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 Life after laminectomy: Dental hygienist receives
surgical option for debilitating occupational pain

Life after laminectomy: Dental hygienist

receives surgical option for debilitating
occupational pain
May 22, 2018
Author displays scar from surgery.

By Theresa McCarter, RDH, BSDH

Asking a dental hygienist if he or she has any musculoskeletal pain is a ridiculous question.
Working in this profession is considered as one of the most damaging careers to your body.
Sitting for long periods, bending and holding your neck in a precarious position, and using our
arms and shoulders in unnatural positions can be detrimental to our bodies.

Very few people are excluded from experiencing pain at some point in their lives resulting from
this career. While there are many different ergonomic modalities that have been introduced over
the years, many of us will experience severe pain, which may not be relieved without surgical
intervention.

I entered this career at a later age than most individuals. I turned 40 at the time of my graduation
from dental hygiene school. I knew that I had to be especially vigilant in keeping my body
healthy from the repetitive stress. I invested in Orascoptic loupes with a light, an ergonomic
chair with armrests, lightweight handles on my instruments, sharp instruments, and many
ultrasonic tips.

I exercised and kept my weight down, ate healthy foods, and read many books and journal
articles that were available on body mechanics. I attended numerous continuing education
courses on ergonomics. I stretched before I started my day and in between patients, and I cut my
work schedule down to two to three days a week.

Unfortunately, I could not escape degenerative disc disease and arthritis, which resulted in
chronic headaches and excruciating neck pain.

Exposure to pain
The pain began 5 years ago when I was 52, with mild to moderate neck pain, muscle weakness in
the upper arms, and occasional headaches. I went to see an orthopedic surgeon who ordered an
MRI and it showed two mild herniations on C-5/6 and C6/7. My range of motion was very good,
and he believed that, with core building exercises, I could relieve my pain. He prescribed 60
Vicodin. The physician stated that this was a very normal MRI for a woman my age and my pain
was likely caused from arthritis. I took this advice and began Tai chi and Pilates, but I did not
take any pain relievers other than ibuprofen. My pain continued.

Over the next five years, I saw three other orthopedic surgeons, two pain management
anesthesiologists, a chiropractor, massage therapists, physical therapists, an acupuncturist, an
osteopath, and this was all in addition to my primary care physician.

The general consensus of all of the professionals was to try any treatment other than surgery to
relieve my pain. The procedures included cortisone injections and radiofrequency ablation,
which offered no relief whatsoever. The medications included Flexeril, Soma, Robaxin, Vicodin,
Mobic, Celebrex, Cymbalta, and tramadol—as well as holistic approaches and essential oils. I
was happy for many of my colleagues who found relief with some of these therapies, but none of
them relieved my symptoms.

My frustration grew, but I continued to work and suffer with the pain. I believe that I hid my
pain from others in my workplace, and the only person who truly understood my pain was my
husband who saw me suffering at night. The only medication that I took at this time was 800mg
of ibuprofen, which barely touched the severe pain.

The breaking point

December 2016 was my breaking point. The pain and headaches were debilitating. I realized that
I could not remember what it felt like to not have a headache. I could not fathom that neck pain
was going to be a permanent part of my life, and I thought that I would not make it to the age of
60, let alone continue with a career in dental hygiene.
The results of MRI on author's spine.

I encouraged my primary care doctor to order another MRI, which would be the third in five
years. The results were shocking because the herniations of C5-7 were very large and the disc
desiccations and osteophytes were right there in black and white.

A friend who was an anesthesiologist referred me to the Tucson Orthopedic Institute. We made
an appointment with Dr. Jeffrey Baron, an orthopedic surgeon. Dr. Baron was a no-nonsense
individual and blatantly stated that cervical spine surgeries statistically do not have favorable
outcomes. He was not optimistic that I would be rid of my headaches or neck pain. He did not
want to hear what any other physician had said about my condition and did an initial exam and x-
rays.

After viewing the films, he agreed that an anterior discectomy/laminectomy and fusion of
Cervical 5-7 with a bone graft was the best surgical procedure. He outlined in detail what the
procedure included from beginning to end, and he expressed his confidence in actually
performing the procedure. He left the decision up to me, and I quickly made the choice to
schedule the surgery and try what may be my last resort.
Fusion achieved during surgical procedure.

I am three weeks post-surgery, and I have no headache or neck pain, nor am I taking any
medication. It will be six months to fully identify if the surgery is a complete success. At this
point, I am hopeful.

The burning question—and I believe I know the answer—is that I will most likely never be able
to return to clinical hygiene in the same capacity as before the surgery. I believe that I knew a
few years ago that I would not be able to perform dental hygiene duties into my sixties due to my
skeletal problems. I began to prepare for different work that was related to hygiene and
education. I am fortunate to have my BS degree in dental hygiene and began to teach one day a
week at a dental hygiene program near my home.

I also became a substitute elementary school teacher for the school district in my city. Most
recently, I created a continuing education company called Hygienewize, LLC that offers CE
courses approved through the Dental Board of California. I also became a CPR/AED/BLS
provider for the American Red Cross, and I offer trainings to dental offices and the general
public.

While none of these will ever replace working directly with my patients and the staff at my
office, I am hopeful that I will continue to make a difference in the oral health-care community. I
hope to help other dental professionals by providing research information on new products,
existing and new therapies, employment opportunities and changes that are happening in the
dental hygiene career.

To other dental hygienists who are suffering with chronic pain, I want to encourage you to plan
for your future in the event that clinical hygiene becomes impossible. Seek higher education,
network with other dental professionals, research other employment opportunities, and create
your own destiny. We entered this career because we loved helping others and being involved in
an important part of overall health for individuals and we must find opportunities that can keep
us involved in the career that we loved but can longer perform in the ame capacity.

Theresa A. McCarter, RDH, BSDH is the owner of Hygienewize, LLC and

provides AGD Pace-approved continuing education programs to dental professionals under a
provider license from the Dental Board of California. She is a Licensed Training Provider for
the American Red Cross and provides certification in CPR/AED/BLS. She is a dental hygiene
graduate of Cabrillo College and Loma Linda University School of Dentistry. She is currently an
educator at Carrington Career College Dental Hygiene program in San Jose, Calif. McCarter is
the community health coordinator for the Monterey Bay Dental Society providing dental hygiene
education to elementary schools in her community. She is a lifelong member of the ADHA and an
active member of the National Speakers Association.

Reference

1. O’Neill, MD, MS, Kevin. ACDF: Anterior Cervical Discectomy and Fusion. Available at:
https://www.spine-health.com/treatment/spinal-fusion/acdf-anterior-cervical-discectomy-and-
fusion (2016). Accessed February 4, 2018.
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