The Reason Dentist Tilts You Upside Down

chair clean clinic dental care
Photo by Daniel Frank on

Don’t like when the dentist chair goes down? Well, you are not alone. When sitting on a dental chair and your dentist begins to tilt the chair down, you feel comfortable to the certain point. But when the seat keeps on going down after you think that surely it cannot go any further and you feel like you are going to slide off the chair, you clutch the chair handles (if there is any – mine doesn’t). You might state that you feel like you are upside down. You might ask the dentist to lift the chair more upward position, or to adjust the head rest so that you feel more comfortable.

Guess what we think at that point? Well, normally we might feel slightly annoyed because you might be the dentist’s fifteenth patient that day and her back and shoulders are aching from the difficult working positions. Nevertheless the dentist might lift the chair more upright. Some might not even tilt patients low enough in the first place to avoid complaint that we have heard gazillion times before.

Neither of these ways is good practice because these dentists and hygienists who are trying to fulfil patient’s every wish, risk their future as dental professionals. Keeping the patient chair in too upright position means that it is practically impossible to work ergonomically. Working ergonomically as often as possible guarantees that we will be working on our dream job (?) until we retire.

Of course there are patients that we need to leave upright position by default. These patient are e.g. heavily pregnant ladies, obese people, people with heart condition and elderly people. But the normal patients can be tilted to the position that is best for dental professionals posture. By normal I mean patients that are healthy or do not have severe medical conditions.

Request for the Patients

Next time you visit your dentist, make her happy by not saying anything about the position of the chair. They will not let you fall. Also you will get better quality of treatment when the dentist can see better to the difficult areas of you mouth. And you don’t need to swallow so much of water when the nurse is able to see the back of you mouth.

Advice for the Dental Professional

But what to do when a patient complains about the chair position? Well, the key to keeping patient happy is to be one step ahead of the game.

First thing you can do is to take the chair down gradually. Taking it all the way down in one go will most probably make your patient complain.

If I hear a complaint even though I’be been tilting the chair down slowly, I reassure the patient by saying

I know you feel like you are going to slide off the chair but so far no-one has. You will get used to the position soon. This position helps me to keep my posture and to see your upper teeth properly.

Patient is often fine during the treatment. When the session is over and I lift the chair up again, some patients state that they feel dizzy when getting up. Tell them to sit still and that there’s no hurry to leave the patient chair (well, you need to make the notes anyway, so it does not require extra time). It is best to sit still, well supported and wait for the things to settle.

If you face a difficult patient that insists to lift the chair more upright even though there is no medical reason for it, tell them that you will do so if the patients feels it is necessary but that you cannot guarantee the best possible result of e.g. scaling because you won’t be able to reach the upper back teeth in a right angle. And if you do still need to lift the chair too upright, it is best to stand up to be able to have as good posture as possible.

If It Really Is Your Dream Job – Important Tip for You

I’ve noticed that it is often the dentists and hygienists that have just graduated that too easily work in non-ergonomic way. It probably is because they still feel invincible. I know, because I did so too! Now having been on this profession for over 20 years and having had both of my shoulders operated (successfully!) due to work related conditions in both of them, I really need to focus on better posture with each patient. And still I get back ache almost every day. But I’m no longer in despair because I have found a cure for the back ache. So keep on reading because I’m going to share the best tip for keeping you going day after day, week after week, year after year in this profession.

I’ve known for a long time that there are these foam rollers that you can buy to exercise at home. Even my gym has had them for ages. But I never really knew how or why to use it until one day I tried one for my back. I placed it between the floor and my back, placed my hands on my shoulders (left hand to right shoulder and right hand to left shoulder) and by using my legs rolled the foam roller slowly up and down my spine like in the picture here. You can also find a good video of using the roller here.

This really keeps me going and I wonder why no-one has told me about it before!? That is why I’m telling you.

Before you start using the foam roller, there is one thing you need to keep in mind. My physiatrist emphasised that if you are going to use a roller, it needs to be a foam roller. Too hard roller will not be good for your spine.

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Climate Change and Dentistry

Dental Revelations Blog-18

The Climate Report in 2018 wasn’t much fun to read. In fact it was rather depressing and raised many worries over the future of our children and their children. We might even face a situation where many adults living today will face the consequences of polluting our Planet Earth. We’ve all seen the warning signs – natural disasters, unusual weather like long heatwaves in countries where it is normally mild weather, extreme dryness causing crops to die just to name few.

Despite the fact that the report was worrying and depressing, I hope that all of you have read it. Hiding your head in the sand will not make it go away or change the fact that it is going to affect you as well.

We should all participate in saving the Planet Earth. Participating in saving ourselves and our children. That can be done by thinking what changes you can do in your everyday life to help in this cause. There are plenty of choices we make every day that can make a difference to the world’s future.

You can choose a product in the food store that use minimum amount of packing. For example choose muesli which has simple paper bag packaging and which is locally produced (or in your home country). Choose fruits and vegetables that have simple packaging or no packaging at all (there are re-usable fruit bags available).

Choose local fruits and vegetables or the ones that are not shipped from the other side of the world.

Reduce the amount of red meat in your diet or become a vegetarian (I’m not vegetarian but I have almost stopped eating red meat) ‘cos plant-based diet it is far more environmentally friendly than meat-based diet. Think about how large area of fields are needed to herd livestock and to grow food for them when these areas could be used for growing plant based food for humans or for growing trees that help the Planet to get rid of the carbon dioxide – it is a gas that is the largest contributor to the climate change.

Also, once you’ve done your environmentally friendly food shopping, do not use plastic bags to pack your stuff. Instead take a re-usable bags with you when you go food shopping. And why not use them the with all your shopping? Do we really need to tell everyone that we’ve been shopping at Harrods or Louis Vuitton? When the climate change reaches the point that our lives are at risk, these status symbols have very little meaning. So have one re-usable bag always tucked inside your LV hand bag, car, rucksack or pocket.

There are plenty of things we can do differently as long as we think we can make a difference. If everyone would think that it makes no difference if you buy these passion fruits that are shipped from the other side of the world or that it makes no difference if you recycle or not, we are doomed.

Together we can make a difference and you can change the way you do things in every aspects of your life, including your professional life. Personally speaking, I have noticed that I feel more and more guilty over the fact that dentistry is so very environmentally unfriendly.

Single-use materials

We produce massive amounts of waste every day. We have many disposable materials that we throw away after each patient. Many of the disposable materials are made of plastic. There’s no way going around it as disposable, single-use materials are the best option when it comes to cross infection control.


Also, have you ever thought about how much water we use everyday? We wash our hands many times a day. Our rotary instruments require water, our instrument maintenance cycle requires water, our aspiration system loooves water (this is how one maintenance guy for the dental units expressed it) so we suck water into it in the morning, between every patient and in the evening. Well, at least this is how it should be done to prevent the backflow.

Backflow means bacteria and viruses travel towards the patient inside the suction tube. When patients close their mouth and form a seal around the tip of the saliva ejector, a partial vacuum occurs. Blood, viruses, saliva, bacteria, debris might travel as far as into the patient’s mouth. If you don’t believe me, read this. This of course means the patients should not close their mouths around the suction.

I have tried to change my way of using water by closing the tap (with my elbow) while I rub my hands together with soap – you know this should last 15 seconds for the soap to kill e.g. norovirus that is causing Winter Vomiting Disease. In that 15 seconds lots of water is wasted if you keep the tap on. The surgery should have taps that are easily operated without using fingers – the tap should be long enough (medical tap) for you to be able also open it with you elbow. There are also sensor-operated taps that will stop the water flow when hands are moved away from the tap.


We use many different chemicals that are bad for the environment. There’s no way going around this one either. Unless the manufacturers are trying to develop chemicals for disinfection that are more environmentally friendly.

Oral Hygiene Recommendations

On top of everything else we recommend products to our patients that are made of plastic. That’s why the wooden triangle-shaped tooth pick has become a product I recommend more and more (I have written about it in one of my previous posts). Of course it’s not suitable for all the patients, but for those that it is, it will make a difference in the amount of plastic waste.


There are not many things we can change in practising dentistry. But even the smallest changes matter. So please everyone, think about what change you can make and challenge your colleagues and friends to participate in saving the Planet.

Lets make it a norm rather than an exception to re-cycle and to live sustainable life.

Lets do it for our children.

Dental Revelations Blog-17

3 Icky Things You Do at the Dentist

photo of man covering his face
Photo by Craig Adderley on

One would think that nothing is making us dental professionals shiver because we see all sorts of things in people’s mouths. But there are a few things that is a bit too much for us as well. Find out what they are.

Putting Your Finger Inside Your Mouth

It always hits me with surprise how clueless people are about transmission of infections. In the middle of the treatment they might show with their finger which tooth feels sensitive. That’s when I say Eew in my mind. Why would you put your finger inside your mouth? And it’s always the index finger which we use to operate our smart (and dirty) phones and push the elevator button (I don’t actually, I use the proximal interphalangeal joint (PIP) of index finger because of my fear of bacteria – read more about it here) that gazillion people have pushed before you with their dirty index finger. Some even do grosser things with their index finger.

So please, do not put your finger inside your mouth. Your tongue is able to do the job instead.

Carrying Your Toothbrush Without Cover

Some people are obsessed about brushing their teeth prior the dental visit. They might do it at the practice’s toilet just before they come in to the surgery. No problem with that, but when you walk in to the surgery with the toothbrush, your car keys and wallet in your hands and place them on our office desk, that’s when we go Eew again. Especially if the toothbrush doesn’t have any travel case. We don’t wipe all the practice’s surfaces after each patient, so there will be germs on the table surface where you leave your stuff. And where are you going to put it when you get back to your car?

Equally gross thing is to put your toothbrush inside your handbag without travel case. But at least then we are not able to see it.

“Sucking the Sucker”

By far the ickiest thing to my mind are the patients who close their lips around the saliva ejector or the high volume suction. I was horrified for the first time it happened with my patient. To be fair, it’s not their fault. They do this probably because some of the dental professional advise patients to do so. Honestly, fellow dental professionals, do your research and stop advising to close the mouth when the suction is inside the mouth.


It’s because of the backflow of bacteria and viruses. When patients close their mouth and form a seal around the tip of the saliva ejector, a partial vacuum occurs. That’s when the nasty stuff in the tube of the suction start travelling backwards – blood, viruses, saliva, bacteria, debris. They might travel as far as into the patient’s mouth. If you don’t believe me, read this.

If you are a patient and your dentist or hygienist advises you to close your lips around the suction, don’t do it. You don’t need to. This might of course mean that you need to swallow tiny amount of water, but the water is cleaner (or is it?) than the stuff that comes out from to suction with the backflow.

It is also absolutely your right to ask if they take care of the suction tube cleaning. They should answer you that

Yes, we flush the lines after each patient with clean water (this will take the nasty staff further away) and at the end of the day we flush the tubes with disinfectant. Also once or twice a week we use special cleaner for the suction lines.

Ok, there it was. Three of the ickiest things patients can do at the dentist. Do you know even grosser thing? Feel free to share it on the comment box below. Let’s see if it gets an Eew -reaction.

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