Dr. Beachergonomic concept
Protects your back andfrees you from back pain

Thinking ahead. Focused on life.

Relieve your back: with a naturaland ergonomic working posture
After treating patients all day, do you often feel exhausted, suffer from a headache and/or backache and findthat you cannot really enjoy your well-earned leisure time? With the aid of the Dr. Daryl Beach ergonomic
treatment concept you could soon reduce the stress on your body to a minimum and live and work free of pain.

Dr. Beach ergonomic concept
Hardly any other occupational group practises its profession in sucha one-sided, unnatural posture as dentists, who have to maintain thisposture for many hours at a time. The result is that about 64 % complainof backache and 42 % of posture-related headaches*.
These physical stresses could be avoided by using the Dr. Beachconcept, also sometimes known as the “12-hour treatment” concept,
which has been practised successfully in Japan since the 1950s. This
concept is based primarily on a natural, stable posture in which only
the forearms are active. Dr. Beach had observed this posture with test
subjects, who were asked to carry out “blind” a controlled sensomotoric precision task (e.g. peeling an apple) and who all instinctively
adopted this natural, stable posture.
Back problems are inevitable if this unnatural postureis maintained for a long time

With the Dr. Beach ergonomic concept the dentist does not bend –with a twisted back – over the patient. Instead the patient lies relaxed
in a specially contoured treatment unit and the patient’s head is turned
so that it is in the correct position. This allows the dentist to maintain anatural posture.

The dentist’s kinaesthesia andsense of touch are indispensable
in ensuring precise preparation
with instruments

Interaction of five senses for optimum treatment
Consideration should be given to the five senses of balance, kinaesthesia,
touch, hearing and sight to ensure optimum dental treatment. It istherefore important to cater for all these senses when designing anergonomic treatment area.

■ Stresses on the dentist caused by an unnatural, incorrect posture■ There is no longer a problem with back pain or headaches.
■ Natural, efficient movements during treatment allow thedentist to work more precisely and safely, even in areasdifficult to access.
■ A balanced, natural posture ensures maximum concentrationand precision.
■ Smooth movements by the dentist promote a more
This bent posture also places too much strain
on the back and causes premature wear and tearrelaxed, stress-free atmosphere.

Determining the initial reference point
The Dr. Beach concept focuses on determining the initial reference point,
i.e. the treatment point from which the dentist can move smoothly in three
directions during treatment (forward – back, right – left and up – down).
Once this point is determined, the dentist can incorporate kinaesthesia inthe dental treatment and in this way control movement of the fingers.
Where is the initial reference point?
It is in the median sagittal plane of the dentist, level with the heart and at
a width of two fists from the body.
Controlled movements at the treatment point
The correct finger position as well as control by a sense of touch andkinaesthesia ensure that the dentist can reproduce the mental image ofthe preparation using a precise, controlled technique with the rotary
instrument and intuitively knows how and where the tip of the instrument
should be positioned and moved and how much force should be applied.

Midsagittal plane

and the associated physical wear and tear are reduced to a minimum.

Finger movements can be optimally controlled when
the fi ngers are in the median sagittal plane, holding thehandpiece with the palm half pointing downwards andinclined to the left

* According to a study by the Freier Verband Deutscher Zahnärzte
(Free Association of German Dentists)23

How to find the correct
working posture
Determining the reference posture
An optimum posture of the whole body is a prerequisite forworking without harming the body. In this respect, Dr. Beachrefers to an instinctive, natural and balanced working postureor reference posture.

Frankfort horizontal (FH)C7

He refers to it as instinctive because everyone subconsciously adopts this posture automatically when carrying out
precision work. It is natural because the prerequisites forthis posture are determined physiologically and anatomically(skeletal structure, muscle tonus). The posture is balanced
because the forces of gravity are in stable equilibrium.

Highest point of the sternumaL4■ Seated posture, seating height at knee height

Lowest point of the navel■ The feet are flat on the floor, the lower legs are in a

Natural and balanced movements during treatment
Each part of our body – arms, legs, hands and feet – has aspecific, natural sphere of movement, i.e. a sphere in whichmovements are made in a relaxed, smooth way and above allwith minimum force. If you move your forearm for example
to the right and left of the elbow – as is frequently necessaryduring dental treatment – you will quickly notice the naturallimits of the sphere of movement.
Cramped movements that place a strain on the body caneasily be avoided if your torso has a stable posture. An
instinctive, natural posture automatically produces smooth,fatigue-free arm and leg movements, a prerequisite for
efficient dental treatment.
Ergonomic movement of the forearm
Try to pick up an instrument by only moving the forearm andyou will notice that the movement seems very natural and is
not at all difficult.

vertical position, the thighs are slightly inclined andform an angle of approx. 30°.
Ischium

The Dr. Beach treatment
concept ensures naturalmovements, re lieving strain
on the backThe two foot control pedals
can be comfortably operated
with the ball of one footwithout having to raise the foot■ The longitudinal axis of the torso is upright.
hb■ The upper arms and elbows hang relaxed due to the forceof gravity, the elbows do not stick out and the forearm isin front of the body.
■ The fingertips are at the treatment point in the mediansagittal plane, level with the heart.
■ The head is inclined forward slightly and the interpupillaryline is aligned horizontally.

The torso remains in a natural upright posture without twisting or bending.
The line between C7 (seventh cervical vertebra) and L4 (fourth lumbarvertebra) – see line a in the illustration – is vertical. A line through the navel,
which is at right angles to line a, runs parallel to the longitudinal axis of thethigh. This is one of the checkpoints for the “reference posture”

1. When looking straight ahead, the line of viewis in the horizontal plane
2. When carrying out precision work, the line ofview is approx. 80° below the horizontal planeline of view
FHli n e ofv iew

4FH

This is the natural movement of the right forearm from thecentre of the body to the right. The further the forearm moves
to the right, the further it moves downwards. This is why thetray with the instruments and other materials is positioned
below the treatment point, i.e. to the side of the headrest of
the treatment unit. Only a slight turn to the right is required
to pick up the instruments.
Natural movement of the feet
The foot control of the treatment unit is positioned so thatit can always be operated using natural movements. When
operating the foot control, the lower leg is moved out of thevertical position by approx. 30° (= treatment position).
The position of the foot control also takes into account thenatural sphere of movement of the toes, which is approx.
20°:5° with upward movements and 15° with downward
movements.

3. The thighs are slightly inclined and the lower
legs are in a vertical position
The right forearm moves naturally from the centre of the body to the right.
The further the forearm moves to the right, the further it moves downwards.
Only the forearm is moved in the treatment position

5

10:0

0

Ensure you and your patients
experience relaxed treatment

12 :3 0

11:3 0Change of positionby the dentist

Five essential movements for maintaining
a stable reference posture
The position of the dentist or patient has to be adjusted
slightly according to requirements so that a stable reference posture can be maintained regardless of the type oftreatment.
Change of position by the dentistThe dentist turns as required clockwise between 10 o’clockand 12.30 o’clock. It is important when doing this that theelbows are not raised and upper arms and forearms hangrelaxed.
Turning the patient’s head to the right and left
Turning the patient’s head to the right and left facilitatesworking in areas difficult to access and ensures anoptimum line of view.
Adjusting the angle of the maxillary occlusal plane
The angle of the maxillary occlusal plane can also be adjusted
during treatment by simply sliding the head support up ordown with the left hand.

The Dr. Beach treatment concept is human centred. It enables the dentist and assistant to adopt a natural working posture – without suffering back pain.
The patient lies in a stable, relaxed position in the EMCIA treatment unit, with the instruments that could cause anxiety out of sightSpaceline EMCIA treatment unit
The Spaceline EMCIA dental treatment unit from Morita wasdeveloped according to the Dr. Beach concept and ideallycombines the requirements of the concept for ergonomictreatment.
In order to provide an optimum treatment unit, we focusedon a large number of detailed anthropometric measurements (height of patient, body width, weight, leg height,back height).
6The result: the Spaceline EMCIA – a treatment unit that is
tailored to the human body and ensures that every patientis treated in a comfortable, stable position. The instruments
and handpieces as well as the control panel of the Spaceline
EMCIA are arranged according to the natural sequence ofmovements so that the dentist and assistant can carry out
virtually all procedures by simply swivelling from one direction to the other.

Adjusting the degree of mouth openingDepending on the type of treatment, the patient’s mouth isopened between one and three fingers wide. The patient’s
mouth only has to be opened the width of one finger for workon the buccal surface of the posterior teeth.

45 °

45 °

Turning the head tothe right and left
120°

90°

Adjusting the angle of themaxillary occlusal plane
13

Adjusting the degreeof mouth opening

Adjusting the height of the patient
The patient is raised to a higher position using the footcontrol for work that requires a very high degree of precision.
Operations such as extractions on the other hand are carriedout in a lower position, as in this position the application offorce is most effective.
Adjusting the heightof the patient

7

How to find the optimum
treatment unit

The two pedals and lever of thefoot control are positioned so thatthey cor respond with the natural
move ment of the toes and take into
account the frequency of use

The handpieces are within thenatural sphere of movement of
the hand so they can be picked
up without bending the elbow

This ergonomically designed treatment chair ensures that all patients – whether asmall child or a “giant” – lie in a stable, safe and comfortable position

Length and contour of the treatment chair
The relationship to the seventh cervical vertebra is used asa reference point when determining the ideal length of thechair. This vertebra is also used as a reference point whenpositioning the patient on the chair to determine the contourlines. As the chair has a fixed horizontal lying area, the position of the patient’s mouth remains at the same level for thedentist even when the height of the chair is altered.
The horizontal position of the patient is also a very comfortable working position for the dentist and contributes greatly
to a relaxed treatment. Even after lengthy treatment, thepatient leaves the treatment chair without any signs offatigue.

Headrest
The headrest supports the head of the patient naturally,
even when increased force is applied.
The headrest should be as slimline as possible andshould not have any projecting parts, e.g. grips on theunderside. The dentist would instinctively try to avoid
these “projections” and automatically change the naturaltreatment position.

Position of the handpieces
Have you ever asked yourself how often you pick up ahandpiece during a working day? If the handpiece is in anunergonomic position, it involves numerous unnecessary
movements, which are also extremely unnatural and placea strain on the body. The result is that by evening your backaches and treatment is less efficient.
With the Dr. Beach concept the handpieces are positionedon the back of the chair below the headrest; they are next
to the tray and therefore in the natural sphere of movementof the arm. The handpieces can be easily brought into theoptimal sphere of movement from this position – without
stretching the arm or turning the torso. Another advantage
is the additional space provided by the comparatively short
handpiece cable.

It is important that the headrest is large enough so thatthe patient’s head rests comfortably when the patient
is in the supine position. It should also be designed toallow the head to turn 45 degrees to the right and left,
i.e. a total of 90°.

Foot control
The foot control is fitted so that it is in the natural sphereof movement of the feet, even when the dentist changes
position.

Stable position for all patients
The development of a treatment unit according to Dr. Beach isbased on correct measurement of the body weight of peopleof different sizes as well as the relationship between different
positions to ensure that all patients lie in a stable, comfortable
position during dental treatment and do not slide back andforward. The measurements of the unit are therefore determined for example using the reference width from shoulder
to shoulder, which is 490 mm, and from elbow to elbow,
which is 670 mm.
The patient’s stable position on the comfortable chair isenhanced by cushioning in the support areas and also in areas
the patient comes into contact with when lying down andgetting up.

8The working stool must be at thecorrect height to ensure that themus cles are not unduly stressed andlong periods of sitting will not cause
any strain

The foot control regulates important functions such as
the rpm of the handpiece, water flow and the height of
the treatment unit. The foot control of the Spaceline EMCIA
treatment unit can also be used to control the operationlight.

(3)
The headrest is large enough toensure the patient’s head automa tically rests in the middle

The headrest also enables themaxillary plane to be inclined
vertically from 80° to 110°(1)

Position of the lower legs in the reference posture (1),in the working posture (2) and in the rest position (3)(2)

Optimum seating
In order to maintain a natural reference posture during
all procedures, the dentist should be able to move freely
around the patient’s head as required. The ideal working
stool is a swivel chair with five functions. It should not havearmrests, as they would interfere with natural movements.

9

Tips for an optimally designed
treatment area

In an ergonomically desig ned
practice movements are madesmoothly and effi ciently

Actions and movements of the dentist and assistant
The daily routine of the assistant also involves many different, repeated movements – including preparing instruments,
assisting treatment as well as washing, sterilising and storing instruments. Ideally it should be possible to carry out
these tasks in the same room using a minimum of natural
movements.
The closer at hand everything is to the dentist and assistantand the less interference there is to their natural movements,
the more efficient and high-quality the treatment will be.
Actions and movements of the patient
When planning a treatment room, it is also important toensure that it is easy for the patient to get onto the chair.
The patient should also not feel restricted during treatment
or when getting off the chair and leaving the treatment
room. This is why, for example, the handpieces are positioned on the back of the chair to avoid the problemof cables hanging in front of the patient’s face.

Coordination of the actions and movements ofthe dentist, assistant and patient
Professional planning takes into account the spatial as well as
chronological aspects of the individual actions of all involved,
automatically eliminating the possibility of people getting ineach other’s way. Mobile trays that could hinder the patiententering or leaving the treatment room should also be avoided
by appropriate planning.
The abovementioned advantages will certainly encourage
more and more dentists to adopt the Dr. Beach treatment
concept in future. They will be rewarded with a relaxed,
efficient treatment posture, a healthy back as well as satisfied
employees and patients.
It only takes a few hours to learn how to modify treatment tothe Dr. Beach concept. Many practitioners regret that they did
not adopt the concept earlier. They could have been free ofback pain a lot sooner!
We would be happy to answer any questions about the“12-hour treatment” concept or about our Spaceline EMCIA
treatment unit. Just contact us!

Ergonomics and design are perfectly combined in this practice. Optimised procedures and increased free space with the Spaceline EMCIA
treatment unit ensure a relaxed environment

Ideal practice layout
Planning or redesigning a practice should be human centred,
i.e. focus should be on the patient, assistant and dentist. This
includes ensuring that personnel in the treatment area have
optimum working conditions.
The aim of professional planning is to have everything closeat hand and provide adequate free space for the dentist andassistant so that they can work without obstructing one
another as well as to ensure that the dentist maintains anatural posture during treatment. Successfully achieving
this aim creates a human-centred practice.

10The position of the tray, which is not in direct view of thepatient, greatly contributes to a relaxed atmosphere

More well-being in just 1½ days
Our various regional courses offer you the possibility oflearning the ergonomic treatment concept developed byDr. Daryl Beach. Practice-oriented, personal and efficient:
In small groups with a maximum of four participants andunder the guidance of renowned dentists you will learn how
to prevent typical complaints easily and effectively. After
just 1½ days, you will be surprised how quickly you have got
used to working in an upright position – a position which has
a positive effect on your neck, your performance capability
and your workflow.
Details of course dates can be found at our website underwww.morita.com/europe or by simply asking your local
dealer.

Professional planning ensures free space for all involved in the treatment

11Diagnostic and Imaging Equipment
Treatment Units
Handpieces and Instruments
Endodontic Systems
Laser Equipment
Laboratory Devices

Distribution
J. Morita Europe GmbH
Justus-von-Liebig-Str. 27a63128 Dietzenbach
Germany
T +49. 6074. 836 0, F +49. 6074. 836 299
www.morita.com/europe
Development and Manufacturing
J. Morita Mfg. Corporation680 Higashihama Minami-cho, Fushimi-ku
Kyoto 612-8533
JapanT +81. 75. 611 2141, F +81. 75. 622 4595
www.morita.com

Subject to technical changes and errors. Printed in Germany, JMMC EN PUB 52674 0714 * 2.