Musculoskeletal disease and disability in dentists

Musculoskeletal disorders and work ability among dentists and dental students in Finland

BACKGROUND

Musculoskeletal disorders are leading causes for long sickness absences and early retirement. Dental work is physically strenuous, and many studies have shown a relation between work-related MSDs and dentistry. However, fewer studies have focused on how these conditions affect the work ability of dentists.

OBJECTIVE

This study aimed to reveal the relationship between MSD, work ability and sickness absences in Finnish dentists and dental students.

METHODS

A questionnaire was sent to 1200 dental workers and students. It inquired of age, gender, use of dental loupes, physical exercise, use of health care, and site, length and frequency of musculoskeletal complaints. Work ability was assessed with four parameters: work ability score (WAS), future work ability (FWA), self-estimation of MSD-related work disability, and sickness absence days.

RESULTS

The questionnaire gained 255 responses (response rate 21%). The majority (90%) of the respondents had experienced MSD during the past year but only eleven percent of them had been on sick leave. MSDs correlated significantly with WAS, FWA and MSD-related work disability. Results remained significant even age adjusted. Age was a strong predictor of declined work ability, but gender, physical exercise or dental loupe use did not have a significant impact.

CONCLUSIONS

Despite all the ergonomic advances in modern dentistry, the occurrence of MSD symptoms is still high. MSDs seem to affect dentists' work ability significantly, but amount of sickness absence is relatively low, which may indicate a high level of presenteeism.

Evaluation of the Cervical Physiotherapeutic Treatment Needs, Work Ergonomics, and Necessity for Physical Activity Among Students of Dentistry at a Medical University. A Pilot Study

INTRODUCTION

A lot of general dental practitioners suffer from job-related health problems. They are more prone to numerous different physical and psycho-emotional triggers that aggravate their working conditions.

THE AIM

The aim of the study was to evaluate cervical physiotherapeutic treatment needs, daily ergonomic habits and the necessity for physical activity among students of dentistry at a medical university.

MATERIALS AND METHODS

112 generally healthy dentistry students (73 women, 39 men) were enrolled for the study. The age range was 20-32, with an average of 22.88 ± 2.7. The study included subjects in their second to fifth year of studies. The survey was conducted with respect to the questionnaires about possible physiotherapeutic treatments, physical activities, imaging tests and diagnoses as well as statements regarding the respondents' knowledge and ergonomics habits. To estimate the association between the risk factor and neck disability as well as chronic pain, the Neck Disability Index, Perceived Stress Scale and the Graded Chronic Pain Scale were additionally applied.

RESULTS

35.71% of dentistry students had undergo physiotherapy in the preceding year. 26.79% of the respondents declared that they underwent rehabilitation on a regular basis. The most common reasons for treatment were complaints of the cervical (7.14%), lumbar (3.57%), and thoracic spine (1.79%) as well as a combination of these symptoms. 6.25% of the subjects had started rehabilitation due to muscle relaxation. 34.82% of the study participants did not do any physical activity. Females exercised more often than males (p = 0.02; 1-β = 0.65). Therapeutic exercises contributed to the improvement of well-being of 56% of students. 64.29% of the respondents chose a sitting position during pre-clinical and clinical classes and 26.79% of the subjects worked in sitting and standing postures.

CONCLUSION

26.79% of dentistry students required periodic therapeutic rehabilitation. 34.82% of the respondents were advised to implement systematic physical activity. Due to professional conditions, dental students are exposed to an early cervical spine disorders. The main factor influencing an early onset of such dysfunctions is increased stress level. An average level of pro-health awareness may be the reason for elevated cost of rehabilitation among this group of patients.

Risk for cervical herniated intervertebral disc in dentists: a nationwide population-based study

Background

Prolonged static postures (PSPs) may predispose dentists to develop cervical herniated intervertebral disc (C-HIVD); however, there is limited evidence supporting this in the literature thus far. We conducted this study to fit the data gap.

Methods

We conducted a retrospective nationwide population-based study using the Taiwan National Health Insurance Research Database to identify 10,930 dentists, an identical number of age- and sex-matched participants from the general population, and 73,718 other health care providers (HCPs, non-dentists). Comparisons for the risk of developing C-HIVD between dentists and the general population, and between dentists and other HCPs were performed by tracing their medical histories between 2007 and 2011.

Results

Dentists had a cumulative incidence rate of 1.1% for C-HIVD during the 5-year follow-up period. Overall, there was no difference of the risk for C-HIVD between dentists and the general population after adjusting for hypertension, hyperlipidemia, liver disease, mental disorders, diabetes mellitus, coronary artery disease, chronic obstructive pulmonary disease, malignancy, stroke, and renal disease (adjusted odds ratio [AOR]: 1.2, 95% confidence interval [CI]: 0.9–1.6). However, stratified analysis showed that younger dentists (≤ 34 years) had a trend of higher risk for C-HIVD than members of the younger general population (AOR: 1.9, 95% CI: 0.9–4.1). There was no difference found between dentists and other HCPs (AOR: 0.9, 95% CI: 0.8–1.1).

Conclusion

Younger dentists had a trend of higher risk of developing C-HIVD than members of the general population.

The prevalence of occupational health-related problems in dentistry: A review of the literature

The study was conducted to report on the scope and prevalence of occupational health related-problems experienced by dentists, dental therapists, and oral hygienists in their practice of dentistry.

BACKGROUND

Professional practice and dental training have many risk factors, and the dental team should be able to recognize these factors to protect themselves. The prevalence of conditions related to the musculoskeletal system, stress, percutaneous injuries, ears, and eyes are of concern. The dental team should also not forget hepatitis B, hepatitis C, and HIV as risks in practice. Dental practitioners should protect themselves by self-recognizing risk factors and by maintaining proper working conditions.

METHODS

The study targeted all empirical research, case studies, and systematic literature reviews written in English. All articles selected were subjected to a data analysis process. Data were captured on an Excel spreadsheet and reported in a comprehensive table.

RESULTS

The literature addressing occupational health among dental practitioners included mainly cross-sectional studies and review papers (2001-2016). Forty-nine studies were included in the review. Musculoskeletal disorders remain the most researched occupational health-related problems in dentistry. Eye protection compliance was low among practitioners. Percutaneous injuries especially among young dentists and students were still a concern.

CONCLUSION

Occupational health-related problems are still prevalent in current dentistry practice, despite changes in equipment and surgery design. The reported prevalence of occupational related-health problems and other findings of investigative studies highlight the need for continuous professional education and a need to improve clinical practice aspects of dentistry curricula.

The relationship between physical load and musculoskeletal complaints among Brazilian dentists

The aim of the present study was to assess the relationship between physical load and musculoskeletal complaints in dentistry and to analyze the prevalence and severity of such complaints in nine anatomical regions using a cross-sectional study of 387 dentists from Natal, Brazil. The highest prevalence of complaints was related to the lower back (58.4%) and the lowest prevalence was found in the elbow (10.3%). In general, symptoms were classified as mild because they did not cause absence due to illness. Pain complaints were associated with the following characteristics: awkward posture at work; prolonged standing or sitting; strenuous position of the upper limbs; excessive tightening of the hands during clinical treatment; and the use of vibrating tools. The results of the present study suggest a high prevalence of musculoskeletal complaints in dentists that are significantly associated with variables related to their physical workload.