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Watch your back

Preventing pain leads to happier life, career

Watch your back
Mr. Caruso

Editor's note: This is the second in a series of articles exploring wellness issues. Resolution 41 directs the ADA to promote a wellness program to encourage healthy diet, exercise and lifestyle for members. The 2009 ADA House of Delegates referred Resolution 41 to the 2010 House for study and report.

Walk into any dentist's office and there's a chance a common scene is playing out: a dentist is sitting on a stool, hunched over a patient.

The position of their backs is less like a straight arrow and more like a curvy question mark.

"I think a lot of practitioners become so focused on the procedures that they're doing they lose track of how they're sitting and the position they're in," said Tim Caruso, a physical therapist and founder of Chicagoland Performance Consultants. "If you multiply that by eight to 10 patients a day, there's a negative cumulative effect on their bodies."

According to a 2007 ADA survey of dentists who reported regularly experiencing pain, more than 58 percent cited their lower back and 52 percent pointed to their neck. Nearly 29 percent of the open claims paid to ADA members by Great-West Life & Annuity Insurance Co. in 2009 were for back or cervical issues. The ADA and Great-West have a longstanding relationship dating back to 1934.

Great-West increases insurance maximums for ADA members

Great-West Life & Annuity Insurance Co. has increased the life and disability insurance maximums, effective July 1.

The coverage increases for ADA Insurance Plans were approved by the Council on Members Insurance and Retirement Programs at its March 26 meeting. Effective July 1, members can apply for up to $3 million in ADA Term Life Insurance.

Members can also apply for up to $15,000 per month in the Income Protection disability plan, effective July 1. The plans are underwritten and administered by Great-West through a partnership that dates back to 1934.

Mr. Caruso works with industrial and professional organizations on wellness, ergonomics and injury prevention and has a number of tips dentists can try before they seek treatment or surgery for their symptoms. He first suggests the entire dental team develop visual and verbal cues to remind each other of their postures throughout the day. He also recommends the dental team take pictures of each other while they're working, so they can see what positions they're in and what they may be doing wrong.

"If they take their digital camera, each staff member gets a day to take pictures in the office," Mr. Caruso said. "By the end of one or two weeks, they have quite a collection of interesting positions they get themselves into during the working day."

Mr. Caruso also recommends dentists pay attention to the type of equipment they're using. If the patient chair or operator stool isn't conducive to reaching the oral cavity, it can be a strain on the dentist's back and neck to have to lean over, he said. Their stool might also be a problem if it isn't adjustable or supportive for their postures during the day. Considering dynamic sitting surfaces to engage core musculature or adding armrests to unload the upper body can do a lot to alleviate the stresses and strains on the back, neck and shoulders during the working day, Mr. Caruso said.

Mr. Caruso advocates using the Mackenzie Method—a comprehensive evaluation of patient back and neck symptoms comprised of a series of back or neck movements or positions that can help determine what effect the movements or positions have on pain symptoms. Within several visits, it can be determined whether the patient is getting better or worse as opposed to weeks and weeks of treatment or possible surgery, he said.

Prevention and treatment of back and neck pain can lead to a longer professional life, improved career satisfaction and fewer insurance claims. A dentist faces a 1 in 3 chance of being disabled for ergonomic or other reasons long enough to collect insurance benefits at some point in his or her career, according to Great West. Dentists are also five times more likely to become permanently disabled than die prematurely, the insurance company said.

The ADA recommends members take out adequate insurance to prevent financial loss, in the event they do have to take a medical leave of absence. The ADA has also created tip sheets on back, neck and hand pain that may be helpful. The tips can be found on at

By taking notice of their posture and taking some preventive measure, dentists can hopefully avoid having to seek out more drastic procedures or spend thousands of dollars on new equipment, Mr. Caruso said.

"I think it's an investment in their health and well-being but, that being said, I don't think folks need to go back and refit all their equipment," Mr. Caruso said. "Sometimes it just comes down to a habit, like sitting up straighter, for better or worse."