and spray going, and especially when we look at like aerosol generating procedures, when they like, uh, do the mock setup and they actually do the spatter spray and aerosols, it's like the sleeves of the jacket, getting it. The chest and then the face, which is why we want the, level three masks. That's why we want to wear a face shield if we can, which I'd love to talk to you about that. And what that, how that lands with ergonomics too.
So when we take those loops off and we just kind of like, let them sit on our chest, like, think about how dirty your chest is. Like it is gotten all that spatter and spray, right?. So, I got into a habit long long ago when I did switched to wireless, to take mine off and then hang them up And like, that's just my rhythm. Like I, you know I get them off the thing. I put them on, I take them off so that they are never like just, you know, hanging out.
And like the amount of times I've walked in and people have literal crumbs in. their lubes
I was. One dentist just told me a really funny story that she had to eat lunch really quickly in between patients and she had chicken salad and she gets back into the office working on a patient and literally just started smelling onions. And she's like, what the heck went through the entire like crown prep or crown seating appointment.
And look down and there was food in her loops, like between the loops and the ear or the nose piece to talk about infection control there, but that makes so much sense. I'm in the bad habit of letting them dangle, but I also think
You and everyone else.
it's a really easy way to break them too. I don't know how many times they flop around or hit things. So, I like that.
And I also think a face shield is a very good idea because There are a lot of nooks and crannies on your loops that could, that are going to get that spatter and spray. And so to make sure you're disinfecting them properly, like it's just, think of it like your air /water syringe. We put a barrier wrap on that for a reason. Cause there's nooks and crannies that we can't disinfect the same for my loops.
Um, do you have any thoughts and feelings about face shields and does that add any kind of weird things to our posture?
¶ The Importance of Proper Posture and Equipment
It can, I'd say there's just like loops, just like saddle stools. There's a wide variety of kinds of face shields. So there are so many really lightweight, more ergonomic face shields that you can wear that you're not going to feel the weight, the pressure, it's not going to pull at you. Another thing is people getting like so hot in their face mask or their mask. So. Or mask and shield.
Hmm. Mm hmm.
I think they're great. I think we should be using them. I'm in a bad habit of not so sorry. Um,
Well, they're not required. I just would like everybody know, like facials are not required. Like if you have a face mask that has that fluid resistance, that's why we like the level three. If you are going to wipe your loops down and take them off and all that, like it's not required. So don't feel bad. I think it is just another layer to the fact that my loops will last longer, maybe, cause I'm not wiping them down constantly and just little things like that. So
yeah,
don't
absolutely. Yeah, I'm getting in trouble. Um, yeah, I think they shields are great. And there's really lightweight ones that you're not going to feel that full or like tension around your head. And again, if you're wearing ergo loops, you're not going to feel it. As much anyway, because your head is aligned rather than looking down.
that's so true. You brought up saddle stools, which I would love to chat about, and then I'd love to hear all your thoughts and then I throw in my infection control piece if I can again.
Yes, please. Just thoughts on
Yeah. What, like, cause right now I use a crown seating stool. I got sized properly, but often I do see a lot of people being like, I'll just get it from Amazon kind of thing.
that is my worst nightmare, and I'm sure there are great ones. Some people love their saddle stool from Amazon or randomly on the Internet, but we are all different shapes and sizes, right? Leg length, hip width, um, just our height is all different. So we really all need different. Saddle stools to support us. So finding one that actually fits and supports your body. You do that by trying them on like you did getting sized and sitting on different ones to see how they feel.
the other piece to it is, yeah, I think saddle stools are great. We need to find ones that are actually made for dentistry that have wheels that can actually go around the operatory that. You can go up to your max height that you want and as low as you want and that has a seat tilt so it can go forward and back to adjust for your body or for specific patients or procedures. So I'm a big fan, but not all . Saddle stools are created equal.
So just like I said about Amazon, typically those are not the best quality. They're not designed for dental professionals. They're not the best material. So you mentioned crown seating. That's what I use as well. I think crown seating is kind of the top tier of saddle stools. BQE makes great saddle stools as well. There are really great ones. It's a matter of just sitting in them, finding one that fits you. And it is an investment.
So a lot of people think I'll just buy a $50 one on Amazon and then they wear out really quickly. Or I had one client that was, she just got, she had three saddle stools from Amazon and all of them under a year, she could feel the metal underneath them. So that is not comfortable. Probably not safe for our body. Not good for us long term.
That's a great point. And you know, what's interesting is that I did just experience that. So I have my Silverton from crown seating in one office. somebody, I was not planning on temping in another practice. Normally I would take it with me and they called and I was like, sure. I got some time. I can come fill your afternoon. Somebody sick. And they had a saddle stool and it was like for hairdressers like that.
And I actually found it pretty comfy from like a sitting standpoint, But, I could not get high enough because now that I have my ergo loops and I'm not like this where I could be lower and my, my working distance was a little different than magnification was a little different than every now I'm up and I could not get high enough to have the patient within my working distance.
Yep. Yeah.
I just had that situation and I was like, Oh my God, I've worked in this practice before back when I had other loops and I didn't have that issue. And I was like, this is kind of interesting that I'm so limited now with this particular stool.
Yeah, and that's the thing with ergo loops is because we go from this head down, shorter working distance to upright, we have a longer working distance, um, that can change our positioning, not necessarily our positioning, but our, how far we are away from the patient.
That's so true.
¶ Infection Control Considerations for Ergonomic Tools
So to throw in my, nuances for infection control, which are saddle stools.
You mentioned the material and not all of the materials are made the same and are going to hold up to our disinfectants because really we should be wiping our chairs down and we should be wiping if you're touching the handles and things like that, wiping the casters down on a regular basis, just as a housekeeping, you know, cause I mean, I looked down the other day and I was like, Oh, there is a lot of dust on these things. Like I haven't done that in a minute. Um,
in there.
oopsie daisy. And so like you want to have quality saddle stools for your body, but also like you said, like you could be just buying them over and over again because your disinfectants are breaking them down with the foam and the materials breaking down. And then like eventually you're just going to be. It's spending the same amount of money that you would have for a stool. I've had my, I don't even know how many years I've had my saddle stool. I don't remember a day without my saddle stool.
Yeah.
I did, but I don't remember it. And so I've had mine so long. Like they really do last if you pick a good one.
Yep. Absolutely. I, I was actually wondering that. I think they're, they're really easy to clean, especially the ones made for dental. There's not those nooks and crannies that we see.
Yeah, exactly. And, you know, I think it's also if you do get like an arm rest because there that is possible. I think from an infection control standpoint, I think thinking about should, could you bury a rapid? Are you touching it? Is it getting spattered and sprayed? I think those are important things to consider, uh, from You know, patient safety and our safety when we're talking about all our, environmental surfaces that we should be managing.
Yeah, absolutely.
So what are some other things that we really should be mindful of? I mean, we talked about like positioning and stuff like that, but is there any other, just like, obviously we should be all taking quick check
a lot of things. I think when you walk into a dental operatory, you want to make sure that again, like the path is clear, really obvious things that there's not cords hanging out that you can get into, especially a 12 o'clock position. Obviously, it's going to be different if you're left handed or right handed, but making sure you have that space around the patient. So you're not positioning yourself. Twisted or just in an awkward position.
A lot of it comes down to our posture and just checking in and paying attention to our bodies. And I think it becomes so much easier to do that when we have tools, like we talked about ergo loops or a saddle stools that help us and position us in a better spot so that we're not going back to old positioning because I don't know about you, but with my ergo loops and the saddle stool, it's almost impossible to go into bad habits that I used to go into. Yeah,
I actually, uh, when I first got my ergo loops, I had not realized how often I was doing a little lean like this. And I was adjusting, I mean, it's not the word, like, I think if you've gotten loops and you sat with loops for a while, the adjustment to ergo, it's. It's something, but it's not like the same that I remember having when I went from nothing to loops. But what I can tell you is every time I wanted to lean over, I thought I was going to fall out of my chair.
Yes.
I kept being so aware of it. I'm like, when did I start doing this? I had no idea I. I had these habits, quite honestly.
I mean, most of
abc
And people
abc
to me and like, I'm in pain. Why? And then we take a picture or even video. If you video yourself while you're practicing, it can be a little bit humbling, but also really insightful because you can see all those minor things that we do. And some of it is just habit or we could just move the air/water closer to us or our instruments closer to us or. If, again, you have a rear delivery and you're writing your probe depths, like that could be positioned in front of you.
So setting, setting your room up is so important. I think the last thing I'll say is our instruments and equipment that we're using, making sure that they're not lightweight or that they are lightweight, that they're not really heavy, that we don't have these really long, heavy cords. There's some handpiece course that can weigh up to 25 pounds. And I've gone into so many offices. Talk about infection control.
I've gone into, I just went into actually an oral surgery office and they had a really heavy, I believe it was
a
a handpiece. Cord
show
and the assistant was, had it draped over her shoulder cause it was so heavy that the doc, so the doctor didn't have that weight on his hand, but then she just had it over her shoulder. I was mortified for her, her body. And then it's just like this weird twisted position, but then an infection control standpoint, that's not good.
That's wild.. What, what a way to take one for the team. My gosh. Like,
that ties to your shoulder and just holds that for you.
And you know, that's an interesting point. So what we're talking about is a device called the Cordy's that goes on the wrist. I've had one for my suction that took that off back when I used the something that had a little more of a chicken wing, uh, thing happening, but you can also like put, uh, your handpiece cord in it, your ultrasonic cord in it. And it does take that drag off.
But from an infection control standpoint, I'm always like, make sure it's autoclavable, get a few, change them between patients because you're going to be taking it off, putting it back, taking it off, putting it back. And as much as I'm like, I'm so happy you got it. One is not enough. Okay.
no, I have multiple and I use them. Well, the office that I was at, I'm left handed and everything was on the opposite side of the room. I mostly used it for my ultrasonic because I was holding it with my pinky. Otherwise,
Mm
which is a no no.
Yes. And I have definitely had that habit that kind of sneaks up every now and again. I'm like, what is it? What did I do? I don't even know where that came from. So that's actually a good point and such a good suggestion because I do like that one a lot. And you know what I think when you mentioned like when your body is in pain at the end of the day, what I think about is inability to cope and make good decisions and not cut corners and, um, think about the steps that you're doing.
I, when I know I've been so tired, I'm just like, do I need to wipe this room twice? Do I need to put these barrier wraps on? Do I need to do these things? I'll do it tomorrow. I'll leave these instruments overnight, all of those things. And that is a huge issue when we're talking about infection control and patient safety. So wanna do all the things that you're talking about so that our body does not feel . so exhausted that our brain is like, cut all them corners, girlfriend. We don't care.
We're exhausted.
It's interesting you say that, because I think about that from a patient care standpoint, right? The
Yeah.
more that we are tired, that we're burnt out, that we're in pain, our mind is not working the way that it should or normally does. So we are going to maybe miss certain things or not go above and beyond or have that extra conversation. But to your point, especially at the end of the day, or when we're rushing between patients, it is easy to forget or skip over things, and it's also easy to be lazy and like, Oh, maybe I'll do that tomorrow.
Yeah. Because you're just exhausted. At that point, you're just surviving the day and you're not being really thoughtful about your steps and how those might or lack thereof might impact people down the line. No.
¶ Final Thoughts and Practical Tips
Any final thoughts as we kind of close out our little time together that you can think of any major like you mentioned, like walking in your room and. Looking at cords, looking at things like that. Any other like ideas like that? Like what could somebody do when they get off this podcast, when they would go back to their office?
I'd say the first thing is making sure that you understand and know and feel in your body what neutral posture is and then whether you're with the patient and it's me, I recommend on like easier patients or maybe someone that you know really well, but taking the time to really pay attention to the movements that you're doing.
And so if we want to maintain neutral posture, And we can be slow enough that we realize when we are twisting, when we're reaching, when we're doing these weird things, it's so much easier to actually correct it. And in that moment, okay, I'm going to move this closer, or I'm going to get an additional cart to make this easier. Or one of those like swivel stands or something like that. So much of it is prioritizing our health, our well being so that we feel good and we, we don't end up in pain.
But a lot of that is also our patient care and our infection control, keeping everyone safe. Right? So it's way more than just ergonomics. It's just, yeah.
actually a good point. And I would love to just quickly share this little journey that I have been on. You're into yoga. You teach yoga like when you, you probably talk a lot about core strength and having like your core in to find that neutral, I would imagine. Is that correct? Am I saying that correctly? So I have not had a core strength for many years. I had a lot of, uh, issues where I ended up losing a giant part of my intestines.
I had major surgery, cut down the center, you know, a lot of scar tissue and things like that. So I've been on a journey with Pilates more than yoga. And this is wild. Like I've been in dentistry 25 years. 2025 will be. 25 years for me. And then the last six months, I can tell you that I just. felt what core strength felt like.
Yeah.
Let's say you come in and and, you're like, you're just kind of like rotating from your core in a little bit. I din't really did have core strength until this last six months . to even be like, Oh! I do. I actually feel that, when I do tuck it in. And so, you kind of mention like being on this wellness journey. Taking, like, be considerate about your own health.
And, I would just encourage everybody to do something like yoga or Pilates that really does focus on like that core strength, because now that I am stronger and that, which has not been easy, I'm not here to tell you that it was an easy journey. At all. At all. Teasers are my nightmare. But, now that I have it, I'm like, Oh my God. Like I genuinely feel like I couldn't set up straw or straighter and have that neutral position.
Whereas before I think if you had said, okay, so we're going to find that neutral. I didn't have the core strength to even get there
Yeah, so many people do so many people don't have even just the muscles like postural strength to hold ourselves up or they're so tight in their chest and their shoulders that they can't actually draw their shoulders back to be in proper alignment. And so this is something that, yeah, so many people struggle with. And I'll say to your point, making sure that you understand where you're at as an individual.
So. You might not struggle with pain, but you might struggle with being super tight and really needing to focus on that. So, everyone's going to be really different, but making sure that you're aware of your own body, aware of maybe your current limitations, and then how can you work towards. Better core strength or better postural muscles or just awareness of what neutral posture is. And so I love that.
I think we can both agree that, like, when you're taking care of yourself, you have the capacity to take care of others. Yeah. that's, you know, what you're doing with ergonomics, what I do with patient safety and our infection control practices.
¶ Caitlin's Resources and Farewell
So I really thank you for coming on the podcast with me. Um, I'd love for you to tell everybody where they can learn more from you, social, websites, your podcast. Tell us more.
Yeah. I am The Aligned Hygienist pretty much everywhere. So my podcast is The Aligned Hygienist. My website is TheAlignedHygienist.Com. I have a bunch of free resources on their yoga classes, a chair side guide. I'm big on Instagram. My handle is @TheAlignedHygienist. And then you can find me on LinkedIn or Facebook. And if you're curious, if you have more questions, you want more support, you can always email me at Caitlin@thealignedhygienist.com.
That's awesome. Well, thank you so much for coming on. I appreciate you and all your advice.
Yes. Thank you for having me.