Determinants of physical and mental health complaints in dentists: a systematic review

Work-related musculoskeletal disorders in oral health professionals: an umbrella review protocol

OBJECTIVE

The objective of this review is to synthesize the evidence on the prevalence, incidence, risk factors, and preventive and management interventions for work-related musculoskeletal disorders (MSD) in oral health professionals.

INTRODUCTION

Oral health professionals face a considerable risk of developing work-related MSD due to the nature of their work. These disorders can lead to loss of employment, reduced job quality, increased occupational injuries, and early retirement. They can also lead to significant financial burdens for employers and society.

INCLUSION CRITERIA

This umbrella review will include systematic reviews and meta-analyses that have oral health professionals as a population group and address at least one of the following topics: the prevalence or incidence, risk factors, and the efficiency or effectiveness of interventions for the prevention or management of work-related MSD.

METHODS

A systematic search will be conducted across CINAHL Complete (EBSCOhost), Dentistry and Oral Sciences Source (EBSCOhost), MEDLINE (EBSCOhost), Cochrane Library (Ovid), Scopus, PsycINFO (Ovid), AMED Allied and Complementary Medicine (Ovid), Epistemonikos, Ergonomics Abstracts Online (EBSCOhost), and Google Scholar (first 200 articles). The search will be limited to articles published in English, with no restrictions on geographical location. Two independent reviewers will screen the titles and abstracts against the inclusion criteria. The reviews will be assessed using the JBI critical appraisal instrument for systematic reviews and research syntheses, and data will be extracted from each review using a modified version of the JBI data extraction tool. A narrative summary and tables will be used to describe the review characteristics and findings. Results will be presented in a table using visual indicators (traffic light system) to represent beneficial, neutral, and negative effects with each risk factor and intervention. The GRADE approach will be used to rate the overall quality and strength of the evidence.

REVIEW REGISTRATION

PROSPERO CRD42023388779.

A Comprehensive Mixed Methods Approach for Studying the Quality of Life of Colombian Periodontists

This study analyzed the association of the sociodemographic, labor, and health conditions on the quality of life (QOL) of the periodontists in Colombia. A mixed study (explanatory sequential design) was conducted. The first quantitative phase was carried out by a cross-sectional survey (n = 187; 60.4% females). Variables: sociodemographics, labor, and health conditions, QOL (WHOQOL-BREF). Normality tests, descriptive statistics, and bivariate analyzes were performed. Factors associated with QOL were established using multivariate linear regression. A second qualitative phase with two focus groups (FGs) delved into those aspects of relevance, through qualitative content analysis and triangulation of information. The multivariate linear regression analysis showed that the factors associated with the QOL scores were in the case of men and negatively (QOL decreases): having low social support (p < 0.001), reporting poor mental health (p < 0.01). For women, QOL scores were negatively associated with low social support (p < 0.001), reporting poor general and mental health (p < 0.01), having greater stress at work (p < 0.05), having a temporary contract (p < 0.05), and living in a medium or low socioeconomic status (p < 0.05). The analysis of the FG allowed us to understand how QOL is permeated by the social context. The specialization of periodontics has generated a change in living conditions, and an adaptation to the workplace that allows them to gain recognition and a higher QOL. In conclusion, the QOL of periodontists is defined in subjective terms (standards) and related to social and labor conditions. Follow-up and evaluation strategies of the general conditions of these clinical specialists in Colombia are required.

The Healing Environment of Dental Clinics through the Eyes of Patients and Healthcare Professionals: A Pilot Study

The physical environment of healthcare settings can promote both the healing process and patient feelings of well-being, as well as instill positive emotions in employees. The present study aimed to evaluate the dental work environment of a typical private and public dental clinic to identify key parameters that determine the perception of health facilities by patients and employees. The study was carried out from 1 to 20 December 2021, in two dental clinics in Ekaterinburg (Russian Federation) using 'ASPECT'. The participants were 58 staff and 94 patients. The results showed that, compared with patients, staff reported higher views scores, nature and outdoors scores, and comfort and control scores. The common criterion that distinguishes private clinics from public ones was comfort and control. Compared with patients in state clinics, patients in private clinics reported higher privacy, company and dignity scores, comfort and control scores, interior appearance scores, and facility scores. In general, while views scores and nature parameters can be singled out as a universal absolute value for everyone in a particular environment, staff pay more attention to factors that contribute to long-term comfortable stay and performance of their duties.

Quality of Life and Related Factors in Specialists on Pediatric Dentistry and the like Graduated from a Public University: A Mixed Methods Approach

This study aims to analyze the factors associated with the quality of life (QOL) in pediatric dentistry specialists and the like, graduated in a public university between 1972 and 2018. A mixed study (explanatory sequential design) was conducted. Firstly, a cross-sectional survey (n = 62, 51% women) was carried out and complemented with three focus groups (FGs) and four semi-structured interviews (SIs). Descriptive statistics, bivariate analyzes and non-parametric correlation were calculated. A multivariate linear regression was carried out to establish the factors associated with QOL. In FGs, the concept of QOL and the factors that influence it was investigated, by following a qualitative content analysis and later the information was triangulated. The median QOL scores surpass 62 points. The multivariate analysis showed that the factors exerted the greatest influence negatively (decreases the QOL score) were: having an independent or service provision contract (p < 0.05), low social support (p < 0.001), job dissatisfaction (p < 0.01), poor mental health (p < 0.01), self-perceived poor general health (p < 0.01). The information from the FGs and interviews allow to establish three categories of analysis: (1) QOL and health: multiple facets, determinants, and dimensions; (2) encounters and disagreements between the postgraduate curricular training proposal and the labor and social field of the specialist; (3) an itinerant clinical specialization. The QOL of participants is considered good in general terms and is conditioned by subjective factors, the social environment, and the conditions of their professional work.

Effectiveness of Ergonomic Training to Decrease Awkward Postures during Dental Scaling Procedures: A Randomized Clinical Trial

Studies demonstrate that there is a lack of effective ergonomic principles for adopting a neutral posture during the execution of dental procedures. ISO 11.226:2000 Standard, Corr. 1:2006 has been thoroughly evaluated and adapted to the way that dentists work by the European Society of Dental Ergonomics (ESDE). However, after 15 years, no studies that showed strong evidence of effectiveness in reducing the prevalence of awkward posture in applying its parameters within the scope of dental practice were found. The aim of this study was to verify the effectiveness of applying the ergonomic parameters proposed by the European Society of Dental Ergonomics (ESDE) and ISO 11226 in reducing the prevalence of the main awkward postures adopted by female dental surgeons during the execution of dental scaling on a dental mannequin. A randomized clinical trial was carried out with sixty dental surgeons randomly assigned to two groups: the intervention group, who received instructions and theoretical and practical ergonomic training; and the control group, who received the same training only at the end of the study. For data analysis, Software IBM SPSS 27 and RStudio was used. Descriptive statistics were performed to verify the effectiveness of the intervention, and generalized linear models (specifically, generalized estimated equation models) were used. Poisson distribution was carried out with log link function and network analyses. Sixty female dental surgeons participated in the study. Twenty-two were distributed in the intervention group and thirty-eight in the control group. It was found that ergonomic training enabled a 63% reduction in the prevalence of awkward postures and that there was a statistically significant difference (p < 0.001) only in the intervention group. The analyses showed that the estimated marginal means of postures not recommended in the groups’ initial control, final control, initial intervention, and final intervention were 8.6, 8.2, 9.0, and 3.4, respectively. The relationship of networks analyses of the variables is shown with different profiles in the control and intervention groups, but the same pattern between the groups only vary in the strength and direction of the correlations. It was concluded that the ergonomic training based on the parameters of ISO 11226 and DIN EN 1005-4, and its adaptations to the dental practice provided by the European Society of Dental Ergonomics, as well as recent studies, contributed significantly to reducing the prevalence of awkward postures adopted by female dentists during the simulation of the basic periodontal procedures; however, it was not effective enough to improve the posture of the head and neck.

Attitudes and predictive factors of psychological distress and occupational burnout among dentists during COVID-19 pandemic in Turkey

The aim of this study was to evaluate the factors affecting the ability and willingness of dentists to work during the COVID-19 pandemic and the effect of this situation on occupational burnout. A 51-question survey, including demographic and pandemic questions and the Maslach Burnout Inventory (MBI), was used as a data collection method and administered to dentists in Turkey via the internet in two stages. A link to the survey (onlineanketler.com) was sent to the participants by e-mail or social media (WhatsApp©). A total of 442 dentists in the first stage and 264 dentists in the second stage answered the questionnaire. The second stage of the survey only applied to dentists who are assigned within the scope of COVID-19 measures in Turkey. Standard descriptive statistics, the chi-square test, independent samples t test and the Kruskal-Wallis test were used for statistical analysis. Most of the participants showed higher stress levels. Occupational burnout levels of participants according to filiation service (serve/FP, did not serve/FN) were 34.4% and 17.6%, respectively. The FP group showed significantly higher stress levels than the FN group. It is important to consider how these results, collected during an infectious disease epidemic, reflect the effects of psychological distress and burnout on dental staff.

Trial Registration Number and Date of Registration: NCT04605692–10/27/2020.

Oral health professionals: An exploration of the physical and psychosocial working environment

BACKGROUND

Musculoskeletal disorders (MSD) are a significant problem in the oral health profession. This study explores oral health professionals' physical and psychosocial working environments in Australian workplaces.

METHOD

Twelve oral health professionals from the public and private dental sectors participated in semi-structured interviews. Interviews were recorded and transcribed. Themes were identified and a coding framework developed which was refined and clarified during analysis.

RESULTS

Participants reported a range of physical and psychosocial experiences in their work environment. Three major categories of themes were identified: Job Characteristics - particularly equipment unsuited for task and time constraints; Job Satisfaction - support from management and colleagues was valued, as was the significance of providing oral health care, particularly to children and minority groups; and Individual Factors - MSD and fatigue were reported by most participants.

CONCLUSION

Oral health professionals are exposed to a range of workplace physical and psychosocial hazards associated with the development of MSDs. Risk management programs for the prevention of MSDs should take into account the range of physical and psychosocial hazards that oral health professionals are exposed to.

A Pilot Study Evaluating the Prevalence of Cervical Spine Dysfunction Among Students of Dentistry at the Medical University

Introduction: Cervical pain affects most people at some stage, especially middle-aged. It is one of the symptoms of cervical spine dysfunction. The prevalence of neck pain varies and depends on the population studied.

Aim: The aim of the study was to assess the prevalence of cervical spine dysfunction among dentistry students from a medical university.

Materials and Methods: The study was conducted on a group of 112 randomly chosen, generally healthy students (73 women and 39 men) of the faculty of medicine, division of dentistry at a medical university, aged 20–32, average 22.88 ± 2.7. The survey was based on a questionnaire about possible symptoms and disorders of the cervical spine in the 6 preceeding months. A bodychart was used to visualize ailments in relation to the scheme of human body, and a Graded Chronic Pain Scale was applied to assess levels of pain. Additionally, the Perceived Stress Scale and Neck Disability Index were evaluated.

Results: With respect to the questionnaire about possible symptoms of cervical spine disorders in the 6 preceeding months, 22.32% of students declared headaches 2–3 times a week, and 45.53% 2–3 times a month. 42.85% of the participants reported difficulties with concentration, 56.25% showed attention issues, and 25% had problems with memory. Moreover, 9.82% of the subjects suffered from depression, and 27.67% declared mood disorders. The bodychart revealed the occurrence of pain within the cervical spine in 47.32% of the respondents. 31.25% of students declared discomfort in the suboccipital area. In 57.14% of people, low intensity of chronic pain without functional disorders was noted. A moderate level of stress was reported in 58.03% of students. Mild cervical spine disorders were found in 53.57% of cases.

Conclusion: The relatively high prevalence of symptoms of the cervical spine dysfunction, chronic pain, stress, and neck disability among young people may indicate that numerous spinal disorders identified in dentists result not only from their profession, in which spine is significantly overloaded, but also individual predispositions including biopsychosocial profile and the changing lifestyle habits of young people.

Self-perceived mental well-being amongst Malaysian dentists

PURPOSE

To assess Malaysian dentists' perceptions of their mental well-being.

METHODS

A self-administered questionnaire was developed based on a conceptual framework of mental health and well-being model. Two aspects were assessed, namely the physiological (two domains) and the psychological (six domains). Participants were asked to rate their experiences of the aforementioned aspects using a 5-point Likert scale ranging from all the time to never.

RESULTS

The response rate was 81%. Most of the dentists (61.7%) perceived having positive mental well-being. Under the physiological aspect, most respondents reported that they were 'generally happy' (93.3%), but about 30% stated they were 'stressed physically and emotionally'. Of the six domains under the psychological aspect, positive well-being was observed in the 'sense of coherence' and 'behavioural stress' domains. Participants who were above 40 years old, married and had children reported having a more positive mental well-being when compared with their counterparts.

CONCLUSION

Overall, most Malaysian dentists perceived having a positive mental well-being. It is crucial, however, to closely monitor and initiate early interventions for those with negative symptoms to ensure the safe practice of dentistry.

Motion analysis in the field of dentistry: a kinematic comparison of dentists and orthodontists

OBJECTIVES

To conduct a kinematic comparison of occupational posture in orthodontists and dentists in their workplace.

DESIGN

Observational study.

SETTING

Dentist surgeries and departments of orthodontics at university medical centres in Germany.

PARTICIPANTS

A representative sample of 21 (10 female, 11 male) dentists (group G1) and 21 (13 female, 8 male) orthodontists (G2) with one male dropout in G2.

OUTCOME MEASURES

The CUELA (computer-assisted acquisition and long-term analysis of musculoskeletal loads) system was used to analyse occupational posture. Parallel to the recording through the CUELA system, a software-supported analysis of the activities performed (I: treatment; II: office; III: other activities) was carried out. In line with ergonomic standards the measured body angles are categorised into neutral, moderate and awkward postures. Activities between the aforementioned groups are compared using the stratified van Elteren U test and the Wilcoxon-Mann-Whitney U test. All p values are subject to the Bonferroni-Holm correction. The level of significance is set at 5%.

RESULTS

The percentage of time spent on activities in categories I-II-III was as follows: dentists 41%-23%-36% and orthodontists 28%-37%-35%. The posture analysis of both groups showed, for all percentiles (P5-95), angle values primarily in the neutral or moderate range. However, depending on the activity performed, between 5% and 25% of working hours were spent in unfavourable postures, especially in the head-and-neck area. Orthodontists have a greater tendency than dentists to perform treatment activities with the head and torso in unfavourable positions. The statistically significant differences between the two groups with regard to the duration and the relevance of the activities performed confirm this assumption for all three categories (p<0.01, p<0.05).

CONCLUSIONS

Generally, both groups perform treatment activities in postures that are in the neutral or medium range; however, dentists had slightly more unfavourable postures during treatment for a greater share of their work day.

Association between burnout and depressive symptoms among Turkish dentists

Background/purpose

Health care professionals including dentists can experience increased professional burnout. The aim of the study was to evaluate the association between depressive symptoms and burnout among Turkish dentists.

Materials and methods

This study was conducted among a Turkish dentist sample in Ankara (Turkey) between February 2015 and August 2015. From a total of 500 dentists, 337 were included. A self-structured questionnaire, Maslach Burnout Inventory (MBI), and Beck Depression Inventory (BDI) were completed by the participants. The Student t test or analysis of variance was used to compare the variables.

Results

A total of 337 dentists (162 female dentists; mean age of participants 36 ± 4.45 years) participated in this study. Age, sex, professional status, years in profession, sector, and number of patients seen/d were factors affecting level of burnout (P < 0.05); 29% of the participants showed burnout and 22.2% showed depressive symptoms. Participants showed increase in emotional exhaustion (38%), increase in depersonalization (22%), and decrease in personal accomplishment (12%). The mean score of BDI significantly correlated with those of the MBI subscales (P < 0.05). All items of BDI except weight loss, irritability, and loss of appetite significantly correlated with MBI subscores (P < 0.05).

Conclusion

Dentists may face burnout and depressive symptoms during their professional life. Increased burnout level can give an idea on depressive symptoms, and may provide an opportunity to identify depression earlier. Creating and raising awareness about burnout are important to avoid and prevent depression among dentists. Further longitudinal studies analyzing the effects of interdisciplinary client-centered self-management programs for dentists on depressive symptoms and burnout must be planned.

General Health status of workers among different workplaces in Qom Province, Iran

INTRODUCTION

In a healthy organization, psychological health and physical health are as important as production and productivity; and healthy workers have higher productivity. Regarding lack of information about workers' general health profile in Qom Province, this study aimed to assess and compare the staffs' general health and its components among different workplaces in 2014.

METHODS

In a cross-sectional study, 2,276 employees working at 46 industries and organizations completed a standardized General Health Questionnaire (GHQ 28) and a demographic questionnaire. Data were analyzed using t-test, ANOVA, and Pearson product-moment correlation coefficient by IBM SPSS version 20.

RESULTS

The mean age of the participants was 32.22 (±7.55) years. Seventy-nine point four percent of participants were married and the rest were single. Highest and lowest scores belonged to social dysfunction and depression, respectively. Also, total score of staffs' general health was 17.87 ± 10.93. The results showed that, in spite of the non-relationship between general health score difference among married and single personnel (p > 0.05), there was a significant difference between men and women and among organizations and industries with regards to general health score (p < 0.05), and drivers had the most difference with others. The relationship between workers' ages and GH was significant (p < 0.05, Pearson's bivariate correlation coefficient = -0.05).

CONCLUSION

The findings of this study collectively indicated that participants had an acceptable condition for mental factors, such as depression, but not in viewpoints of social dysfunction. In other words, staffs' interfaces with circumstances and personal innovation/creativity in the workplaces are at risk. Altogether, the general health score in the studied population was suitable in its entirety.