Cervical Spondylosis “A Dentist’s Nightmare”


By Dr Humayun Kaleem Siddiqui & Dr Shehryar Hameed Siddiqi

Oral &Maxillofacial Surgery Department, Baqai Dental College

Cervical spondylosis is a gradual wearing down or deterioration of the bones and cartilage in the cervical spine. Even though it can also be caused by injury, the condition is usually caused by collective changes brought on by daily normal activities.

Over time, the discs between vertebrae may begin to dry and shrink, slip, or collapse, that may cause the spaces between disc and bone to narrow or eventually collapse. This places mountingstress on the facets of the bone, which eventually begins to weaken. As the cartilage on bone ends wears down eventually causing the bone rubbing against bone.

A dentist typically involves himself working in a standing posture, which requires prolonged bending over a supine or reclined patient, variety of hand tools in a delicate manner is used by the dentist, and occupy extended periods of time, typically less than an hour per patient for a dentist. Some causes also include Whiplash injury &TMJ injuries.

Over the years, research results show that cervical spondylosis issomewhat commonplace among dentists and surgeons, and problem relates to their equipment design,postures and extent of working time.Several different surveys of dentists in Pakistan, Nebraska, South Carolina, India, Canada, Denmark, Poland and Norway, consistently showed that approximately 40%-60% report cervical symptoms and low back pains.

Signs and Symptoms

Neck pain and stiffness is commonly seen.Tingling, numbness weakness in the arms hands legs or feet. Lack of coordination and difficulty in walking is even one of the sign. Abnormal reflexes and muscle spasms also can be felt.

Fortunately, there are steps that can be taken to minimize the problems.

Prevention fromCervical spondylosis

Ergonomic recommendations for minimizing the risks of cervical spondylosis focus on improving working posture and equipment design. These include:

1) Change of Posture: Static muscle fatigue will decrease, if one alternate between standing and sitting to reduce postural fatigue and maximize postural variety.Indirect vision should be enforced in training to adapt to a comfortable posture by the dentist.

2) Use Support – When standing or sitting, don’t lean forwards or bend in an unsupported posture for prolonged periods. With a good back support you can sit, sit up straight or recline slightly in a chair and one can use a good footrest if needed. You can find something to help you lean against if, standing for a prolonged period.

3) Safe reaching: Avoid having to reach uncomfortably to equipment and work close to the patient. Keep the items used most repeatedly within a distance of about 20 inches (50 cm). Use assistants to help move equipment into this zone.

4) Normal arm posture: Keep upper arms andelbows close to the body and don’t elevate and tense the shoulders when working. Also, ensure that hand postures are not deviated because this could lead to wrist problems.

5) Use Comfortable Equipment: Use equipment that isn’t too heavy, that can be used without uncomfortable upper body posture, and that feels comfortable to use. Equipment that is designed ergonomically helping to minimize stresses on the back and upper extremities.

6) Manage Time: Try to avoid long appointments, or mix together these with frequent short rest breaks in which you can relax the upper extremities and change your posture.

Treatment of Cervical spondylosis includes neck immobilization, pharmacologic treatment, lifestyle modifications and surgery.

Adopting the right postures in clinical practice and having a favorable work environment could reduce the incidence for cervical spondylosis. Therefore, it’s very important to promote the occupational health and prevention programs regarding ergonomic postures which must be adopted by the dentists during their clinical practices.

February 11, 2016

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