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Journal of Indian Society of Pedodontics and Preventive Dentistry Official publication of Indian Society of Pedodontics and Preventive Dentistry
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ORIGINAL ARTICLE
Year : 2015  |  Volume : 33  |  Issue : 1  |  Page : 35-39
 

Pediatric dental chair vs. traditional dental chair: A pediatric dentist's poll


1 Department of Pedodontics and Preventive Dentistry, Modern Dental College and Research Centre, Indore, India
2 Department of Public Health Dentistry, Modern Dental College and Research Centre, Indore, India
3 Department of Pedodontics and Preventive Dentistry, Rishiraj Dental College, Bhopal, Madhya Pradesh, India

Date of Web Publication9-Jan-2015

Correspondence Address:
Dr. Khushboo Barjatya
Modern Dental College and Research Centre, 3-B Bakthawar Ram Nagar, Indore - 452 001, Madhya Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-4388.148973

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   Abstract 

Objective: Proper positioning of the child patient, can not only have positive ramifications for the operator's posture, comfort, and career longevity - it can also lead to better treatment and increased productivity. The aim of the survey questionnaire was to assess the utilization, need, and attitude concerning dental chairs among pediatric dentist while working on and managing the child patient. Study Design: The questions were structured using adobe forms central online software, regarding the user-friendliness of pediatric dental chair vs. traditional adult dental chair available in the market. Results: Our result shows that out of 337 respondents, 79% worked on pediatric dental chair, whereas 21% had no experience of it. Of these 79% pediatric dentist, 48% preferred pediatric dental chair. But pediatric dental problem still has certain disadvantages like higher cost, leg space problem, lower availability, etc. Conclusion: During the research it was found that ergonomics and usability issues were the main problems. Thus, pediatric dental chair is not so popular in the current scenario. This study allowed for general ideas for the improvement of dental chairs and thus improved dental chair would fill the gap in the current scenario.


Keywords: Ergonomics, pediatric dental chair, pediatric dentist, traditional adult dental chair


How to cite this article:
Barjatya K, Vatsal A, Kambalimath HV, Kulkarni VK, Reddy NB. Pediatric dental chair vs. traditional dental chair: A pediatric dentist's poll. J Indian Soc Pedod Prev Dent 2015;33:35-9

How to cite this URL:
Barjatya K, Vatsal A, Kambalimath HV, Kulkarni VK, Reddy NB. Pediatric dental chair vs. traditional dental chair: A pediatric dentist's poll. J Indian Soc Pedod Prev Dent [serial online] 2015 [cited 2019 Aug 17];33:35-9. Available from: http://www.jisppd.com/text.asp?2015/33/1/35/148973



   Introduction Top


The 1990s ushered in technologic advances affecting the forefront of dentistry. This technology was the harbinger of a change in dentistry from a need-driven to a want-driven profession. Improvements have been made to dental chairs throughout the 19 th and 20 th centuries to encourage patient and operator's comfort. [1] Dental chair can greatly impact posture and positioning of the dentist. Poorly designed models can cause a forward leaning posture and excessive forward reaching with the arms. [2],[3]

As the problem of work-related pain and injuries among dentists has increased, manufacturers are increasingly focusing on the features for dentist's comfort. [4],[5] But what about the pediatric dentist's comfort, who has been treating children on dental chairs meant for adults. As a result of the positioning of the child patient on oversized dental chair operator posture suffers, this mismatch equation has taken a toll on the pediatric dentists.

Therefore, a questionnaire survey was designed to know the pediatric dentists' view regarding the utility, need, and attitude toward pediatric dental chairs over traditional dental chairs, while working on and managing the child patient.


   Materials and Methods Top


The aim of the survey was to assess the utility, need, and attitude concerning dental chairs among pediatric dentist while working on and managing the child patient. The questions were structured using adobe forms central online software, regarding the user-friendliness of pediatric dental chair vs. traditional adult dental chair available in the market, and one open-ended question where additional deeper insight was necessary regarding the modifications required for improvement.

A pilot study was carried out among the pediatric dentist of Indore city. Then pretested questionnaire was mailed to 1000 pedodontists, including postgraduate students who were the members of the Indian Society of Pedodontics and Preventive Dentistry (ISPPD).

The total of 337 forms was returned. Out of these, 62% were males and 38% were female respondents; 20% respondents were professors, 17% reader, 15% senior lecturer, and 48% postgraduate students. Of the total respondents, 62% worked only in private institutions and 28% combined work in both private institutions and as practitioners. However, only 10% worked in government institutions. The data presented below was calculated and statistically analyzed for only 79% of respondents as 21% of pedodontists did not work on pediatric dental chair.


   Results Top


Out of 337 respondents, 79% pedodontists worked on pediatric dental chair, whereas 21% of the surveyed dentists had no experience of pediatric dental chair because of unavailability of pediatric dental chair. Out of these, 89% of respondents had a positive attitude toward the use of pediatric dental chair and 11% didn't felt like working on it.

The overall majority of pediatric dentists (48%) preferred pediatric dental chair over traditional adult chair (9%), whereas 43% percent preferred working on both the chairs. Additionally, managing special child is easy on pediatric dental chair according to 47% of respondents, 27% comfortable with traditional dental chair and 21% preferred both while working with special child.

Total 58% pedodontists declared pediatric dental chair is more comfortable when working with children till 6 years of age, 40% are more comfortable till 12 years of age whereas only 1% of respondents are comfortable working till 19 years of age. According to 51% pedodontists children till 6 years are comfortable sitting on pediatric dental chair, 44% responded felt that children till 12 years were comfortable, 4% felt till 19 years; whereas, only 1% said children are not comfortable sitting on pediatric dental chair [Figure 1].
Figure 1: Pediatric dental chair comfortable for

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It was found that responses were in favor of pediatric dental chair (53%) in terms of safety as compared to traditional dental chair (7%), 39% felt both were similar when safety is considered.

Respondents felt that pediatric dental chair is more attractive and acceptable to children (90%) as well as parents (58%) as compared to the traditional dental chair.

Total 52% of pediatric dentists had leg space problems while working on pediatric dental chair, 11% on traditional dental chair, whereas 36% felt no such problem. Total 51% of taller dentists felt uncomfortable while working on pediatric dental chair, 5% felt uncomfortable while working on traditional dental chair, 12% were uncomfortable on both, though 32% of taller dentists were comfortable on both. [Figure 2]
Figure 2: Pediatric Dentist feels space problem in

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In all, 53% of the respondents claim that instrument tray size is sufficient in both the chairs. Whereas patient positioning and visibility is significantly better in pediatric dental chair (51%) as compared to traditional dental chair (9%), but 39% of respondents felt it is comparable on both the chairs. Our study shows head rest adjustment for a child patient is easy on pediatric dental chair (65%) when compared to traditional dental chair (8%), yet 22% felt it is similar in both. [Figure 3]
Figure 3: Headrest adjustment, positioning and visibility for pediatric patient is better in

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In all, 93% of pediatric dentist replied that spittoon is necessary while working on a child patient and it is easily approachable on pediatric dental chair (85%). Our result proves that the majority of pediatric dentists prefer pediatric dental chair in their clinic, but more than 40% felt buying it is not a cost effective option. [Figure 4]
Figure 4: Poll for pediatric dental chair

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When asked that can modifications be made to traditional dental chair to make it standard pediatric chair 55% respondents gave positive response but 27% were against it.


   Discussion Top


The present study is a first national study about the user-friendliness of pediatric dental chairs over traditional dental chairs, while working on and managing the child patient. The results indicate that majority of dental professionals have worked on a pediatric dental chair (79%), still some have not worked (21%) at all due to unavailability of pediatric dental chair. Out of the 21%, majority of the professionals belonged to government institutions. However, no positive correlation was obtained between experience of the professionals and preference of dental chair.

Out of these 79% pediatric dentists, 48% preferred pediatric dental chair over traditional dental chair (9%). But still it is not so popular in the current scenario. When considering dental chair desirable features should facilitate neutral posture of the spine, shoulder, elbow, and wrist; and excessive reaching should be limited. Valachi (2009) often observed operators having difficulty gaining close proximity to the oral cavity while maintaining a neutral posture. [6]

Chair length in pediatric dentistry is a frequently overlooked consideration when purchasing a dental chair. As pediatric dentistry is an age-defined specialty, which should be adapted to the unique requirements of infants, children, adolescents, and those with special health care needs, [7] our study shows that pediatric dental chair is comfortable for operators (58%) as well as for child (51%) for sitting only till 6 years of age. Pediatric dental chairs are quite small to accommodate children of all ages and sizes. [Figure 5] On the other hand, traditional dental chairs are quite big for small child. [Figure 6] Therefore either the size of the pediatric chair should be increased to a certain level or the "Stay N Place Booster Seat" can be used that raises the patient to a comfortable height, and eliminates time-consuming "scooting up." [Figure 7]
Figure 5: Due to Small size of Pediatric Dental Chairs, unable accommodate children of all ages

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Figure 6: Traditional Dental Chairs are quite big to accommodate a smaller sized child

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Figure 7: "Stay N place booster seat"

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The American Academy of Pediatric Dentistry (AAPD) recognizes patient safety as an essential component of quality oral health care. [8],[9] Our result shows that pediatric dental chair (53%) provides more child safety because of its compact size than traditional dental chair. In addition to structural issues regulated by state and local laws, other design features are planned in some pediatric dental chairs, for example, padded board and papoose board, commonly used to immobilize children for dental work. The child is placed on a flat board and wide fabric straps are wrapped around the upper body, middle body, and legs. The restraints can be applied quickly to keep a child from struggling and resisting treatment, thus protecting the child from injury.

It has been observed in the study that pedodontists felt leg space problem especially for taller dentists with pediatric dental chair, which does not allow close operator positioning, the dentist is forced to either reach excessively forward with the entire arm, or to bend the trunk forward. Both place the operator at risk for injury. [3] A base should be positioned more toward the foot of the patient chair as it is less likely to become an obstruction by hitting the operator stool pedestal and thus allowing close positioning of the operator. [10]

Movement around the patient's head is important for dentist's health; for that a narrow profile backrest is desirable. [2] Many dental chairs in the market now have thin upper backrests, but are still quite wide through the shoulder area. This inhibits close positioning, especially at the 9 to 10 o'clock positions. [11] The poll for head rest adjustment and patient positioning is more for pediatric dental chair as compared to traditional dental chairs. Patient positioning aids can be very helpful when treating pediatric patients, in order to keep the head properly positioned in the headrest for optimal accessibility. [6] Small, thin and adjustable headrests allow easier/enhanced accessibility to the patient. Double-articulating and magnetic headrests will allow greater flexibility in patient positioning. Majority of pediatric dentist think instrument tray size is sufficient in both the dental chairs. However, different delivery system has its impact on the operator's health and productivity-either positively or negatively. Some are better suited according to operatories, some work best for taller operators and others lend themselves well to higher productivity. [6],[12]

Respondents experience that spittoon is an important part of dental chair and felt it is easier for a child to reach spittoon on a pediatric dental chair due to its size and its close proximity. It could be explained as patients don't have to stand or lean forward to reach spittoon as in traditional dental chair. To overcome this problem a movable or adjustable spittoon should be available.

A very significant finding in our study was that pediatric dentists prefer pediatric dental chair for their clinic, but don't think purchasing it to be cost effective. As most of the pediatric dentists are general practitioners so prefer traditional dental chair in their clinic as pediatric dental chairs cannot accommodate adult patients. This may be an important reason why pediatric dental chair is still not so accepted in the current scenario.

In conclusion despite lots of pros and cons about pediatric dental chairs, respondents believe that modifications in traditional dental chair possibly will make it a standard pediatric dental chair.

Summarizing the above points, it is indispensable to change the available pediatric dental chairs. According to Newell and Kumar, dentists can reduce the risk of developing musculoskeletal discomfort by using proper body posture and positioning during clinical procedures. [5] Proper positioning of the child patient, can not only have positive ramifications for the operator's posture, comfort, and career longevity - it can also lead to better treatment and increased productivity.

During the study, it was found that ergonomics and usability issues were the main problems. Well-designed patient chair and dental delivery systems are of paramount importance to the comfort and health of the dentist. [6] When a dentist buys a chair that fails to incorporate proper ergonomic design and features, there are only 2 choices: To live with it and suffer from musculoskeletal discomfort or buy new equipment and sell the old. Neither is an attractive option. It makes more sense to do study and formulate certain standards or guidelines for pediatric dental chairs that will benefit our health and extend our career right from the start! The present study is based on the self-reported experiences of the respondents. Doing a comprehensive study would provide more detailed information. The study allowed for general ideas for the improvement of pediatric dental chairs available in the market and thus improved dental chair would fill the gap in the current market.

 
   References Top

1.
Glenner RA. The dental chair: A brief pictorial history. J Am Dent Assoc 1973;86:38-49.  Back to cited text no. 1
[PUBMED]    
2.
Valachi B, Valachi K. Mechanisms leading to musculoskeletal disorders in dentistry. J Am Dent Assoc 2003;134:1344-50.  Back to cited text no. 2
    
3.
Nagpal A. Train yourself to work without Pain - Maintenance of Musculoskeletal Health in Clinical Practice. Indian J Dent Sci 2012;4:17-8.  Back to cited text no. 3
    
4.
Kierklo A, Kobus A, Jaworska M, Botuliñski B. Work-related musculoskeletal disorders among dentists - A questionnaire. Ann Agric Environ Med 2011;18:79-84.  Back to cited text no. 4
    
5.
Newell TM, Kumar S. Prevalence of musculoskeletal disorders among orthodontics in Alberta. Int J Ind Ergon 2004;33: 99-107.  Back to cited text no. 5
    
6.
Valachi B. Ergonomic guidelines for selecting patient chairs and delivery systems. Dent Today 2009;28:130, 132-3.  Back to cited text no. 6
    
7.
American Academy of Pediatric Dentistry reference manual 2011-2012. Pediatr Dent 2012:331-12.  Back to cited text no. 7
    
8.
American Academy of Pediatrics. Principles of patient safety in pediatrics: Reducing harm due to medical care. Pediatrics 2011;127:1199-210.  Back to cited text no. 8
    
9.
American Academy of Pediatric Dentistry. Policy on Patient Safety. Pediatr Dent 2008. p. 103-5.  Back to cited text no. 9
    
10.
Valachi B, Valachi K. Preventing musculoskeletal disorders in clinical dentistry. J Am Dent Assoc 2003;134:1604-12.  Back to cited text no. 10
    
11.
Hokwerda O, Wouters JA, de Ruijter RA. Ergonomic requirements for dental equipment. Guidelines and recommendations for designing, constructing and selecting dental equipment May 2006. Available from: http://www.optergo.com/images/ Ergonomic_req_april 2007 [Last accessed on 2014 Jan].  Back to cited text no. 11
    
12.
An Introduction to Ergonomics: Risk Factors, MSDs, Approaches and Interventions. A Report of the Ergonomics and Disability Support Advisory Committee (EDSAC) to Council on Dental Practice. p. 1-26.  Back to cited text no. 12
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7]



 

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