ERGONOMIC IN DENTAL PRACTICE SETTINGS

ERGONOMIC IN DENTAL PRACTICE SETTINGS

Drg. Ni Kadek Fiora Rena Pertiwi, M. Biomed

Dentistry Undergraduate Study Program and Dentist Profession

Faculty of Medicine

Udayana University

ergonomics is the study of interaction between humans and other aspects of a system, as well as professions that use theories, principles, data, and methods in design and workmanship to optimize the system to fit the needs, weaknesses, and human skills and cannot cause injury and disease in its application

the objectives of applying the principle of ergonomics when working are:

1. Ergonomics aims to improve physical and mental well-being by preventing work and injury from work, reducing physical and mental workload, and promoting promotion and job satisfaction.

2. Ergonomics aims to improve social welfare through improving the quality of social contacts, managing and coordinating appropriately and increasing social security during the period of productive age and also after earning.

3. Ergonomics aims to create a rational balance between various aspects namely economic, technical, anthropological and cultural aspects of each work system carried out so as to create high quality work and quality of life.

The benefits obtained by applying ergonomics are understanding the effect of a type of work on workers and the worker's performance, being able to estimate the potential effect of work on the worker's body, evaluating the suitability of the workplace and work equipment with workers at work, increasing productivity and efforts to create conformity between the ability of workers with work requirements, build basic knowledge so as to encourage workers to increase productivity, prevent and reduce the risk of illness in workers due to work, increase work safety factors, increase income, profits, safety, and welfare for individuals and institutions

Equipment work in dentistry is usually called a dental unit. This equipment must be owned by a dentist (Briefing, 2018). Some of the tools that must be owned by a dentist include:

Dental tweezers actually resemble tweezers in general. But for dental tweezers are designed to adjust the shape of the mouth to be comfortable when used. In addition, the retaining portion of the dental tweezers is also stronger than the general tweezers. This is because the function of dental tweezers to clamp cotton, gauze, which is used to clean teeth must be strong and not easily separated.

Spiegel / Mirror Mouth

Spiegel is a dental tool that serves to diagnose oral problems in teeth. Spiegel tools consist of a small mirror that can be inserted into the mouth. The mirror is what helps the doctor to see and know the physical form of the tooth that is in trouble so the doctor can easily diagnose what is happening to the tooth.

Functions of spiegel include:

1. Knowing the signs of tartar, cavities, or debris on teeth

2. Helps in seeing the surface of teeth and gums that are difficult to see.

3. Find out any abnormalities and problems in the gums, tongue, oral cavity or palate.

4. Assist the doctor in expanding the work area because this tool helps in holding the tongue, lips and cheeks which can prevent the doctor from overcoming problems in the teeth.

5. Helps in seeing the results of repairs or treatments that have been done before.

Excavator

An excavator is a dental health tool that looks like a dredger. In accordance with its physical form, this tool is used to dredge or unload temporary lifts on teeth, clean dental caries with soft tissue, can clean and remove dirt attached to cavities, and can take excess amalgam, cement, and fletcher.

 Scaler

Tooth scaling tool or commonly known as scaler is very important in dealing with the problem of coral on teeth. This tool can actually be used privately because of its use which is quite easy while following the instructions for use. Scaler consists of various models depending on the function you have. Scaler consists of file scaler, chisel scaler, hoe scaler, curret scaler, and sickle scaler.

Dental X-ray

Dental x-rays are used to see dental conditions that cannot be seen by the naked eye more clearly. Dental x-rays can help doctors to find problems in dental tissue disorders such as the roots of the teeth, gums, and tissue in other teeth. Dental x-rays will usually be used if the patient's dental condition is quite severe and difficult to diagnose.

Handpiece

Dental drill tools usually function in removing or pulling a tooth that is diseased, but cannot be removed using an ordinary extractor. The tooth in question is a tooth whose condition is perforated, but the tooth root is still strong so it is not possible to be extracted using an ordinary puller. This dental drill should not be used arbitrarily because it is feared that it can damage the nerves in the gums.

Tooth Extraction Tool

Tooth extraction tool is a dental tool that looks like a pair of pliers but with a smaller form. Pliers that resemble teeth pliers function in delivering pressure on the teeth so that it can cause luxation, alveolar dilation, and extraction of the teeth. The design of this tool should be made as comfortable and safe as possible, both for patients and for doctors.

This tool consists of various designs depending on their needs. This tool is distinguished in each use. Like dental pliers for children, certainly different from dental pliers for adults. Plucker pliers certainly differ from pliers pluckers for other teeth. if incorrectly used, this tool can cause pain in the teeth and discomfort.

Spatial

The waiting room

Before the patient enters the action room, the patient first goes to the waiting room. The waiting room must be arranged to be a comfortable room for the patient to avoid being bored and not having a bad impression on the patient. One of the factors that influence the arrangement of the patient's waiting room is color, lighting, additional facilities and the most important is the ergonomic seating (Tanuwidjaja et al., 2015). The colors that are suitable for use in the waiting room are green and yellow. The green color depicts calm and the yellow color that represents excitement (Zein, 2013). The most important thing from the waiting room is that the chair, chair or seat used must be ergonomic which contains a backrest and footrest considering the patient has to sit to wait their turn. The addition of footrest aims to accelerate blood circulation in the legs and backrest in the chair serves to support the entire spine and back load (Pardede, 2013). Finally, lighting, in the waiting room requires good lighting in order to attract patients to come and not feel bored while in the waiting room (Tanuwidjaja et al., 2015).

Administration room

The administration room is the first room visited by the patient. In this room all administrative readiness is provided in the form of stationery, telephone, table and chairs. in the private practice of doctors and dentists, administrative rooms usually tend to be joined to waiting rooms. To achieve safe, comfortable and productive work safety, the tables and chairs used in the administration room should be designed to be ergonomic.

Ergonomic design of tables for administrative officers should be adjusted to the characteristics of officers and their work. In the administration room, the officers do all the trouble starting from typing, writing, and tidying up his desk. The shape of the table should make it easier for officers to move and the height of the table should be adjusted with the height of the elbow of the officer, so that the officer is comfortable working, so that the results are optimal. For convenience in working, the table should be equipped with footrest so that the officer does not feel tingling quickly. In addition, the table must of course be made of strong materials to provide a sense of security for its users. The color must also be adjusted to the office environment and not reflect light, for example by giving a blue color to give officers peace of mind

In the administrative desk, of course there are items relating to administrative needs in the form of stationery, telephone, and most of all is a computer which of course must be done ergonomically. In his administration the administration equipment should be easily accessible by the officer, so that there is no excessive muscle contraction. If the administrative officer works on a computer, the computer should be placed within 60 cm of the user's eyes. The recommended keyboard form is one that requires a light touch. In addition, the arrangement of the cable must also be tidied up to avoid the electrical short circuit which can be fatal. The cable should be coated with insulation or pipe and the location is not transversely on the road, so that the officer can work comfortably (Puti, 2015).

For the design of chairs should be set high and low by rotating the backrest of the chair so that it can be adapted to the anthropology of officers. The chair should also be equipped with a backrest so that the waist can relax, the aim is to avoid muscle tension that is too long so that it will cause excessive fatigue (Santoso, 2008).

Action Room

The action room is the main place in the practice of dentists to do their jobs. Some things to consider in the action space include:

Work path and movement

Based on the concept of Four Handed Dentistry, the concept of division of work zones around the Dental Unit is known as the Clock Concept. Clock Consept is divided into 4 zones including:

Static Zone

Static zone where the zone when the patient's head is centered and 12 o'clock is located directly behind the patient's head or in the direction of 11 to 2 hours. Static Zone is an area without the movement of the dentist or dental nurse and is not visible to the patient, this zone is to place the instrument table movable (Mobile Cabinet) containing hand instruments and other equipment.

Assistant Zone

Assistant’s Zone or in the direction of 2 to 4 hours. Assistant’s Zone is a zone where the movement of dental nurses, the Dental Unit on this side is usually equipped with water / wind spray and saliva, as well as a light cure unit on a complete dental unit.

Zone Transfer

Zone transfers or in the direction of 4 to 8 hours. Zone transfer is an area where the exchange of tools and materials between the dentist's hand and the dental nurse's hand.

Zone Operators

Zone Operators or in the direction of 8 to 11 hours. The zone operator is a place for dentists to move in addition to the movements that occur around the Dental Unit, other movements that need to be considered when designing the layout of dental equipment. (Finkbeiner, 2010)

Layout placement of tools

The main principle in the layout design of the placement of dental equipment in the dentist's office using the ergonomic principle, which is to harmonize or balance between all facilities used both in activity and rest with the abilities and limitations of humans, both physically and mentally so that the overall quality of life becomes better location is only one factor in ergonomics.

Based on Consideration in an Ergonomic Standard for Dentistry, the minimum size of action space for a Dental Unit is 2.5 X 3.5 meters. In this action room one Dental Unit, Mobile Cabinet, and two Dental Stools can be included. Other supports that can be included as audio-video or television as entertainment for patients who are being treated.

The main thing in designing the placement of equipment is the dental unit. At the time of felling the length of the dental unit is around 1.8-2 meters. Behind the Dental Unit requires 1 meter of space for Operators' Zone and Static Zone, therefore the ideal distance between the bottom end of the Dental Unit and the back wall or Dental Cabinet is placed behind is 3 meters; while the distance between the lower end of the Dental Unit with the front wall is at least 0.5 meters. Generally Dental Units have a width of 0.9 meters, if the Tray is open out then the overall width is generally 1.5 cm. For movements in the Operator's Zone and Asistant’s Zone, each side is at least 0.8 meters apart. Mobile Cabinet as a place to store materials and tools that will be used when treatment is placed in the Static Zone. This zone will not be seen by patients and is located between the Operator's Zone and Assistant Zone so that both dentists and dental nurses will easily take the materials and tools needed for treatment. If there are more than one Mobile Cabinet, the second Mobile Cabinet is placed in the Operator's Zone.

The last big tool in the action room is the Dental Cabinet as the main storage area for dental materials and equipment. Generally shaped half-body sideboard like Kitchen Cabinet with a thickness of 0.6-0.8 meters. If only one side, this cabinet is placed in the Static Zone, whereas if it is L-shaped, it is placed in the Static Zone and Assistant’s Zone. There are also other factors that are ergonomic elements in the design of action space such as color design, lighting, temperature, noise, and air quality etc. (Pendyala, 2014)

Toilet

When a dentist will open his own practice room, the thing that is no less important is the availability of a toilet for the dentist and his patients. In general, a doctor's toilet is separated from a patient's toilet. Even though it sounds trivial, the available toilet must be kept clean and comfortable. Toilets must be equipped with a sink, toilet paper, sanitation and ventilation that is very good because it is an area that is at high risk for transmitting disease. It is also important to prepare a small trash can near the toilet and doormats at the entrance to the toilet. Patient toilets are usually located near the waiting room. This is done so that patients do not need to walk further to the toilet while waiting for the queue. Whereas the dentist's toilet is usually located near the practice so that the dentist can be more flexible and effective in treating patients. The lighting used in the toilet must also be appropriate to the width of the toilet so that the light is neither more nor less. The design and color of the toilet used can be adjusted to the color of other rooms to produce harmony between rooms. For pediatric dentist patients, toilet designs and colors usually use bright colors and cartoon characters that children like. Whereas for adults, usually the design and colors of the toilets used are soft colors or pastel colors