The Harmony Handle is perfect for a modified pen grasp: the tapered shape invites and improves the coupling of the finger pads during high force pulling motion required for scaling. (Images: HuFriedyGroup)
The choice of a particular ergonomic design of a hand scaler or curette can have strong implications on hygienists and patients. The proactive search of the best tools can be a strategy to prevent pain and to protect the hand health of the clinicians as well as add evident comfort to the patient.
Musculoskeletal disorders (MSDs)
MSDs are not rare nor uncommon among dental clinicians and hygienists are at greater risk for chronic pain due to the repetitive nature of their job.1,2 MSDs are defined as injury of the bones, joints, ligaments, tendons, cartilage, nerves, blood vessels and/or muscles of the hand, arms, neck, back, legs or any combination.3 Very debilitating!
Attention to its diagnosis and treatment need to be just as immediate as signs or symptoms appear. One may experience aches, stiffness, burning sensation in the muscles, fatigue, twitches, up to chronic headaches and sleep disturbances.4 Same for joint noises, tingling, inflammation, weakness and a decreased range of motion. Pain comes suddenly and relentlessly affecting professional performance causing the inability to maintain an enjoyable workplace environment and a high-quality lifestyle.
Ergonomics is prevention
We can’t assume we will continue to remain healthy if we don’t consider ergonomics. Especially for those hygienists who scale by hand, practicing good ergonomics, avoiding pain and wrist protection, prevents long-term issues associated with MSDs.5
Inevitable forcefully pinching between thumb and index, repetitive strain and cumulative trauma can also be worsened by anti-ergonomic choices of the instruments: too heavy instruments (>25 gr), too smooth or thin (<0.6mm) handles, inadequate shape of the handle (that doesn’t enable an easy maneuver and rolling in between the fingers), unbalanced dull instruments.6,7 Same for the posture, the equipment and the environment: a weak fulcrum, an inaccurate grasp (i.e. uncontrolled hyperextended finger joints), poor lighting, the incorrect clinician posture on the stool, a poor variation in clinical procedures and an unbalanced work-life balance can be of serious impact for the overall health of the clinician.8
Ergonomics is science
The design of an ergonomic instrument cannot be intuitive or based on assumptions: it has to be the result of test data and empirical.9 TrueFit Technology is an advanced sensorbased technology that, for the first time in the dental field, gives voice to a scientific approach to ergonomics. This sensorbased system is capable of measuring touch sensitivity and pressure on the tooth. Similar to software engineering, this iterative development process allowed the research department of HuFriedyGroup to collect 2,878,320 data points from hygienists around the world, with no bias to the brand nor product preference, who participated in testing several different handle design. The data were finally revised and elaborated by an unbiased analytics firm outside the dental industry.10
This step-by-step approach of design-test-revise allowed to make evidence on key factors like reduction of pinch force of the fingers around the handle and pressure on the tooth. Harmony are the first scalers with a science-based design.
Look and try
The Harmony Handle is perfect for a modified pen grasp: the tapered shape invites and improves the coupling of the finger pads during high force pulling motion required for scaling.11 Moreover the difference of diameter along the handle allows the grasp to change position while adapting the working end to the different areas of the mouth: another hint to distress the pinching too forcefully the instrument and avoid cramps and rigidity.6
Adaptation to all hand sizes is also facilitated by the recessed double-helix knurling pattern surface texture assuring a safe and easy rolling of the instrument between the fingers. The final results are very encouraging: there is a good combination of decrease pinch force against the handle (65% compared to other ergonomic scaler design), minor pressure needed against the tooth (37% less compared to other leading scaler handle design) that results in significant and precious patient comfort without sacrificing effectiveness.10
The combination of these obtained features with the EverEdge 2.0 Technology of outstanding sharpness of the cutting edge (72% sharper than the next leading competitor) gives evidence to the efficiency, comfort and ergonomic qualities in one instrument.
Netanely S, Luria S, Langer D. Musculoskeletal disorders among dental hygienists and students of dental hygiene. Int J Dent Hyg. 2020; 18(2): 210-216.
Hayes M, Cockrell D, Smith DR. A systematic review of musculo skeletaldisorders among dental professionals. Int J Dent Hyg. 2009; 7(3): 159-65.
Lalumandier JA, McPhee SD. Prevalence and risk factors of hand problems and carpal tunnel syndrome among dental hygienists. J Dent Hyg. 2001; 75(2):130-4.
Rempel D, Lee DL, Dawson K, Loomer P. The effect of periodontal curette handle weight and diameter on arm pain: a four-month randomized controlled trial. J Am Dent Assoc. 2012 Oct; 143(10):1105-13.
Mulimani P, Hoe VC, Hayes MJ, Idiculla JJ, Abas AB, Karanth L. Ergonomic interventions for preventing musculoskeletal disorders in dental care practitioners. Cochrane Database Syst Rev. 2018; 10(10):CD011261.
Dong H, Barr A, Loomer P, Laroche C, Young E, Rempel D. The effects of periodontal instrument handle design on hand muscle load and pinch force. J Am Dent Assoc. 2006; 137(8):1123-30.
Dong H, Loomer P, Barr A, Laroche C, Young E, Rempel D. The effect of tool handle shape on hand nuscle load and pinch force in a simulated dental scaling task. Appl Ergon. 2007; 38(5); 525-531.
Michalak-Turcotte C. Controlling dental hygiene work-related musculoskeletal disorders: the ergonomic process. J Dent Hyg. 2000; 74(1):41-48.
Villanueva A, Dong H, Rempel D. A biomechanical analysis of applied pinch force during periodontal scaling. J Biomech. 2007; 40(9): 1910-15.
Hayes MJ. The effect of stainless steel and silicone instruments on hand comfort and strength: a pilot study. J Dent Hyg. 2017; 91(2):40-44.
Villa-Forte A. Musculoskeletal pain. Merck Manual Consumer Version Updated Feb 2021.Accessed Jan 7, 2022.https//www.merckmanuals.com/home/bone, joint,-and-muscle-disorders/symptoms-of-musculoskeletal-disorders/musculoskeletal-pain.
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