Mouth Mirrors + Ergonomics :)

Okay, now I'm talking about dental instruments, and it's because I don't have new make-up to talk about-- oh wait, no, that's a lie, I actually have an unopened Tarte Tease Palette, but oh well, make-up isn't everything. At least not today. 

I had just purchased new mouth mirrors which I've actually grown very fond of, primarily because they're unlike the mouth mirrors I've had in the past. These are seriously my new lub lubs, but it's not just because they look cool.

Almost a year ago, my mentor, Dr. Brian Esporlas, made a research on the level of awareness of clinicians at my school with regards to ergonomics, along with a few other professors. It also happened to be an inter-institutional collaboration with DLSHSI. Even if the research uncovered so much about the significance of ergonomics, I never really took time to actually sit down and read about it-- until now. Oh, by the way, if you're a bit confused by the word ergonomics, it's defined as the applied science concerned with designing products and procedures for maximum efficiency and safety. Or something like that. 

At school, we're tasked to perform all sorts of procedures, and a mouth mirror is almost always an integral part of the whole armamentarium enchilada. According to the text I've read, "Mouth mirrors have been referred to as the most important, yet underutilized instruments within the dental practice", and true enough, there's no way I could disagree to that. During treatment, we hold mouth mirrors around 85% (or more!) or the time. For something that important for really important work, I could probably use better and more muscle-friendly instruments.

I really don't know where to start. Because of instruments getting lost or damaged every now and then, I tend to purchase mouth mirrors from different vendors, and because different vendors sell different models, not all my mouth mirrors are the same. Unfortunately, with different handle designs, it's quite difficult to have mouth mirrors of the exact same ergonomic values. I'm primarily quoting a file on SlideShare here, but I've recently learned that the goal of proper instrument selection is to reduce force exertion, while allowing for neutral joint positioning. 

I've yet to fully understand the ins and outs of dental instrumentation and ergonomics, but I've found handle texture and diameter rather interesting. There's a really good chance that I don't know what I'm talking about, so.. Yeah.

HANDLE TEXTURE

These aren't all my mouth mirrors-- I have a few more inside my locker at school. I have a thick criss-crossed hexagonal handled mirror,  really smooth-handled mirrors, half-smooth handled mirrors.. Well, yeah, but these are a few that I have lying around the house--

It's been said that knurled handles such as diamond-shaped, or crisscross patterns serve to reduce pinch grip force due to an increase in tactile sensation as a result of the knurl. I'm guessing that what this means is that knurls on handles will require less effort to hold the instrument. Thinking of application, I'm inclined to periodontal scalers and curettes, but I really think this holds true for mouth mirrors as well.

Okay, so let's talk about knurls. I know that knurl is such a cutesy word, but from what I've gathered, knurls are basically little projections.

One of my mouth mirrors has criss-crossed knurls, but only a few centimeters into the handle until it smoothens out the rest of the way.

I spent a good five minutes re-evaluating where along the handle do I actually hold the mirror, because if I hold it along the smooth area, then the criss-cross knurls would pretty much be.. Useless. 

I also have mouth mirrors with parallel grooves along the entire length of the handle. I'm somewhat curious as to why the criss-cross pattern is superior to parallel grooves.

The first one (criss-cross + smooth) is actually rounded, while this one is octagonal. Text says that a round handle, compared to a hexagonal handle will reduce muscle force and compression, but I do wonder, would the two extra sides in a very small area render the fact that it's a sided shape rather than a circle negligible?

Well, it's almost round, riiiight?

With so many conditions for proper instrument selection, I can't really say that my new chubby mouth mirrors are the best, because while they're of an acceptable diameter and have good diameters, their handles are hexagonal.

So maybe, just maybe, I've yet to find perfect mouth mirror handles. Hmm.

Oh my goodness, these mouth mirrors are just beautiful.

DIAMETER

It's really common for people to refer to thick instruments as mataba, which in Filipino literally translates to "fat" or "fatty"-- and I know it makes no sense, because pieces of metal do not contain lipids. Apparently, mataba instruments are actually good, becuase guidelines for handle diameters actually do exist.

As expected, my chubby mouth mirrors stand out with 9mm.:)

I was really confused when I read a bit that dental instrument diameters typically range from 5.6-11.5mm, but two of my mouth mirrors actually fall short. As stated by Dong in 2006, larger handle diameters reduce hand muscle load and pinch force, although diameters greater than 10mm have been shown to offer no additional advantage. This has seriously got me wondering-- with my 4.5mm and my 5mm diameter mouth mirrors, am excessively loading my muscles, by actually forcing them to exert more force? Damn it. I've been cruel to my body.

SO, WHAT NOW?

If you came here hoping for really intellectually-valuable insights on ergonomics, I'm really sorry to have disappointed, because in all honesty, I don't know anything. While being versed on ergonomics is totally possible, sometimes it's actually difficult to apply it in the clinics. Remember that I'm writing this from a student's perspective-- and as a student, I'm pretty much inclined to buying the cheapest and most readily-available instruments I can get my hands on, and sometimes, these "cheapest and most readily-available instruments" aren't the best, speaking from an ergonomic standpoint.

In the dental field, physical labor plays such a huge role in doing our stuff properly. Our instruments help us perform. The sad reality is that sometimes, these instruments that we greatly rely on also contribute to deterioration of our skills, especially when we start experiencing pain here and there. I'm lucky that I've yet to experience that, but I do know fellow students who actually have. Okay, so what do we do?

Maybe we can actually read up on ergonomics so that we can select our instruments better so we don't end up with twisted necks and arms by the time we graduate. Okay? Okay!

Corine Magenta