Where the head rests

Frequently during my career as a dental hygienist I have thought to myself – who designs these chairs? Since this period is closer to four decades than three, I have pored over a good many dental chairs.

But, hang on – pored is too passive a verb for what I have done. I have sweated, sworn (inwardly) seethed and slumped exasperatedly as I failed to manoeuvre the patient into a position from which I could see inside their mouths. If I was a young clinician today I would have little idea about what chair to buy. I would be drawn to the space-age contours, or perhaps the comfortable padded backs if I was a sofa devotee. But I probably wouldn’t think of asking a colleague to play ‘patient’ for me in the showroom or exhibition hall so that I could try it out, or see how comfortable it was for me if I was in the correct position for an operator to see.

Sometimes it must be agony and I can understand why the poor patient keeps
slipping down or wriggles continuously; they are suffering and that’s before we even do anything! I have subsequently discovered that the old adage, ‘one size fits all’ is false. If you consider how many of us are troubled by back and neck pain we probably should consider firstly how close we can get to the top of the patient’s head rather than what the chair looks like.

Sources of strife
The problems I have encountered are the bulkiness of the headrest, whether it moves or not, and the length of the back. Small adults have to move up the chair for their heads to reach the top and this is impossible to gauge from the sitting position. It has to be done from
the lying position if the back and headrest are all in one, and then sometimes the headrest moves up with them, which doesn’t help. The bump where the seat and back join is often too big for them to slide over so you’re left with an expanse of chair at the top, necessitating a curve in your own back to see into the mouth.
The arm rests are another potential source of strife – sometimes they protrude so much you cannot work from the front, and in one particular surgery with little space, hands lying on the arm rests have been battered by the heavy console as it’s pulled forward. Yet patients need somewhere to put their arms! Frequently the only position for them to take is with arms folded over their chest like a corpse in a coffin but this is
impossible for the larger,
overweight patients we have.
My ideal chair would have a small, adjustable headrest independent from the back that could be placed under the base of the patient’s head (rather like the old Rathbone units of yore!), and adjustable arm rests that could be swung in or out as necessary. But, of course, it’s a matter of taste and what the designers supply.

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