dentists

Next time you are in the dentist chair, spare a thought for your dentist’s posture and the postural demands of their job. Doing dental procedures shares many challenges with other surgical procedures, such as having to maintain a steady position for long periods, maintain a clear line of vision, and hold and manipulate tools with precision. Working in the oral cavity of a conscious patient is a pretty significant challenge. 

Dental professionals place many physical demands on their structure. They can be regarded as “occupational athletes.” Image from Pexels

Dental personnel and health

Unfortunately, these demands take a toll. Of adults in the U.S. general population, 13.8% experience significant neck pain; among dentists, that figure is a staggering 67%. Dentists and other oral health practitioners (OHPs), including dental nurses and hygienists, also report suffering from above average incidences of lower back pain, headaches, shoulder problems, and work-related tendonitis, bursitis, and carpal tunnel syndrome. Such problems can make life miserable, both in and out of the dental office. Some OHPs are forced to abandon a career they have spent up to eight years training for. Of dentists taking ill health retirement, 55% cited musculoskeletal disorders as the cause.

The Gokhale Method for Dentists and Oral Health Practitioners

Since 2008, well over 100 dental workers have sought out the Gokhale Method® to help them solve their posture puzzle and get out of pain. They are both welcome and in need of what our courses (in-person Foundations, one-day Pop-up, and online Elements) offer. Given their particular professional needs, we are now working with some of our dentist and hygienist alumni to develop a special Gokhale Method offering for oral health practitioners. 

This will be a tailored training delivered at dental offices, clinics, and teaching hospitals. The goal is  that oral health practitioners learn the posture tools they need to future-proof their careers.

An introductory workshop for oral health practitioners with Gokhale Method teacher Julie Johnson was recently received with great enthusiasm at a dental practice near Stuttgart, Germany. 

Dental practice team members, Bridget, Amy, and Julie, practice seated hip-hinging with teacher Julie Johnson. The Gokhale PostureTracker™ wearable gives biofeedback—and they’re having fun!

From a dentist’s perspective

One of Julie’s recent Gokhale Foundations students is Warren Blair, an American dentist living and working in Germany who, though counting himself fortunate to have had relatively few serious musculoskeletal aches and pains over his four decades of practice, understands the value of the Gokhale Method. 

Warren Blair, D.D.S., M.S.D., is a specialist in periodontology, implantology, microsurgery, and endodontics—and a student of posture!

Warren shared many things about the ergonomics of dentistry with us, both from the dentist’s and patient’s perspective:

The physical aspect is a problem—all dentists have problems. Some are in their mid-thirties and they're walking around crooked because they have a charley horse (muscle spasm). I periodically stretch the muscles around my back and shoulders, or pull away from my microscope eyepieces to reset. Doing the Gokhale Foundations I have learned that posture is key to the solution; having healthy posture early on in the profession will prevent future problems, but if problems with your musculoskeletal system do crop up then you can do something about it by changing your habits and adopting the principles of healthy posture.

Warren confirmed that dentists are taught not to round over their patients, and to work with their knees wide, but admitted that these positions are not always easy to maintain on the job. Learning and preserving healthy postural habits is especially difficult given that many dental workers, like most people in our culture, will, unfortunately, be approaching their training from a poor posture baseline. 

Healthy posture is an ecosystem

The basic instruction that trainees receive is not nearly as nuanced or integrated as the movement patterns taught in the Gokhale Method. In typical modern western fashion, we are all given stand-alone instructions, e.g., “don’t round when you bend.” The hip-hinging bend taught as part of the Gokhale Method is part of a whole movement pattern, involving nestling an anteverted pelvis, getting the femurs out of the way of the pelvis, anchoring the rib cage, engaging the inner corset, keeping the shoulders posterior, and maintaining a healthy neck position. Altogether, these elements give dentists the resilience needed for sustained bending, even with some variety of twist.

This practitioner is maintaining her J-spine, with her behind behind and her back tall and relaxed. This is a healthy baseline for sitting and forward bending. Image from Pexels

Posture instructions given in isolation don't translate very effectively into practice. However, as part of a holistic education that pays attention to the way we do everyday life activities, posture training becomes transformative. For example, walking well, both in and out of the office, is a natural reset for a tight psoas muscle. Learning to stacksit allows your breath to mobilize your back. Sleeping positions, done well, can enable you to heal damage and inflammation. 

Learning the Gokhale Method at work means you immediately put posture into practice in your profession, and sets up many opportunities for colleagues to support one another. If you are a dental or medical professional and would like to know more about how the Gokhale Method can help you and your team, please email: [email protected].

If you would like to support your dentist, send them this invitation to one of our free online workshops. 

Best next action steps 

If you would like to improve your posture, for work or leisure, get started by booking a consultation, online or in person, with one of our teachers. 

You can sign up below to join any one of our upcoming FREE Online Workshops…

Why is neck length so important? When I have taught in corporate settings, neck pain seems to be an even more common problem than back pain. It doesn’t help that most ergonomic furniture is not only unhelpful, but even counterproductive (the Herman Miller Aeron chair won the “cool” race in corporate America — and it’s my least favorite of all). Posturenomics®, a term I coined, reflects the philosophy that it's not furniture alone, but also knowledge, which together create the conditions for healthy posture.

We’re also surrounded by people who model poor (usually slumpy) posture with forward head — and whether we know it or not, it’s in our DNA to mimic what’s around. And last, but not least, our lay and medical experts have adopted a particularly unhelpful (and in fact, counterproductive) set of posture guidelines (including “chin up,” “chest out,” “stand up straight,” do crunches, tuck your pelvis — all of which harm the neck among other parts of the body).

I photographed this mannequin at the Stanford Shopping Mall years ago. "Her" neck curvature is intense and unhealthy.

Observe this mannequin from the Stanford Shopping Mall in Palo Alto, CA. She cranes her neck to look up. The base of the skull where it meets the neck is fine as a joint to rotate on, but the amount of curvature in her neck here is intense and unhealthy. I like to think of the neck as beginning in the thoracic spine (upper back). T5 is usually at the apex of the thoracic curve. Her thoracic curve is excessive. The origin of this problem is actually lower in the back and pelvis. Her pelvis is tucked, causing excessive sway in the lumbar spine, which gets reflected higher up as excessive curve in the thoracic spine, Then, in order to look ahead of her, instead of down toward the ground, she cranes her neck. If you pattern yourself on mannequins like this, you’ll soon end up bent out of shape.

 
This renowned arm surgeon working in the OR displays intense neck curvature as well. Unfortunately, many surgeons develop spinal problems.

Observe this surgeon’s cervical (neck) curvature. This posture will not serve to maintain healthy cervical discs and nerves. Surgeons are remarkably able to step up to work incredibly long hours, and sacrifice comfort for the benefit of their patients, but at some point the effects of bad working posture catch up with even the most determined of us. Paresthesias in your hands are not symptoms anyone can will their way past. Surgeons have trust in their craft, and seem to readily subject themselves to surgery (I saw a surprising number of neck scars in my 2-week stint as an observer in the OR at Stanford University hospital). But if surgery is not accompanied by measures that get to the root of the problem, the problem comes back — like it did with my own failed back surgery. The plight of many surgeons is to be forced into early retirement due to injury. They have usually earned enough to have a financially comfortable retirement, but their older years are often compromised by pain and disability.  Most of this, based on my experience, is preventable — and such a poor reward for enormous effort and societal contribution.

As is true of surgeons, forward heads and craned necks among dentists often lead to problems over time. Image courtesy H Shaw on Unsplash.

Dentists also receive no training on sustainable, healthy ways to bend over their patients and twist to examine their teeth. A full third of dentists retire early due to disability.

This Yao woman’s head and neck posture are exemplary. Not only does she have a regal and dignified bearing, but her healthy posture also protects her neck and spinal health.

Decades ago, I had the chance to hike to remote locations in the highlands of Thailand. I was fortunate to have encountered this woman and child when I did: more recently, this area has become more heavily trafficked by trekkers and finding a spot where the local people welcome a non-commercial interaction with foreigners is more challenging. But in those days, it was possible. I’m actually the proud owner of a Yao jacket. It has a wool ruff sewn onto a hemp shell, a fabric so durable that only after 30 years is it starting to fray. This woman’s elegant, lengthened neck is something we can all learn to approach.

How to get to a lengthened neck: a few techniques

1. Gather in your hands a handful of hair at the base of your skull on each side and gently and smoothly tug upward and backward. Try to pull symmetrically. if you’re able to move your arm back enough to grab one tuft of hair and pull back and up, go for it, but this does require some mobility in the shoulder joint.
2. You can also pull on your head itself. Be careful that you’re not pushing or pulling your face in the opposite direction from the front. Your hands should be on your ears or behind them, gently guiding your head up and back.
3. My favorite way uses the tips of your three central fingers on each hand (index, middle, ring) on the occiput to gently push the base of the skull back and up.
4. You can also imagine that you have a helium balloon inside your head. Survey the area, discover and release tensions, and let your head waft up.

The key ingredient in all of these techniques is to first relax your neck. If you tense your neck, your hands are going to be challenged to help with lengthening. You want to yield to the push/pull of your hands.

There’s more to learn, but if you begin with the above steps, you’ll be well on your way to repairing whatever damage has happened and preventing future damage. Your neck will then be able to live a long and happy life!