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| ORIGINAL ARTICLE |
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| Year : 2018 | Volume
: 7
| Issue : 1 | Page : 13-17 |
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Effect of handedness in professional dentists
Anu Arora1, Pinky Saiya2
1 MPT, School of Physiotherapy, D.Y. Patil University, Nerul, Navi Mumbai, Maharashtra, India
2 B.P.T, Physiotherapist, Mumbai, Maharashtra, India
| Date of Web Publication | 11-Jun-2018 |
Correspondence Address:
Dr. Anu Arora
D.Y.Patil University, School of Physiotherapy, Nerul, Navi Mumbai - 400 706, Maharashtra
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jdas.jdas_22_17
Context: The availability of appropriate tools and equipment's according to the dominant hand is very important for safe and effective dental education and professional dental practice. Aims: To study the effect of handedness on professional practice in left and right handed dentists from Mumbai and Navi Mumbai. Settings and Design: Cross-sectional study of left handed and right handed dentists (including students pursuing final year in dentistry, interns, post graduate dentists and professional dentists) Subjects and Methods: A self devised questionnaire was drafted with due reference to the review of literature. The pre validated questionnaire was administered to the study subjects via a face-to-face method. Statistical Analysis: Descriptive analysis of the data was done using mean and standard deviations for quantitative data and proportions for qualitative data. Results: 53% of left handed were males rest 47% were females. Currently 53% of the left dominant dental population were using left sided dental chair however 83% would prefer to use left sided chair in their future practice. 93% of the left handed population did not receive suitable tools according to their hand preference. 80% did not receive the guidance based on hand preference during the educational years. 7% of right handed and 20% left handed dentists experienced injuries due to the right biased tools and/equipment's, whereas 7% suffered an injury due to right biased layout of work. 37% of the left handed population believed that their performance would be better if they would have been right hand dominant. Conclusions: Handedness was found to have profound effect in the professional work of dentists in both students studying dentistry as well as in professional dentists.
Keywords: Dentistry, dentists, handedness, questionnaire
How to cite this article:
Arora A, Saiya P. Effect of handedness in professional dentists. J Dent Allied Sci 2018;7:13-7 |
| Introduction | |  |
Dentistry is a profession concerned with various problems related to mouth, teeth, and gums managed through dental care and correction, extraction of teeth, filling and fitting dentures, oral surgeries, replacement of extracted teeth, etc., Proficient dental practice not only requires a sound theoretical knowledge but also a high degree of manual dexterity along with the use of correct tools and equipment to perform the dental procedure, proper angulations of the tools to be used along with the appropriate position of the dentist as well as the patient.[1]
The advances in technology have witnessed a rise in the advent of highly sophisticated equipment to enhance the efficiency of dental practice. However, optimum usage of these is reliant on the dominant hand, which thus is a very important consideration in a field-like dentistry wherein majority of work depends on the precision of the hands.
Handedness is the dominance of one hand over the other or the unequal distribution of fine motor skills between the left and right hands. Left-handedness is the predominant use of left hand over the right hand. Evidence in literature points to a preference for the right hand in around 90% of the population.[2],[3]
The world of dentists such as all other professions though is dominated by right-handed professionals, there still exists a sizeable proportion of dentists who are left handed.[4] There exists a need to increase, acknowledge, and appreciate the need for tools and equipments to cater to this neglected segment.
According to the Occupational Health Safety Association, work-related musculoskeletal disorders (MSDs) are defined as the disorders of muscles, skeleton, and related tissue, which have been shown or suspected to have been caused by workplace activity.[5] Evidence in literature corroborates that the dental professionals are known to be at a higher risk for work-related musculoskeletal problems including cumulative trauma disorders.[5],[6],[7]
The past century has seen a remarkable advancement in the use of technology in all spheres of life. Medical and dental field is no exception to this technology boom. Unfortunately, however, his advent has been biased toward the right-handed people. Inadvertently, though this could have an adverse effect on the professional practice of these professionals, especially those professions such as dentists where dexterity is of paramount importance.
Hence, this research aims to study the effect of handedness on professional practice in dental professionals.
| Methodology | | |
A retrospective study was conducted on a group of thirty dentists with minimum practical experience of 3 years performing various dental procedures. The conveniently sampled participants were stratified as per their hand preference with 15 subjects in each category, i.e., left- and right-handed practicing dentists.
Individuals suffering from concomitant musculoskeletal or neurological disorder which could affect the outcome of the study were excluded from the study.
Ethical approval
The ethics clearance was obtained from the Institutional Ethics Committee of D. Y. Patil University, School of Physiotherapy, after submission of a detailed synopsis with methodology. Written informed consent was obtained from all the study participants.
Procedure
For the survey, a questionnaire was formulated with due deliberations of the available literature and validated by two experts in the field. Revisions were made based on comments regarding the language, format, and context issues of the questions.
Questions were based on the differences seen among the left- and right-handed dental populations during the educational years and professional practice due to the choice of hand dominance. This was based on the unavailability of appropriate tools and equipment, increased level of difficulty compared to the right-hand dominant counterparts.
The survey questionnaire contained information on the following domains:
- Demographic details (age, height, weight, gender, information regarding the dominant hand, education qualification, and professional experience)
- Availability of left-sided study chair and dental chair during the educational years
- With the current dental practice which sided dental chair being used by the left-handed dentist, which sided chair would be preferred (if given a choice) in future professional practice
- Preferred side to keep the instrument tray according to left-hand dominance
- Preferred side foot to be used to manage foot controller by the left-handed dentist
- Requirement for an assistant for performing various dental procedures
- Prevalence of various musculoskeletal problems in the right- versus left-handed dentists
- Level of difficulty experienced by the left-handed dominant dentist when the required tools and equipments are not made available
- Information about appropriate guidance made available to the dentist during study years according to the needs of the hand dominance.
The data were collected through the questionnaire by a face-to-face method, and the analysis of the data was carried out using descriptive statistics.
Data analysis and representation
The data were analyzed using Microsoft Excel sheet and Microsoft Word 2010. Means and percentages used to describe data variations.
1. Demographic details - 53% of left-handed dentists were males whereas remaining 47% were females. However, there was an equal distribution of males and females in right-handed dentists
2. Availability of left-sided study chair and left-sided dental chair for left-handed dentists
Inference from data analysis. During the education years, the availability of left-sided study chair was 27% and dental chair was 53%, respectively [Table 1]. | Table 1: Availability of left-sided study chair and leftsided dental chair for left-handed dentists
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3. Which sided dental chair is currently being used by left-handed dentist and which would be preferred in the future dental setup
Inference from data analysis. 53% of left-hand dominant dentists are currently using a right-sided dental chair whereas the remaining 47% are using a left-sided dental chair. However, among the left-handed dentists, 80% would prefer using a left-sided chair, 7% a right-sided chair, and 13% an ambidextrous chair in future dental practice [Table 2]. | Table 2: Dental chair currently being used by left-handed dentist and future preference for a left-biased chair
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4. Using a right-sided chair, the levels of difficulty experienced
Inference. The level of difficulty experienced by the left-handed dentists, whereas using a right-sided chair, 13%was mild difficulty, 47% moderate difficulty, and 40% severe difficulty [Table 3].
5. The availability of left-sided tools and equipments
Ninety-three percent of left-handed participants reported that suitable tools and equipments were not available during their education years.
6. Awareness of the availability of left-sided tools and equipments
Forty-seven percent were not aware of the tools and equipments catered for the left dominant dental population.
7. Injury due to right-handed tools and equipments and right-biased layout of tools
Seven percent of right-handed and 20% of left-handed dentists suffered injuries due to right-handed tools and equipments. Nearly 7% of the left-handed population experienced injury due to right-biased layout of work.
8. Placement of the instrument tray preferred on which side
Twenty percent gave the preference of having the instrument tray to be placed on the right side, 73% on the left side, and 7% choose to have it on both sides.
9. Foot controller controlled by which foot
Sixty percent of left-handed dentists would prefer using the right foot to control the foot controller.
10. Assistant required during the dental procedures
Seventy-three of the left-handed and 53% of right-handed dentists needed an assistance to hand over the instruments.
11. Training availed as per the need of the dominant hand.
Eighty percent said they did not get the required training from a tutor according to their dominant hand.
| Discussion | | |
The study was undertaken to assess the effect of handedness in professional dentists through a survey-based analysis of current status and future preferences in left-handed and right-handed practising dentists.
Gender-based demographics
Demographic analysis pointed to the fact that the number of left-handed female dentists (47%) was less compared to the left-handed male dentists (53%). The society, in general, has always dictated certain norms with respect to what is considered a normal behavior. Such a leaning is clearly seen toward right-handed persons wherein every possible means are tried to convert a naturally left-handed child into right-handed one. This is particularly relevant in the Indian society, where the females especially are expected more to adhere to the norms, and right-handedness is considered the so-called normal way of doing things. This could probably be the reason for more left-handed male dentists as compared to females.[8]
Dental chair
Treatment is greatly influenced by right-/left-sided dental chair being used by the dentist based on the needs of the dominant hand. In India, there do not exist any specifications for the type of chair being used for the dental procedure. In our study, 100% of right-handed said that they were using a right-sided chair at present and would prefer the same in the future. However, the same scenario was not observed among the left-handed dentists. A greater number of left-handed dentists were performing treatments on the right-sided chair; this was primarily due to the difficulty in availability of the left-sided dental chairs. This discrepancy could also be due to the paucity in awareness about the existence of handedness-based chairs among dentists.
This could be because less importance is given to the needs of southpaw due to various reasons which might include the following: decreased comparative prevalence of left-handed individuals, low awareness about the need of adequate tools and equipments catering to the dentists' hand preference for pain free and safe practice.
However, a majority of the left handed would prefer to use the left-sided dental chair, with about 13% preferring to use an ambidextrous chair, this could be because over a period of time they might have adapted themselves and become ambidextrous.
Foot controller manipulation: Choice of foot
Depending on the left- or right-sided chair and the laterality of the practicing dentist, it depends on which foot would be preferred to control foot controller. Usually, the foot opposite to dominant hand is most preferred for effective treatment (as coordination can be best understood with the example of walking, opposite hand and foot move together, i.e. when the left foot moves forward simultaneously the opposite hand swings ahead).
The opposite hand and foot work in a combination. However, a number of left-handed dentists (40%) preferring to use the left foot to manipulate the foot controller could be attributed due to unavailability of the left-sided dental chair.
Instrument tray
The most preferred side to keep the instrument tray is toward the side of dominant hand. Nearly 100% of right-handed preferred it on the right side; since being right handed using the right hand for lifting the tools would prove to be most ideal. However, in case of left-handed dentists, majority preferred it on the left side with about 20% of the population preferring it on the right side and 7% requiring an instrument tray on both sides. The placement of the instrument tray on the left side with a right-sided chair would require the left-handed dentist to perform more work in terms of twisting and turning of the back to lift the instruments from the wrong side. Furthermore, it would need more time if the instrument is picked up with the right hand to transfer to the dominant hand. This could lead to inconvenience experienced by the left-handed dentists with respect to right hand-biased tools and equipments.
Requirement of an assistant
More number of left-handed dentists requiring an assistant could be caused due to greater inconvenience experienced by them due to right-handed tools and equipments and right hand-biased layout of work.
Ambidexterity in practicing dentists
Thirteen percent right-handed and 20% left-handed expressed that they could use the nondominant hand as well the dominant without any difficulty. This greater ambidexterity in left-handed as compared to the right-handed dentists could be because of the fact that the world has been designed for right-handed individuals wherein left-hand dominant individuals have always had to adapt themselves to carry out their life tasks. This practice over a period of time helps them develop ambidexterity.
UG/PG college offering equipments specific to the needs of a left-handed individual
Majority of the left-handed participants in this research did not receive a left-sided study chair, dental chair, and adequate training from an experienced left-handed tutor. It is also important that correct techniques being taught to the left-handed dental student by a left-handed tutor to train them and guide them for optimal patient treatment (modify techniques).
This could be since the prevalence of left-handed people compared to right-handed is very low, i.e., 10% of the population is believed to be left-handed.[9] Furthermore, the right-handed teacher would not be aware of the difficulties faced by the left-handed counterparts, thereby not being able to guide them better.
Discomfort experienced
Seventy-three percent of the left-handed dentists experienced discomfort when the above (left-sided study chair, dental chair, training guides from tutor, and left-handed biased tools and equipments) were not provided during their study years. This means that if the basic things could be provided to them during their study years, then the learning would be more effective and smooth.
Levels of difficulty experienced by left-handed dentists using right-handed chair
Right-handed dentists experienced less difficulty as compared to the left-handed dentists since the needs of right-handed dentist are met with a right-sided dental chair and right-biased tools and right-biased layout of work catered specially for the right-hand dominant individual. Since these were not made available to the left-handed counterparts, they usually face more difficulties.
Performance affection
Performance affected in terms of reduced speed/skill, promotion not achieved, and teasing from coworkers. Nearly 60% experienced that their performance was influenced due to right-biased tools and equipments. Almost 20% were not promoted. Nearly 7% experienced teasing from coworkers or supervisors. This could have been prevented if the practicing dentists would be provided with adequate tools and equipments according to their hand preference.
Injuries experienced while using right-biased tools and equipments
Our study revealed that 7% of right-handed and 20% left-handed individuals experienced injuries. Although multiple risk factors have been identified for MSDs, the most prominent ones include poorly designed or improperly used tools and equipment, awkward body posture, repetitive movements, and the use of vibrating tools. Since all the above-mentioned risk factors are part and parcel of routine clinical dental practice, it is not surprising that a high prevalence of MSDs is seen in professional dentists.[6],[7] This risk naturally increases many folds when left-handed dentists are forced to use tools and equipment designed for right-handed dentists.
Although injuries are seen in the right- as well as left-handed individuals, its prevalence found to be greater in the left-handed (20%) than right-handed dentists (7%). This could be owing to the disadvantages seen in left-handed dentists, in terms of right-handed tools, right-biased layout of work, inefficient training guidelines, etc.
Our study pointed out that though a sizeable proportion of left-handed dentists, either because of lack of availability of handedness-specific equipment or lack of awareness, have not reported much difficulty or an enormous rise in the incidence of musculoskeletal problems viz-a-viz right-handed dentists. This not only indicates their optimistic attitude but also a tendency to accommodate to existing circumstances.
Awareness of the availability of left-sided tools and equipments
Forty-seven percent of study participants were not aware of the availability of left-sided tools and equipments. With such high prevalence of lack of awareness, even if there are commercially available options to cater to the needs of left-handed dentists, they would still not avail of them.
Believe performance would be better if the out handed individuals would be right-handed
Thirty-seven percent participants believed that their performance would have been better if they were right-handed. Handedness is predetermined, left-hand dominance should not be considered as a disadvantage rather equal importance should be given, and appropriate availability of the required requisites should be made for the same. Both hands are mirror images, and hence equal importance to develop tools and equipments catering to the needs of the hand should be made.
Appreciate the above to be made part of dental curriculum
The dental reported that as students they did not receive guidance in proper and handedness specific use of chair and equipment. Nearly 93% of right-handed dentists and 100% of left-handed dentists said that the above is made part of the routine dental curriculum. This reemphasizes the need for a more empathetic consideration by dental teachers and the dental institutions so that the specialized needs of this marginal but not any less significant number of dental professionals are catered to.
| Conclusion | | |
Although as per statistics, left-handed dentists are in minority but still form a sizeable proportion of the population.
There exists dearth of awareness about availability of handedness-specific tools and equipment in dentists. There does not exist a pattern of teaching in dental education institutes that caters to the needs of left-handed students in terms of availability of study chairs, dental chairs, handedness-specific tools and equipment, and left-handed dental professors to impart training.
Prevalence of musculoskeletal problems is high in dental professionals per se, and this affliction rises further in left-handed dentists making the use of tools and equipment and techniques conscripted for right-handed personnel.
Hence, through this study, we recommend remedial measures to cater to these lacunae in dental practice, thus optimizing its effect and making it safer.
Dentists require good fine motor skills. The intrinsic muscles of the hand need to be strong as they utilize various instruments to be held in the hand for long periods of time to perform dental treatments without undue muscle fatigue.
An intensive exercise program should be made mandatory for all dental professionals to improve the strength of intrinsic muscles and thereby elicit pain-free dental treatments.
Acknowledgment
The authors would like to thank the dental students and professional dentists who were a part of this research.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3]
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