Visual ambiance for dental practices.

Argesanu, Veronica ; Popa, Anca ; Jula, Mihaela 等

1. INTRODUCTION

Research in dental ergonomics is addressed on how the environment (office, dental laboratory, the interpersonal relationships) influence the dental team and the patient. In this respect studies have been conducted regarding noise level of illumination, chemical and microbial pollutants, and studies of the psychology of group relations (Argesanu, 2004).

Physical stress is an important factor for dental work, while maintaining the integrity of the eye's morpho-functionality, is a major requirement.

Light energy is the main stimulus for the visual analyzer. Environmental factors that determine the practical applications are visual lighting and color of the workplace environment; plain said visual ambiance.

2. VISUAL ENVIRONMENT

2.1 The integrity of visual acuity can be affected by close and frequent or long operations, lighting the oral cavity with shadows and brightness. Thus visual eye fatigue and even overall eye fatigue can be installed. In order to prevent these undesirable aspects it is necessary to adapt lighting to qualitative and quantitative requirements, bearing in mind that it is not an end in itself but is intended to facilitate the view of the problem areas.

2.2 Quantitative requirements of a dental office on the level of light required viewing, set by standards ISO AFNOR, ranging between the brightness value of 100 LUX in terms of relaxation and up to 20,000 LUX for high fidelity interventions. DIN standards regarding lighting in practice dentistry, fixed the following qualitative requirements:

* uniform distribution of light in all office and lab areas to avoid contrasts

* providing a visual acuity in the right area of preparation and the reminder of the cabinet, likewise in the laboratory for the work day (type and gantoproteic device)

* achieving a spectral composition similar to that of natural light which the eye supports better and reproduce true natural colors

Light sources are classified according to their nature: Natural sources and artificial sources can be incandescent and fluorescent.

Incandescent sources give a light with shades of yellow and red and create a warm and comfortable ambiance to dental practices or laboratories.

Fluorescent sources use the discharge of rare gases into vacuum: neon, silver, halogens and mercury vapor; which are preferred for economic reasons, have reduced brightness and in certain proportions can provide a light with a spectral composition similar to that of natural light.

2.3 Visual acuity is the limit angle under which the visual analyzer has the ability to distinguish two different points. It varies with age, reducing it gradually with aging. Increase lighting causes constant improvement of visual acuity.

So eyesight is affected by illumination in that it decreases sharply as the environment is darker. It shows that you should not only illuminate the field operator and leave the rest of the room in darkness or shadows but obtain an overall good lighting of the whole room.

Visual environment relates to other characteristics of the cabinet, laboratory and facilities there in: architecture, composition, design proportions.

3. VISUAL FATIGUE

Visual fatigue is manifested by symptoms felt in the fight of the conscious visual analyzer to clarify the picture through ineffective adjustments. Visual fatigue of the dentist is due to inadequate lighting of the operating field, frequent visual adaptations caused by the incorrect operating acts, a big difference between lighting in the operating field and the rest of the work place, extended working time and work in direct eye contact (mirroring). Visual fatigue is manifested through symptoms felt in the struggle of the visual analyzer to clarify the picture by more or less effective adjusting, perception of color breakdown, diplopic, vertigo, disturbance of assessing spatial relationships.

4. ILLUMINATION OF THE MOUTH CAVITY

In the analysis of the positions of the medic and medical aid, we can consider as a reference a virtual clock dial, with the oral cavity of the patient in the center of the dial. Starting from this representation we show suggestive positions operators can use (Fig. 1).

This figure of the clock dial (the plane of reference) was the subject of an international ISO conference and then was adopted by the AFNOR (Association Francaise de Normalisation).

In Romania, the International Congress of Ergonomics (1974) discussed the problem of ergonomic position. Meanwhile, questions have been debated extensively worldwide and today the international standards that legislate the conditions of activity in different areas and of different products were recommended and have a very precise regime, bulletins by ISO, working conditions in dentistry. Romania joined the international body, adopted their standards and took to putting them in practice. Physicians themselves are required to comply with these rules, understand them and not considering them as an imposition from outside.

[FIGURE 1 OMITTED]

It is permissible for the ergonomic position of the medical aid and physician to work seated on a wheelchair, which provides free movement for both doctor and nurse. Any other position is misconduct and has a negative effect on the health of the operator.

The seated position has many advantages, being the "human natural position", with low energy consumption. Unlike orthostatic, where blood and fluids tend to accumulate in the lower members, in the sitting position the muscles are relaxed and low hydrostatic pressure in veins provides a low resistance to blood return to heart.

The seated position, shows through studies that have been conducted that it helps to stabilize your body's joints to maintain a comfortable, stable position, with minimal muscle contraction, the ideal position for fine movements and accurate operations.

Existing studies show that not all concerns were focused on the dentist, but there have been authors who have focused attention on patient comfort, because we need to organize work so as to make treatment session as easy and pleasant for the patient.

The authors argue that the priority of achieving comfort for the doctor is based on the fact that he works a daily practice of 8 hours and more, while the patient is a quarter hour or up to one hour in office, then return to their own activity, they can relax, sport, etc.

Organization of work-based dental ergonomic is considering putting the patient in a more ergonomic position for the doctor, but at the same time ensure a degree of patient comfort, because relaxation to favorably influence the efficiency of business operator.

Ergonomic position of the patient is performed in an anatomical chair, the patient being placed on a spindle which makes an angle of 20[degrees] with the ground. As I said, is a stable body weight is distributed evenly, no ischemic problems, vomiting reflex is avoided, the doctor can work in a calm atmosphere and a perfect relaxing skeletal muscle.

The patient is in position, with his head in the center circle. Then, the areas of the dial are places that can hold the doctor or medical aid, in close proximity of the patient. It is classic when seated, practitioners work to adopt positions based on private preferences.

It is mandatory that the lights can follow movement and is well known that the patient is immobile in position 6. A dentist placed 8-9 PM will be practically focused on the mouth, with a correct posture in the dental armchair.

[FIGURE 2 OMITTED]

According to literature, (Hokverda, 2008), the direction of the light beam should be parallel with the dentist looking to prevent the shadows and thus protect eye health. This is accomplished by moving the lamp on 3 perpendicular directions. Improving lighting can be made by a mechatronic system that has (Popa, 2002):

* motion on 3 perpendicular planes

* telescopic arm

* adequate lighting with small lamp leading to a good focus of the working area

In order to improve the image there can be added

* screen displays with clear images

* HI - FI camera

5. CONCLUSION

In recent time the safe conduct at the work place has taken a prominent role, patient and operator comforts being taken into consideration in the construction and furnishing of a dentistry practice. The most important aspects are those regarding lighting and working posture thus avoiding discomfort for both patient and practitioner.

6. REFERENCES

Argesanu V. (2004). Ergonomics of the equipment and medical departments, editura, Eurostampa, 2004

Burdea, et al. Robotic system for dental subtraction radiography. Proc. Of the IEEE Intl. Conference on Robotics and Automation. pp 2056-2062. Sacramento, USA, ISBN 0-8186-2163-X

Hokwerda, Oene (2008). Jerome Rotgans Dental ergonomics = health for the dental team, 2008

Hokwerda, Oene & de Ruijter, Rolf. Adopting a healthy sitting working postureduring patient treatment http://www.optergo.com/uk/images/Adopting.pdf

Irimie, S. (2008). Ergonomie industriala. Editura AGIR. Bucuresti. 2008

Popa A. (2002). Digital control of mechatronical systems, ed Orizonturi Universitare, Timisoara 2002

Virtanen, T. (2001). Ergonomic Survey of Dental Care. Proc. Of NES 33rd Annual Congress pp 398-401, ISBN 951-445222-4, Tampere, 2001

***R.A.G. de Ruijter Significance of the "Ergonomic requirements for dental equipment". 2007, http://www.esde. org/docs/ significance_of_the_requirements