The Prevention of Musculoskeletal Disorders in Dentistry  

By Rick Williamson, CPT, Body Praxis, LLC

More than 80% of dental professionals suffer from pain associated with musculoskeletal disorders caused by the demands of their profession. Years of hunching over patients, reaching and stretching in awkward positions, fighting with equipment, and coping with the physical redundancy of the occupation leaves the professional with daily pain and chronic discomfort. Dentists commonly suffer from tingling and numbness in fingers and hands, and deal with shoulder, back, neck and hip pain.

These regularly occurring conditions, if ignored, can cause cumulative physiological damage that may lead to a career-ending injury. Like a professional athlete, the dental professional needs to understand how rigorous physical strains and repetitive movements lead to muscle imbalances, postural dysfunction and compensatory movement patterns. Overused muscles fatigue while underused muscles fail to properly support the spine and extremities. Fortunately, the pain and discomfort of dentistry is avoidable. Like an athlete, the dental professional needs to physically train to prevent and reduce pain. Unfortunately, if muscle imbalances and compensatory movement patterns already exist, general exercises can be detrimental. They tend to only reinforce faulty movements and imbalances. Without focused and specific movement reeducation, the strong and overused muscles and systems will be further strengthened while the neglected musculature will remain weak.

Biomechanical reeducation must be introduced and consider the occupational, recreational and daily activities. Oppositional movement patterns must be created to counteract imbalances and common repetitive positions. The importance of muscle recruitment, balance, spine segmental mobility, stabilization, and breathing techniques need to be properly learned to restore function and alleviate pain. We advocate the introduction of these specific programs as early as dental school. A strong emphasis on a daily commitment to the program will provide career sustainability and contribute to overall wellness.

“The dental professional needs to learn to break out of the habitual posture any time they are not engaged with the patient.”

One specific concept that is valuable to many dental professionals is the concept of engage-disengage. This is a concept that anyone can easily incorporate into the workday. Often, procedural work places the dental professional into a postural position of forward flexion and rotation of the spine and hips in one direction. This creates imbalances that the engage-disengage technique can address. The dental professional needs to learn to break out of the habitual posture any time they are not engaged with the patient. They need to learn to come into a neutral postural position to retrain the body to know where proper alignment is. They learn to incorporate it throughout the day and even outside of the office in other activities, reducing the cumulative trauma of repetitive faulty positions.

Another common problem is hip and pelvic pain. Sitting in the dental stool forces the pelvic bones into a rotation, which is held for long periods of time. Over time, the cumulative effect can lead to a fixed rotation of the pelvis, causing misalignment and pain.

A common movement or exercise used to reeducate pelvic alignment is pelvic rolls on a stability ball. While seated on a stability ball, movement is initiated by the coccyx (tail bone) as the pelvis is rolled forward and back. This creates a nutation and counternutation of the pelvis, which reeducates and realigns the pelvis to eliminate pain.

These techniques are demonstrated and further explored in my “Body Praxis” seminar at the 2022 Florida Dental Convention (FDC).

Mr. Williamson is the creator of the Body Praxis System and can be reached at He will be presenting his course, Body Praxis: Physical Rehabilitation for Dental Professionals  — “The Prevention and Reversal of Musculoskeletal Disorders in Dentistry,” on Saturday, June 25 at 9 a.m.-12 p.m. and again at 2-5 p.m.

View all FDC2022 speaker and course offerings today. Registration opens in March 2022.

Reprinted from Today’s FDA, Jan/Feb 2021. Visit to view Today’s FDA archives.

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