Dr Anikó Ball founded Optimum Dental Posture to save her colleagues from suffering occupational chronic pain as she did for decades until she learned to recognize and change harmful work postures by applying Inner Ergonomic principles.
VIDEO - DUwHF #1233 - Aniko Ball
AUDIO - DUwHF #1233 - Aniko Ball
Trained in mind-body calming techniques and Inner Ergonomics, Anikó teaches dentists and their teams around Australia and NZ how to reduce occupational chronic pain and stress. Her vision is the integration of ‘Inner Ergonomics & Wellness’ training in the undergraduate curriculum of dental schools.
Howard: it's just a huge honor for me to be podcast interviewing Dr Aniko Ball DSC diplomat clinical hypnosis advanced diplomat in Alexander Studies she's a founder at optimum dental posture in Melbourne Australia practicing general Denix general dentistry periodontics and dental sleep medicine an eco suffered frequent neck back and shoulder pain for decades doctors and physical therapists offered short-term symptom relief without identifying her condition as work-related 11 years ago Aniko was declared a hopeless case she was told anti-inflammatory medication and surgery were her only options fortunately she found out about the Alexander Technique and received the right help to recognize her harmful work posture habits learned about biomechanical design and how to apply inner ordinate or economic principles and she got well three years later Anna ko undertook a 1600 hour part-time course over four years at the Melbourne alexander school gaining an advanced diploma and founded optimum dental posture to save her dental colleagues from suffering occupational chronic pain trained in mind-body calming techniques and inner economics Anika teaches dentists and their teams around Australia and New Zealand how to reduce occupational chronic pain and stress her vision is the integration of inner organ onyx and wellness and dentistry trained in the undergraduate curriculum of dental schools thank you so much for coming on the show I'm will be 57 next month and a lot of us older guys are paying a huge price like my neck is trashed because I you know my big 10-pound ball bowling ball head you know I just leaned over and was looking direct and you're right now podcasters are young so a quarter of the people listening right now are still in dental school the rest are all under 30 what could you say to them so they don't end up like me at 57 you were we trashed our bodies trying to do dentistry
Dr Aniko Ball: well first of all I am delighted to be talking with you and thank you for the invitation what I need to say and I have a lot to say that will help young and middle and older than this but something that you may not be aware of how it is that the young dentists are in more trouble than our generation when I started teaching optimum general posture training programs I expected my generation to be flocking to my courses and what I'm finding is that young than this who are barely out of dental school mostly the participants in my workshops and they are in more pain than you and
Howard: I have ever been and I have I will talk about why this is happening does that surprise you well you know I never thought about it until you said that because I guess you know you just think of your own personal framework but yeah I see with kids a lot of times we we were out playing in the park and on the farm and exploring and they're basically just sitting there looking at their phone so I would imagine with the cell phone revolution that they get a lot less physical movement
Dr Aniko Ball: well that is one big part but also the way they look at their cell phones and mobile devices they take their head to the device and the spine wasn't designed for that so that's one of the reasons I believe and they're just not so active these days they often live in virtual reality instead of being out there kicking a ball or doing something but also and this has been a very big surprise and disappointment to me is that as most dentists these days wear magnification lives and young dental students begin to use them already and first second and third year dental school I'm finding that the declination angle of these loops is insufficient which forces young students and dentists to bend their neck in ways that the neck wasn't designed for are you aware of this problem this is something I only realize in the last two years
Howard: um this is huge yeah yeah the Engel I I know that when you get loops you should have someone come out and custom take the measurements and try to avoid all SF um but I know a friend of mine right here in Phoenix he had to go to a microscope because he could no longer bend his head he has to look at it like almost like a submarine periscope he can set up straight and look straight ahead and the microscope you know which he can adjust from 1x to 8x looking down and then I have another buddy in town who set up a video equipment just like my podcast studio where he has a screen on the wall so the video looks so he's operating looking at the big screen because he has back problems and all that stuff so what do you think of all the old guys that are in their 50s and 60s and 70s who went and had surgeries they had there's many of their spinal cervical vertebrae fused together because of dentistry
Dr Aniko Ball: well this is this shouldn't have been happening first of all we should be learning in dental school how to get our pair of eyes and hands over to the patient without twisting our bodies into a pretzel and something again that most people don't know and I surely work that way that's why it's in pain for decades already I said then all students are suffering because most right-handed dentists will twist over to the right and bend their spine and especially their cervical spine and of course we do terrible things with the shoulders and we can talk about that later so my my recommendation is that as early as possible we should be learning what not to do and what is required is very simple knowledge of biomechanical design principles and I call this inner economics 101 it's not rocket science we should know where our very important joints are and which joints are designed for bending and which are not so coming back to your question about older than this already had spinal surge for them it's more important than ever to look after their restored spine and do all the right things both in dentistry and away from the industry because what I see how it is that dentists are doing damage in the clinic and also outside the clinic with various habits whatever we do we tend to do it without thinking about ourselves and my most important message is you are your most precious instrument I see then tis taking better care of their cars and their hand pieces than themselves
Howard: yeah I mean don't even get me started on that and when you don't spend your own money on it you don't have any any incentive in the game I mean when you look at dentists as when they're employees and you go to they go to seminars they just sit there on their iPhone all day when they own the dental practice that they take notes and it's sad that humans own your own house own their own car and get totally involved in it but then they turn their health care over to other people and they don't actively get involved and own it yeah the incentives are messed up in medicine but absolutely yeah and you go to you go to these people with all the the 20 richest countries like your country of Australia New Zealand and Canada in the United States and their health care costs are exploding you say well what if you just had a 5% co-payment they did get less surgery I mean you walk into an 80 year old man and say your well your knees got arthritis you need a $50,000 knee replacement they go well you're the doctor but if you said but you have to have a 10% co-payment you got to pay five thousand of that fifty thousand well how many old men would say now forget that I'm not paying five thousand dollars that and walk out of there and then and then other people think well that's abusive he should have had it free well there's no push back you know there's no him saying well maybe if I lost weight or maybe if I quit smoking or maybe I should join a gym I mean I got to pay ten percent of this $50,000 hip replacement knee replacement you know I mean so they don't have any the economic incentive but but so now you think these younger dentists are gonna have it worse than than we did
Dr Aniko Ball: they already do whenever I run workshops or I often present to hundreds of dentists and often large percentages young I always ask for a show of hands who is having pain discomfort tingling whatever symptoms in various body parts and you would be shocked to see what happens almost there almost is not a single dentist whose then hands don't go up many times I've also been in Melbourne dental school teaching oral health therapy students who are only in general student clinic and all of them a hundred percent out of fifty-five or put their hand up for four different paint locations so this is typically what I'm finding among young than this not just multi-pane severe pain and I'd like to just come back briefly to your question about a bath loops it is not enough to be measured that first of all people then they should never buy loops online or at temple Expos because you should be measured up in your practice however what I'm finding to my great disappointment is that the people who come out to measure you have no idea about biomechanical design and they set up even though they'll measure your interpupillary distance they seem to set up the declination angle as if you were working in front of you and not down where the patient's mouth is so there is a so what most people don't understand that manufacturers certainly don't is that unless you're using a periscope type arrangement for example microscope or there is now an type of loop called Pentax made by Hoya which is like an upside down periscope but it's a loop unless you're using one of those you cannot sit upright and hope to look into your patient's mouth without damaging your neck anyone who is using regular loops should be people think forwards at the hip joint without thing and and bending the spine and then look down from the top of the spine which is just at the height of the ear so if you imagined that there was an imaginary rod between your ears that's where the hairs can actually look down from the top of the spine and there's only a 10 degree freedom to look down beyond that you're damaging your cervical spine and the declination angle that's required is it's about 45 degrees and most loops do not have that I have not yet seen fixed loops that understand that there is the amount they need to provide and of course then this that would have the right amount of declination angle if they're sitting upright they can't possibly look after themselves
Howard: I noticed a lot of times if you say the word organ Amon to dentist a lot of them say oh oh yeah I already got I got the chair like basically if they buy you know they buy something a chair and they can check that category off and so what try to explain to this dentist listening to you who thinks oh I don't have a posture problem I this you're talking about somebody else and they do it right now it's above their comprehension how could you paint a picture so this young dentist listening to you knows that that's them or not
Dr Aniko Ball: well yes that's a very good question and I'll start with my own story after having decades of pain I asked my local dental association to send out somebody who could advise me about the ergonomics and someone came out from work health and safety and looked at the bench height and my dental chair didn't actually look at what I was doing and I was twisting myself into a pretzel and years later when I started training in in the Alexander Technique and looking at what I was doing inside myself I realized that all the research and development in dental ergonomics has been about the outer about the dental chair the stool the instruments which are all very important and by the way and we can talk about this separately a lot of what is supposedly economically designed after I call all these outer ergonomics is not economically designed and not respecting biomechanical design and then I separated what we're doing inside ourselves and there is the dentist's efficiency in posture and movement is the inner economics and that is just as important as the after economics so the way you sit how you hold certain instruments the way you bend over the patient what you're doing inside yourself is very important and it's been completely overlooked and what I spend all my time in is teaching dentists how to organize themselves from the inside out so that they're not damaging themselves and of course there are times where there's an outer and inner economic interface such as the magnification loops or the dental stool that I investigate because no matter how well you have learned to sit and pivot at the hip joint they look into the patient's mouth if the declination angle is not right of your magnification loops or the dental stool is truly hopeless and many are then you can't look after yourself but my focus is on the in ergonomics
Howard: and so on your website what could my dentist homies find if they went to optimum dental posture com I assume it's just a picture of me sitting in my dental chair perfectly
Dr Aniko Ball: at this point on my website people will find some information about optimal posture and the various programs that are available at this point I haven't put all my postings on my website which I will do the best way that this can educate themselves on what will make a difference is if they they look me up on on Facebook and post on there my name and also on their optimal dental posture Facebook page I have a lot of postings with tips and advice and techniques I do post on LinkedIn however LinkedIn hand is now limiting the word count on any posting and that times I give up because I need to cut out too much when did when did they do that
Howard: Oh in the last two years that Microsoft bottom and as an American I'm you know when I see Bill Gates out there and he's gone around the world trying to get rid of these and everybody's like oh he's a new Ghandi yeah this is the guy that during my entire business career for thirty years every time they release software just filled with bugs filled with errors filled with everything usually you'd give Microsoft two or three hundred dollars for software than have to pay someone three thousand dollars just a patches stuff together so you know when America when Microsoft is a company the world gets another Chrysler they're not gonna get a mercedes-benz they're not gonna get Alexis or gonna just so when they bought LinkedIn the first thing I thought was oh god now they're just gonna and and now you're saying they limited the word count
Dr Aniko Ball: absolutely I used to post them Lots on or LinkedIn now a lot of the time I don't bother because they're it's not even a word count it's its character count so it's it's ridiculous so
Howard: so wait why do some countries like Germany and Japan just want to build an excellent product and America is just known for a man if she'll buy it at that price just sell it or don't have to work right I mean what wait where does that come from you're talking about dentistry yeah I mean I know I'm you were talking about Microsoft buying LinkedIn it's just embarrassing but we'll go back to I think if you want it here's my thoughts on LinkedIn is that I'm the dentist or on dental town Facebook whatever but if you're in the business you're the manufacturers if you're the whole rusted value chain the dental manufacturers the dental insurance you know anybody who's not in clinical dentistry the dry hands are on LinkedIn and and I appreciate the 40,000 dentists who follow me on LinkedIn it's a very unique crowd than the the dentists we have on dental town but but back but let's go back to these these young kids do you think they are they when are they first in pain
Dr Aniko Ball: I mean it is paying the first time they realize that something's wrong does it take pain well a lot of dental students write to me so I receive emails and and facebook Messenger contacts from dentists and dental students all over the world especially from Australia of course and many of them are already in second and third year as soon as they start using loops and there is a dental comes as a company selling loops at ridiculous discount 40% discount and of course the students buy it is irresistible and the declination angle is completely wrong it's fixed through the lens so it can't even be adjusted and they are in pain unfortunately by the time people feel pain trauma has been happening for some time this is called cumulative trauma every time we are twisting our bodies repeatedly or holding postures that we're not designed to hold then damage is happening as a cellular level and it accumulates so by the time you feel it it's been accumulating for some time and so pain and stiffness are our warning signs but it's already been happening so my aim is gone no so you basically what you're saying is that the loop has to be adjustable from the glass it cannot be fixed to the glass well it could be if meth manufacturers and the reps who fit them understood what is required otherwise I recommend these days to buy adjustables provided loop's have got enough adjustability because some adjustable loops don't have enough adjustability some have a nose piece that sits right above your nose and if you don't have a small nose or there's some irregularity on your nose it will be limited in the adjustment and I've seen this and unfortunately Howard even dentists who have adjustable loops don't actually know how to adjust it so when that is coming to my programs the first thing I do is is I adjust it for them and would you believe and this is absolutely crazy that the companies who make adjustable loops provide the dentist with such a shallow kiss that even once it's adjust that in order to fit it back into the case they take it out of adjustment so I'm talking to all the different general companies that or companies that make loops and explain to them that they need to improve their products improve their case I'm calling all the companies that I get a chance to communicate with accountable they haven't been looking after than this as well as they should have
Howard: so what's the list of those companies um there's um who would you say the big the big loops are
Dr Aniko Ball: orascoptics or escopeta carbine trying to educate in Australia they have no idea what is required it's fine if you are a certain operating on an operating table or you're a jeweler or a dental technician and your work is in front of you at your desk height but it's it's not suitable for dentists Oris Coptic has been making fixed loops at the as insufficient declination angle settings and I've had a number of conversations with Australia Norris Coptics and I'm hoping they make changes at the moment they can't provide sufficient angle I finding that heine understands biomechanical design principles Judah's hiney hey G and H e I Andy Heine it's a German company distribute through Ivo Claire in Australia okay so Heine I need dental loops through yes these are adjustable and they have a good amount of adjustability I have tested it and you can definitely get the correct declination angle now the first one you said or sculpted do they sell adjustable or is it all fixed as far as I know I've only seen fixed and at this point I don't recommend they're fixed loops okay and and the see these are high knee
Howard: Hynde dental adjustable loops there they are ha and who to guess a superior made product was from Germany I'm just really really surprised so and
Dr Aniko Ball: by the way Howard I just like to say that are not associated or involved with any dental company I I firstly protect my independence so that I can critique everything from a perspective of inner economics what's truly good for dentists
Howard: well good that that is uh it's a meaning I the one thing I've noticed the most in my short time on earth is the how much trust is gone I mean it's just amazing how many people I mean you tell them anything and they don't trust sources I mean they so it's great to see people that are still focused on the need for trust another one you didn't mention was a surgical
Dr Aniko Ball: surgical is the company that has got this no space I thought initially that surgical and high knee had the same amount of adjustability but the design of search cell is such that it there's no space which sits right above your nose and it's part of the adjustability design is won't work for certain people who have got unusual shi'ite noses or larger noses
Howard: so that that was that was with Serge Attell yes yeah now or skeptic that got bought by mmm-hmm kur and I got my Danaher and they're spinning off their dental division this month and so it's always not a really great sign when the parent company wants to spin you off because they want to focus on someone else but Sir to tell that that that's still ran by the founding father I would have you talked to him
Dr Aniko Ball: I've only talked to the Australian manager and I I very honestly give feedback my interest is to improve the company's abilities I offered for example or ask optic free training to all their reps just so they understand what they need to do III I am happy to give feedback to any company and upon them well or escopeta didn't for about two years the new Australian manager has had a conversation with me I'm not sure what it will take to make changes okay well
Howard: I just I just sent you an email to the owner of Serge Attell I can and that that guy he's more obsessed with I mean he's so into this I can't imagine him not wanting to learn all about it from you so I'll just send you an email yeah thank you yeah but so and so we talked about orsk optic surgical hyn optic optic and in germany in any other ones
Dr Aniko Ball: I have yet to investigate zeiss adjustable loops however recently I was in Tasmania training then all team I go out to practices and trained teams and several of the dentists had the adjustable zeiss loops and I was quite impressed with the adjustability I
Howard: I have some dentist friends like Craig steak in an Albuquerque he who is a you know just an amazing a hunter and I didn't know what to get him for his birthday one time so I bought him the Zeiss binoculars and it just blew him away I mean he can't believe that they were that good I mean it's just it's just amazing but so you so what has the company of Zeiss have they been accessible and available to you –
Dr Aniko Ball: well they they approached me last year and wanted to meet with me and they had big plans and then nothing happened this has happened this this is something that's happened many times that companies are very keen to get my input and I'm so happy to do that I don't charge for my time it's my pleasure to make a difference to any product that helps dentists and quite often nothing happens yeah does that make you feel bad or how do you how do you deal with that I have a very good attitude Howard I just think that sooner or later something will come of it I think of sowing seeds and I keep spreading my message and companies get in touch with me and eventually they'll call me back again
Howard: yeah so Carl Zeiss I you know a lot of work I've had the best luck is just seeing them in their in their own environment I mean that's when you when you go see those companies you get a see you know like when you walk in there is it clean or is it available do they do they um you know just what does it look like and I've just done that like my dad did with us but I've taken my boys to probably every major dental company like when we went to Melbourne where you live um you know you have the largest biggest international dental company SDI and so I went over to SDI I said who who's this SDI and the guy didn't know me from Adam his name was hot Cheatham he invited me in he showed me the whole facility with I think I had two or three of my boys and at the time his daughter was about my age and she was in the workings now Samantha is the own as the CEO of that company she's podcast 1181 but when you walk into the facility lately here's what I learned about American companies when you walked into a German or a Japanese company they had ten guys in lab coats they were PhDs but they didn't have a marketing department they didn't have a telemarketing you know al bound sells no graphic just not just R&D; that with the belief that if you make it good it'll sell then you go to American companies that do a hundred million dollars a year not one PhD and then you walk in a room is like 30 people telemarketing dialing for dollars they have a goal when a thermostat and they're trying to do this and there's raw raw and you know it's like Americans can sell anything and then you go to China and their whole padilla's we will make this so cheap you'll just buy it because it's so cheap and and a lot of times it's too cheap I just think the world needs to look what Chinese doing and try to make things lower price they need to look at what Germany Japan do and make them higher in quality and they need to look at America just sun-god marketing and advertising and if you blended the three of those strategies together you'd really have something but Americans are but like Zeiss and Germany I mean some of these German dental factories I've seen are just I mean you just don't see anything like that in the United States but have you gone down to SDI in your own backyard there and that was Samantha Cheatham
Dr Aniko Ball: no I haven't what I tend to do is I am usually a presenter at General congresses and I outside my presentation and teaching time I I walk around and meet all the older displays of companies and boots and talk to all the people who are making anything that's relevant to dental ergonomics so I don't look at materials as such but look at the way instruments are designed I look at the all the loops I look at denill stools i I investigate everything quite often these companies send me products to test out and I send it back and I give them feedback so I I don't have the ability to travel everywhere at the moment although I am invited and travel quite a lot in the state and overseas
Howard: so we talked a lot about loops we talked about wheres Coptic surgit L Zeiss behind is the chair what's what do you think is the bigger factor the chair you're sitting in or the the loops and and what would be next after loops
Dr Aniko Ball: well but before we leave loops I just want to specify that unless you are using an operating microscope or a Pentax type loop you cannot sit upright and this is a huge myth that dentists don't understand is that you have to be pivoting your torso slightly forward and then look down and we can come back to that later now what you sit on makes a very big difference and when answering partly the question about American and German and Japan and and the way that general products or any product is designed I'm finding that American and Australian companies design according to what they think will sell and plush soft they think will sell which is really bad for you whereas in Germany and Japan the companies are more willing to make a firm stool which is much better for you so what you need to look for in a general stool is that it should be firm because unless you're sitting on a firm seat and you should be sitting on your sit bones unless you get this firm feedback against your sit bones which activates your deep postural anti-gravity muscular support system you're just sinking into it and you tend to roll off your seat bones and then of course your spine is being damaged so the first thing is it should be firm the next part it should be you should be able to create a slight forward tilt many many general stores don't have that the reason is that your hip joint should be a little bit higher than your knees and it's much easier to pivot forward and look into a patient's mouth when you're sitting on a slightly forward sloping surface and that shouldn't be more than about eight degrees and the trouble is that a few dentists tools that I've seen there can tip for wood are slippery so you feel like you're slipping off so it should be a non-slip a grippy surface so these are the three points plus the backrest should be upright you shouldn't be leaning back against the backrest when you're working unless you're able to sit upright with a microscope or a special type of fluid but when you're talking to the patient you should be supported in the upright because what happens is most the back rests are back with sloping and then of course you come off your sit bones and then you're reversing your lumbar curve so and of course the the guest list the height of the chair should be fully adjustable to your height so these are the criteria that I look for and in the dental chair itself for the patient there are some very important criteria it should be very thin the back should have should you should be able to slide your knees underneath and also the headrest should not have any mechanism that gets in the way of you being able to slide your knees underneath so that's also important so
Howard: so the most important things would be the loops the chair you're sitting on the dent the stool and in the chair that the patient's in very much now these are after economics so I and also the control it should this is what
Dr Aniko Ball: I call the outer ergonomics so mix into outer which is everything in your surgery but you and they have to be well designed Sergi layout has to be right and by the way while we're at it the space behind the dental chair when the dental chair is fully supine horizontal the space between the back wall or the cabinetry and the edge of the headrest is a critical measurement that's usually overlooked it should be a minimum 70 centimeters Ida leave an AC because if the dent is up to 90 because if the dentist can slide the stool enough backwards enough when the patient is lying back in a horizontal position then the only way the dentist can look into the patient's mouth is bending the spine so these are critical after organ ohmic aspects what I teach is in ergonomics what you're doing inside yourself how you bend what to do and not to do with your spine with your shoulders with your legs with your hands and I have a lot to say about that if you if we have time we do have time
Howard: so the out so you don't teach the outer organ omits that was the outer yeah the outer organ ah mcc's was was mainly loops what you call the Dennis tools that we call it that the common word loops to the
Dr Aniko Ball: dental stool the patient chair the delivery system whether it's a side delivery or continental the the surgery layout cabinetry the space around the dental chair also the the foot control it's better to have a foot control that's an up and down activation because the knee and ankle are hinge joints although the ankle can twist it's better not to not to sit and activate the drill with twisted ankle and the profile shouldn't be too high now I do teach this in my programs because I want to add we're dentists on what to buy and whatnot Dubai yeah one last thing what about the light I I noticed that the biggest irritating thing to me is the light the overhead I got a track on a pole a lot of my friends now are going to a headlight on the head any thoughts on lights absolutely a headlight is a must it's like I'm gonna buy one I'm gonna go I'm finally gonna go do it which one do you do you recommend I haven't looked at the laser syringe because I've been so busy looking at the magnification loops but my recommendation is that it shouldn't be too heavy go for the natural color rather than the blue there are some that have got a bluish color Asian a blue light it's better for your eyes and also you can see gingival coloring much better and for cosmetic dentistry so I'd look for a warm color but I couldn't I don't have a particular recommendation however the light makes such a difference because what I realized I got in headlights years ago and what I realized was that I spent about a quarter is not more of my time in my appointments diddling with the light trying to get it to where I needed it the second it's attached to your glasses or loops wherever your eyes are that's where the light is it's amazing it's a game-changer say the last part again though it's Galactica headlight it's a game-changer yeah you use that expression in America a game-changer um
Howard: so okay so that was all the outer egg organ omits but you you like to focus on the inner organ homage so so tell me about either ergonomics what does that mean
Dr Aniko Ball: so what that means is that it's let me take a step back because this will make sense to you when you learn to drive your car you learn the bath road rules and you learnt about gears you would that be right yes and you learned that if you're driving a hundred kilometers or miles an hour you're in a high gear and if you're going up a steep hill you're in a low gear that is cooperating with the cars mechanical design and you don't have to be a mechanical engineer to know this and also you learn that you got to give way certain Road rules the body has got biomechanical design principles which we don't know we think that we can do anything with our body there are flexibility allows unfortunately that that is correct if you're in movement if I'm dancing I can twist and do anything the problem is that when we hold a particular position as a posture and in the industry we do that for lengthy period that's when knowing what your body was and wasn't designed for is essential so for example knowing that we below the height of your ears all your spinal joints are gliding joints what that means is that they're not designed for twisting and bending even though you can twist them banned because you've got this between yours your vertebra that will allow you to squash and distort them but if you don't come back to neutral very quickly and in dentistry we hold a particular twisted position for really long periods like half an hour or longer and we barely miss a lot of the time this between the vertebra don't forget a chance to recover and rebound and that's when we do damage so that's one aspect so knowing that you can't hold twisted postures and all the auntie's do that as well as their dental assistants is one part so I teach people how to look into the patient's mouth using the correct joints that's like driving in the right gear the reason why I was in pain for so many decades of my practicing life as a dentist was because I was driving my body in the wrong gear so I teach people the road rules the right gears meaning which joints to use for the right job is part of what I teach the other is that you have got different types of muscles and the muscles that move the arm for example are movement muscles and they are not designed to hold up the average arm is about four kilos they're not designed to hold up your shoulder and your elbow in the air for lengthy periods so for example a right-handed dentist with the mouth mirror in the left hand have a tendency to twist over to the right damaging their spine and then they have their left shoulder elbow and hand up in the air and movement muscles of the arm are not designed to be contracting for lengthy periods so most dentists have got and hygienists have chronic pain in their left shoulder would that be right do you know
Howard: gonna be my next question I'm what she's driving to work she's you know they're they're all alone in there in the car what would are then most likely dental occupation injuries what would you see them a what what's the cluster
Dr Aniko Ball: so the cluster is a neck back and shoulder they are the highest incidence of us chronic pain and and how neck back and shoulder and how many of them do you think eventually becomes disabled because of this have you talked with any disability people is this sound you know what percent of dentists eventually become disabled and collect disability because their injuries are so high no I haven't looked into that what I do ask all all dentists who attend my programs I ask if they've have to cut back already their sessions and at their practices are they considering early retirement and you wouldn't believe how many young dentists are already thinking of retraining in another field not because they don't love their work but because they are in too much pain many have already cut back
Howard: wow that's sad it's very sad and but I don't want to ask you on to the older people like me who 20 30 years ago you know you never know how much is fat and how much is gonna stick like it was a corporal tunnel and everybody was having carpal tunnel surgery and you know that that's the American deal they find a problem and they find a surgery and they say you start doing it and a lot of my friends would always say well you know if Jim would have just done like maybe five push-ups every month you know put his hands flat against the floor and did some push-ups maybe he shouldn't have had that surgery done that that was a long time ago but looking back now that we've known about carpal tunnel forever do you think do you think dentists could have avoided a lot of that with more exercise or what's your thoughts on carpal tunnel
Dr Aniko Ball: so what I teach and even in my short presentations I talk about the fact that hands are our livelihood and what I see is that dentists are this is for everyone but I'll talk specifically about than this even when we're not doing dentistry there's a tendency to have the fingers contract that for example most dentists when they're sitting and listening to a lecture they are either holding something in their hand or they've got their hands curved and I trained dentist to extend their hand meaning I'll just hold my hand up so doing that whenever they can so for example if they are working in in the practice and they're waiting for a material to set or the nurse is preparing something to put their instruments down and do a full extension with the gloves on and not touching anything so that they're not contracting their fingers if you're not doing the industry and you're not grasping and doing something with your hands then extend so when you're driving and you get to a red light or a railway crossing do a full extension on the steering wheel when you are walking around that the party don't keep holding your mobile phone keys and an empty glass in your hand put things down so I train people to watch their group habits and extending their hands because the tendons of the the what people don't realize is that the carpal tunnel is a very narrow tunnel and when our hand is in contraction this often people think this is a relaxed position for the hand in their lap and that's the lack contraction so you want to extend as much as possible I believe that it can be a carpal tunnel surgery can be avoided and the other one is mobile mobile phone use I just want to say this do you know that a lot of young people are scrolling with their thumb when they are texting and scrolling they're using their thumb I've already seen a number of young dentists who have some injuries and chronic pain and I tell people don't use your thumbs for strolling and texting the thumb is not a finger use your fingers
Howard: Wow I've not heard of that one but it's funny because when you go to government websites and say occupational hazards to dentistry they say infectious hazards and number one infectious hazards needles and other sharp objects are psychological hazards from dealing with stations allergic reactions from the gloves containing latex and physical hazards these include muscular skeletal commerce complications which have direct relation to dental procedures like postural situations that may increase the risk of twisting and contorting the body and that's less mercury health hazard ionizing radiation non ionizing radiation and anesthetic gases so uh my god would you say dentist the the occupation of Dentistry relative to all the other occupations you think we're in the middle more hazardous less hazardous actually you probably don't even know what hazard is because you live in the continent that has 7 of the 10 deadliest snakes so you guys probably your whole life are just expecting to get bit by a snake any second but do you think dentistry is a hazardous job or
Dr Aniko Ball: very much so III knew already as a 40 eternal student that I was about to graduate into a very stressful profession and that's why I trained in in hypnosis and mind-body relaxation techniques and I teach dentists in my in my courses have to look after themselves until with time pressure relaxed themselves and their patience because and that's a big problem and of course occupational chronic pain twisting and bending is a huge hazard so both of them need to be addressed and I've seen a lot of studies done on dentists and I believe that were among the highest risk and high suicide rate burnout threat stress rate yeah all of which can be helped all of which can be helped yeah and you know and you
Howard: you see that like when you're working on someone and you also you feel your chest tightening and it's like I'm totally relaxed yeah but I know that I'm reacting to this person this person and so I'm in tune with that so I always take a deal and say okay relax your hands relax your back you know try to get him relaxed but it's funny how ice I feel it on me as it's happening to them so it has to be an extremely psychological I believe where some type of a social herd animal that you know like bees and ants and you know these animals and I think a thousand years from now they'll understand a lot more they do now but I definitely think we're social in the fact that if someone is comes in your office afraid and then you're gonna feel the fear and anxiety
Dr Aniko Ball: oh absolutely and something that I teach to all the dentists that I I actually taught myself as a young than this is not to take it personally because what happens is that often patients come in very scared and they cover up the fear with some sort of prickly somewhat hostile at exterior and if we don't understand that underneath it is a very frightened person who is almost rude dressing to a child we take it personally and then we go on the defense and it's not a great thing so I the way I look at it is that when you go out into the rain you get wet but the rain doesn't come at you personally it just you just get wet and so not to take it personally when a patient is difficult or prickly and to see past that altar and call on your compassion and understand that this is just a frightened human being and then apply relaxation techniques even just dropping the voice tone talking very slowly taking an audible breath next to the patient and these are very subtle techniques that are very powerful already makes a difference
Howard: yeah and you know I have no excuses because my dad told me this years ago he owned do they have something they don't have sonic drive-ins in Australia do they sonic drive-ins where you pull up in a car and you they don't have those do they drive in yes no driving we have less these days yeah but he went my dad owned a restaurant and when I told him I want to be a dentist like my next-door neighbor he said but you know when you're in a restaurant you get to see the best sighted people when they go out to eat and go to McDonald's there that's the best there ever gonna be but if you become a policeman or a dentist or in those jobs where you see people at their worst and it's just tough because you're right I mean we see people at their worst and if you worked at business I mean I remember when I took my kids at Disneyland one time the kid in from me actually was so excited he actually mess up his pants and I thought man this is a different world than dentistry I mean no one's ever jumped up down and soiled their pants waiting for me to open my doors at 7 a.m. so it's tough but um so so what would the message be now um what do you what do you want my homies to take away so do they go to your website would that be the first start if they go to optimum dental posture calm
Dr Aniko Ball: well those of your audience who who are not in Australia or New Zealand and can't get to Australia easily my website is not not the most informative place at the moment if they get on my Facebook page optimal posture Facebook page or under my name on equable profile page and they scroll back up to last year they will find a lot of useful information where I post about a particular aspect of the way we practice dentistry and give very important advice and recommendations that would be the first step but of course I am willing to come to America and Europe and trained dentists and present that at dental congresses that's a very good way to meet me and interact with me come to Australia and attend my two-day ergonomics and wellness in dentistry workshop that's the best way to learn because I teach the in ergonomic principles and then we apply all that you learn around dental chairs over a mannequin in simulated dentistry and get lots and lots of individual training and practice so I'm open to
Howard: I got another question when um when I I graduate high school in 1980 so from 76 to 80 any kid in Bishop Carroll who had a dad that was a dentist I mean doctor prepared doctor Peltzer doctor Knutson I was always like King well your dad let me and John lys go spend the day in your obviously as John Lisa's my friend that we went from seventh grade to the end Adele's for the other and we used to go to these offices and John and I would always talk to his doctor prepared he was a stand-up dentist and the other ones were sitting down now the oral surgeons they all stood but I'm talking about a generalist so the oral surgeons all stood everybody else sat down except for doctor prepared and our doctor Peltzer I'm sorry and so looking back was standing up healthier was that a better strategy than sitting in a chair and how do you compare what's happening with oral surgeons who all the oil surgeons I know are standing when they do surgery so so what's different things stand up and sit down
Dr Aniko Ball: very good question so there are many ways of standing that are just as dead as sitting the only good thing is that they move whereas dentists tend to be more stationary when they see it however it's essential to learn how to stand well so on day two of my two day program I teach people how to stand them bend over the dental chair whether you're a surgeon or just a general dentist doing extraction and I teach them this have to bend from the hip and balance the way that's in front and behind them because gravity acts on you vertically I get people to bring in forceps and I teach have to stand and do extractions using your whole body wisely and not loading your arm yes so there is a know-how in ergonomics comes into standing as well but in the old days when Dennis was standing at least they were moving I've had ear nose and throat specialist attending my programs and I've gone to operating theaters and trained them have to bend over the patient in in the operating theatre and there are just as many bad harmful posture habits as there are in sitting
Howard: and how you know is then to ergonomics is that include stress management and stretching or is it is it separate or which is the eve or is economics base to stretch exercising how are they related
Dr Aniko Ball: so moving stretching is really good and whether you call it ergonomics or not it's there it was designed to me is I don't know if you've heard there was research done in Australia in Melbourne actually and and they said fitting is the new smoking we're not designed to sit for more than 35 45 minutes so it great to move and stretch unfortunately a lot of people do harmful exercises at the gym and and some personal trainers don't know what people should be doing with themselves so I've seen I've met dentists who did a lot of damage working out in gyms with the right know-how knowing which joints are designed to bend and which are not and how to pick up a heavy weight and work out working out in a gym can be very good yoga can be very good provided the yoga teacher understands that you're not meant to bend down with straight legs locked knees and middle of the spine bending so again you want to know about biomechanical design principles walking is fantastic music is very good and while we're talking about health I just want to bring in eye health with the use of firm let's end and microscopes and and high magnification loops it's very important to look after our health so it's important to take off glasses loops and look look out into natural art look distant look into the distance and and also use your peripheral vision otherwise we'll have I problems as well in future I problems yes that's one I wasn't gonna be thinking about eye problems from from what the sector they are just like we weren't designed to sit for lengthy periods were designed to me is the eyes were designed to look into the distance look around what's around you you know danger in primitive there is we were forever scanning gets to what's around now in dentistry we're looking down along a very narrow focus and that is a tendency to not use all the relevant eye muscles and and it's just not great for the eyes to be so narrowly focused for lengthy periods of seen dentists who don't take off their magnification loops and go out to the waiting room greeting their patient with loops on take them off look around look near and far I've spent some time with people who are trained in natural vision improvement
Howard: do you think any countries or regions and you're out there next to New Zealand Australia Japan the whole do you think any countries are better Durga naam exten others or do you think they all have the same problem or are some people more focused on it well a lot of it is hearsay but
Dr Aniko Ball: what I have heard is that in the past Japanese designers of dental equipment were more aware of good ergonomics and dentists in in Japan were more willing to buy well-designed equipment and that there was something that was in the past I'm not sure if there is still the case III don't have figures to compare as to where people are more more aware of economics what I found how it is that the inner economics what you're doing inside yourself is foreign to just about every dentist that I've come across and so I would say that there's probably better after ergonomics better design equipment in perhaps the some of the European countries certainly German Scandinavian designs are very good and some of the Japanese designs then perhaps America where and Australia where we're more focused on the plush comfy kind of look instead of what's actually good for you and while we're talking about all this something I wanted to mention is that I am frequently asked what position should a dentist sit in should I get lots of questions like should I be an 11 o'clock or 12 o'clock in America do you have that positioning where you're behind the patient or to the side and you call it an o'clock position right absolutely right now looking at what position to sit in is what I call an outside-in organization because that doesn't take into account your structure and the patient and of course every head and patient is different and what quadrant you're working on so what I teach is to go from the inside so it's an inside-out perspective I say too and the people the dentist I train is once you know that you're not supposed to be twisting yourself to the side organize your cells to sit wherever you can be so that you look after yourself then you bend at the right joints mister then that patient chair mister patient ask the patient to turn their head a lot of dentists don't ask their patients to turn their head they rather twist themselves in their pretzel then ask the patient to turn to the side so go from the inside out and say this is the way I can look after myself so I'm not twisting and bending myself
Howard: and all I'll say the kids is on and you know this on the reason the big problem is you just make bad habits and habits are so hard to change I'm fine get away with this but you know you start looking direct and it's cheating you know I just want to lean over and look straight in there and it's faster and it's faster so it's immediate gratification and then you're gonna have you're gonna pay for it later and my gosh lutely you only you only are born with one body and and why are you thrashing it for your patient
Dr Aniko Ball: well people don't actually get that I call it a shortcut you know twisting around too quickly look at the computer twisting to pick up the hand pieces on a side delivery or twisting round to get direct vision these are shortcuts for which we pay a very heavy price and of course happy changes there is a big issue and I teach I spend a lot of time training dentists have to become aware and develop postural awareness and change habits and in fact this is where I find that training eternal team where I trained the dentist and the dental assistant together so that they observe each other and remind each other to break habits you have to break over and over and over again habits for about a thirty day period before you develop a new default and improve default and what happens is that whatever you've been doing feels comfy and right even though it's doing you damage and you don't even notice that you're back to the old twist now
Howard: you're very helpful your name is Aniko is that how you say it Aniko yes Kyle wants to know if you're related to Anakin Skywalker no are you familiar with Anakin Skywalker but anyway our sound Anakin I mean it's a tannic Oh Anakin was did you go to school with Anakin Skywalker okay well hey um anak oh um seriously thank you so much my brother moved to us Sydney Australia I go down there all the time and I love it's the only country that every time I go back there I always say why am I going back home and it's only because I got four kids and five grandkids but if if I never had children if I had no kids no grant you whatever I Australia is the only country I would never come back to I think Sydney Melbourne Perth I mean it's just I actually love Perth the most I probably Gold Coast and Max Sydney just just love it all down there I love the people of Australia they're just so they're just at a different level of just fun laid-back and cool every time I go visit my brother Paul I'm just like why am i come back home but I just want to thank you it's um it's 5:18 p.m. here on a Monday night what time is it there in Australia it's 17 hours ahead so it's Tuesday morning quarter past 10:00 okay and thank you so much for waking up this morning and skyping me all the way to ten thousand miles away and talking to all these young kids about how they need to think long-term about their posture or they're gonna pay for it so it's Aniko her websites optimum dental posture and you're gonna remember her name Aniko because I said Anakin Skywalker so she and I would I would start doing that just dr. Aniko Skywalker Ball BTS diplomat clinical hypnosis Advanced Diploma Aniko posture do what's right don't waste your body Aniko oh thank you so much for coming on today it was an honor to and a privilege to podcast you it's been a pleasure talking with you thank you alright have a great day