Prevalence of musculoskeletal disorders among dental healthcare providers: A systematic review and meta-analysis

The Knowledge and Attitude of Undergraduate Dental Students toward Dental Ergonomic Principles in Occupational Health

BACKGROUND

Undergraduate dental curricula and courses containing ergonomic principles are introduced to students from the very beginning of dental education. Still, dentists present a high prevalence of musculoskeletal disorders, which are a direct burden on quality of life, leading to early retirement from the profession. This study aimed to assess the state of students' knowledge and awareness regarding the role of ergonomics in dentistry and its practical implementation.

METHODS

a cross-sectional study using a predesigned self-administered questionnaire was conducted among fourth- and fifth-year dental students of the Medical University of Silesia in Katowice, Poland (response rate of 69.2%).

RESULTS

A total of 94.6% of students declared a good, fair, or moderate level of knowledge of the subject, with a significant difference in favor of the fifth-year students (p = 0.008). Moreover, 76.1% of respondents showed a good or very good attitude toward ergonomics as a university curriculum subject. A total of 72.3% of respondents declared that the practical application of ergonomic rules in clinical dentistry is very important (five in a five-point scale). Women found dental ergonomics more important than men (p < 0.001). However, 79.3% of participants admitted not following basic ergonomic principles during clinical procedures.

CONCLUSION

The research revealed a discrepancy between theoretical knowledge and awareness and the practical application of ergonomics in a clinical environment. Only by inculcating correct occupational standards and abiding by them from the commencement of dental education can consistency between theory and practice be achieved. This will hopefully ensure the health and well-being of dental team members throughout their professional lives.

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.

Assessment of ergonomic risk of work related musculoskeletal disorders among dentist in Kolhapur region

BACKGROUND

Work-related disability is caused commonly due to musculoskeletal disorders (MSD) in dentistry. Prolonged static awkward and repetitive postures cause MSD in dentists. The study was executed to confirm the development of MSD in various body regions as they have to work in a small oral cavity to perform crucial dental procedures with precision and concentration.

OBJECTIVE

To assess the occurrence of the MSD in several body regions of dentists and to carry out postural study thereby helping them improve posture.

METHODS

Dentists were assessed for their current working postures with various MSD symptoms and its effects. The questionnaire was devised to get musculoskeletal health data from dentists. The postural load was investigated using Rapid Upper Limb Assessment (RULA). Various risk factors contributing to MSD symptoms were identified after data were statistically analysed using IBM SPSS version 27.

RESULTS

According to the current study neck, shoulder, lower back, upper back, wrist hand, elbow, hip, thigh, knee, and ankle were the most affected anatomical regions. Average RULA score for the current study was found to be 6.75 which indicated a need of change of posture while performing dental procedures. There is statistical correlation between gender, Body Mass Index (BMI), uncomfortable positions, stretching, use of ergonomic saddle chair, hand dominance and MSD. There is no statistical correlation between years of experience and MSD.

CONCLUSION

Current workstation (Dental Chair) requires immediate improvements as evident from the postural load analysis, thus immediate implementation of intervention program is required.

Ergonomic Analysis of Dental Work in Different Oral Quadrants: A Motion Capture Preliminary Study among Endodontists

BACKGROUND

Dentists, including endodontists, frequently experience musculoskeletal disorders due to unfavourable working postures. Several measures are known to reduce the ergonomic risk; however, there are still gaps in the research, particularly in relation to dental work in the different oral regions (Quadrants 1-4).

METHODS

In this study (of a pilot character), a total of 15 dentists (8 male and 7 female) specialising in endodontics were measured while performing root canal treatments on a phantom head. These measurements took place in a laboratory setting using an inertial motion capture system. A slightly modified Rapid Upper Limb Assessment (RULA) coding system was employed for the analysis of kinematic data. The significance level was set at p = 0.05.

RESULTS

The ergonomic risk for the entire body was higher in the fourth quadrant than in the first quadrant for 80% of the endodontists and higher than in the second quadrant for 87%. For 87% of the endodontists, the ergonomic risk for the right side of the body was significantly higher in the fourth quadrant compared to the first and second quadrant. The right arm was stressed more in the lower jaw than in the upper jaw, and the neck also showed a greater ergonomic risk in the fourth quadrant compared to the first quadrant.

CONCLUSION

In summary, both the total RULA score and scores for the right- and lefthand sides of the body ranged between 5 and 6 out of a possible 7 points. Considering this considerable burden, heightened attention, especially to the fourth quadrant with a significantly higher ergonomic risk compared to Quadrants 1 and 2, may be warranted.

A quantitative study on the impact of educational modules on the awareness of postural ergonomics among the dental clinical trainees of Jouf University: A North Saudi Arabian Cohort

This research aimed to evaluate the difference between self-reported and actual work postures among dental clinical trainees and the effect of health education on their ergonomic postures. Bad postures induce fatigue, musculoskeletal pain, errors, a negative attitude, and job dissatisfaction. It is necessary to evaluate the awareness of posture ergonomics among clinical trainees as the bad postures captured during their learning years transform into habits that could affect future productivity. Hence, a three-level quantitative study was conducted among the dental trainees at Jouf University, Saudi Arabia. The first level comprised a self-reported survey and an observational study to record the working postures of the participants. At the second level, appropriate health education is customized based on the findings observed at the first level. An unannounced observational study was conducted at the third level to assess the impact of ergonomic education on the working postures of the participants. Gender and the academic year level of the participants were the variables considered in the study. The study found that the participants overrated their correct postures (P = 0.005). Fortunately, the final post-ergonomic education observations found a significant improvement in work posture (8.6 vs 12.4), regardless of the variables considered in the study (P = 0.001). The three best correct postures were placing the feet resting on the floor (52.6 vs 92.8 %), using the seat of a dental chair (57.9 vs 89.5 %), and using an upright position of the legs at the thigh-to-leg angle (53.9 % vs 86.2 %). Therefore, the study emphasizes the importance of training in ergonomics and regular, periodic observation to eradicate bad postures before they become a habit among young dentists.

Risk Factors and Prevalence of Occupational Musculoskeletal Pain among Endodontists in the United States

INTRODUCTION

A musculoskeletal disorder (MSD) of pain, weakness, numbness, or paresthesia is a common issue for dental health care providers. The aims of this study were to (1) identify the prevalence of MSDs among endodontists in the United States, (2) to identify risk factors of MSDs among United States endodontists, and (3) to compare these findings with other published findings for dental providers.

METHODS

A 24-question survey regarding the demographics, potential risk factors, and prevalence of MSDs was formulated and distributed to 5394 members of the American Association of Endodontists. Data were then analyzed using descriptive statistics and chi-square analysis to find significance at α = 0.05.

RESULTS

Six hundred twenty participants responded to the survey for an overall response rate of 12%. Of the submitted surveys, 527 of them confirmed to be endodontists practicing in the United States, and all results were derived from those 527 surveys. Seventy-four percent of respondents reported having experienced MSDs in the last 12 months, and 88% reported having experienced at least 1 MSD thus far during their career. Eighty-five percent of female participants reported an MSD within the past 12 months compared with 70% of males.

CONCLUSIONS

MSDs have a high prevalence among endodontists in the United States. The neck and lower back were the areas of highest MSD prevalence. Female sex and the frequent adoption of awkward postures were factors associated with significantly higher rates of reported MSDs in the last 12 months.

Assessment of dental ergonomics among dental students: A retrospective study

INTRODUCTION

Musculoskeletal (MSK) disorders account for 11%-98% of occupational health issues for dental professionals, with an onset as early as in dental school. Dental ergonomics is among the risk factors; thus, a prompt assessment is crucial in preventing future MSK pain. The aim of this study was to retrospectively assess dental ergonomics of second-year dental students after dedicated lectures were introduced in the predoctoral curriculum.

METHODS

Three cohorts of second-year dental students were evaluated during preclinical activity in July 2019, January 2022, and December 2022 by an Occupational Therapy (OT) faculty and calibrated OT students. Dental ergonomics was assessed with the Rapid Upper Limb Assessment (RULA). Dental student cohorts were compared with one-way analysis of variance (ANOVA).

RESULTS

The average RULA final score of 409 participants was 5.1 ± 0.9, with no difference between the three cohorts (p = 0.676). The January 2022 cohort scored significantly lower in wrist-arm score than that of 2019 (p = 0.001) and December 2022 (p = 0.046). Neck and lower limb posture were significantly higher in January 2022 cohort than in 2019 (p = 0.001 and 0.013) and December 2022 (p = 0.001 and 0.005) cohorts. The December 2022 cohort revealed a medium, high and extremely high risk of developing MSK of 40.2%, 37.1%, and 21.6%, respectively, with no difference between sexes.

CONCLUSION

The risk of developing MSK pain was medium-high in predoctoral dental students and was not related to sex. The overall dental ergonomics required attention and rapid change. Further implementation of varied forms of teaching and monitoring of dental ergonomics from the early years of education is recommended to prevent development of MSK pain at young age and foster better postural habits.

Worldwide prevalence of carpal tunnel syndrome among dental health care personnel - A systematic review and meta-analysis

Background: Carpal Tunnel Syndrome (CTS) is one such common disorder among dental health care personnel caused due to the entrapment neuropathy of the median nerve in the carpal tunnel. We aimed to evaluate the pooled estimates of the CTS among dental healthcare personnel. Methods: We systematically reviewed the existing literature from six databases till January 1 st, 2022. Studies reported in English along with the prevalence of CTS or where prevalence could be calculated were included. Independent screening of title and abstracts, and the full text was done by two examiners. Information collected was authors, year of publication, geographic location, type of dental healthcare personnel, sample size, distribution of age, sex, CTS, method of diagnosis, and risk of bias. The random effect model was used to estimate the pooled estimates. Results: Thirty-seven studies yielded 38 estimates. A total of 17,152 dental health care personnel were included of which 2717 had CTS. The overall pooled prevalence of CTS among the included studies was 15%, with a high heterogeneity. Meta-analysis showed no significant difference in the pooled estimates of CTS between male and female dental healthcare personnel (OR: 0.73; 95% CI: 0.52 -1.02; I 2= 69.71). The pooled estimates among the dentist and dental auxiliaries were 20% and 10%, respectively. The pooled prevalence of CTS with self-reported measures, clinical examination and NCS were 21%, 13% and 8% respectively. Meta-regression showed that the prevalence estimates were significantly associated with publication year (coefficient: 0.006; 95% CI= 0.002-0.01). Conclusion: One out of seven dental health care personnel may be affected by CTS. No significant difference was seen in the prevalence of CTS between male and female dental healthcare personnel.