Abstract
Aim
To quantify the magnitude of musculoskeletal disorders (MSDs) in dentists working in the Greater Athens area in relation with personal characteristics, work and psychological risk factors.
Methods
Using cross-sectional methodology and by means of a self-administered questionnaire, 80 dentists provided information on personal characteristics, employment history, use of specific dental instruments, working and personal habits, perception of the job’s physical and psycho-social demands, general health status, need for recovery at the end of a regular working day, the affected body region and the MSDs frequency.
Results
A total of 83 % dentists reported at least one MSD (past year), 54 and 70 % reported monotonous/repetitive movements and strenuous back postures, respectively, while 38 % sought medical help for MSDs of the cervical/shoulder and back region. Direct vision in the oral cavity was significantly related with a higher frequency of chronic pain in the cervical region (odds ratio, OR = 6.8). Absence of a dental assistant and use of manually handled endodontic instruments were significantly related with a higher prevalence of hand senso-neural disorders (OR = 3 and 3.4 respectively). Passive free-time activities were significantly related with a higher prevalence of MSDs in the shoulder region (OR = 4.16). Smokers had significantly higher need for recovery at the end of a working day compared to non-smokers (OR = 2.6).
Conclusions
Dentists could prevent or alleviate MSDs, by adopting appropriate work practices and by modifying personal habits. Education in dental ergonomics and correct working postures is of paramount importance and should preferably be introduced during undergraduate dental practice.
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References
Åkesson I, Johnson B, Rylander L, Moritz U (1999) Musculoskeletal disorders among female dental personnel: clinical examination and a 5-year follow-up study of symptoms. Int Arch Occup Environ Health 72:395–403
Alexopoulos EC, Stathi IC, Charizani F (2004) Prevalence of musculoskeletal disorders in dentists. BMC Musculoskelet Disord 5:16. doi:10.1186/1471-2474-5-16
Beach JC, De Biase CB (1998) Assessment of ergonomic education in dental hygiene curricula. J Dent Educ 62:421–425
Brage S, Bjerkdal T (1996) Musculoskeletal pain and smoking in Norway. J Epidemiol Community Health 50:166–169
Donaldson CC, Nelson DV, Skubick DL, Clasby RG (1998) Potential contributions of neck muscle dysfunctions to initiation and maintenance of carpal tunnel syndrome. Appl Psychophysiol Biofeedback 23(1):59–72
Dong H, Loomer P, Barr A, Laroche C, Young E, Rempel D (2007) The effect of tool handle shape on hand muscle load and pinch force in a simulated dental scaling task. Appl Ergon 38:525–531. doi:10.1016/j.apergo.2006.09.002
Droezea EH, Jonsson H (2005) Evaluation of ergonomic interventions to reduce musculoskeletal disorders of dentists in the Netherlands. Work 25:211–220
Falkiner S, Myers S (2002) When exactly can carpal tunnel syndrome be considered work-related? Aust NZ J Surg 72:204–209. doi:10.1046/j.1445-2197.2002.02347.x
Finestone HM, Alfeeli A, Fisher WA (2008) Stress-induced physiologic changes as a basis for the biopsychosocial model of chronic musculoskeletal pain: a new theory? Clin J Pain 24:767–775
Finsen L (1999) Biomechanical aspects of occupational neck postures during dental work. Int J Ind Ergonomics 23:397–406
Finsen L, Christensen H, Bakke M (1998) Musculoskeletal disorders among dentists and variation in dental work. Appl Ergon 29:119–125. doi:10.1016/S0003-6870(97)000017-3
Gijbels F, Jacobs R, Princen K, Nackaerts O, Debruyne F (2006) Potential occupational health problems for dentists in Flanders, Belgium. Clin Oral Investig 10:8–16. doi:10.1007/s00784-005-0003-6
Harutunian K, Gargallo-Albiol J, Figueiredo R, Gay-Escoda C (2011) Ergonomics and musculoskeletal pain among postgraduate students and faculty members of the School of Dentistry of the University of Barcelona (Spain): a cross-sectional study. Med Oral Patol Oral Cir Bucal 16:e425–429. doi:10.4317/medoral.16.e425
Hayes MJ, Cockrell D, Smith DR (2009) A systematic review of musculoskeletal disorders among dental professionals. Int J Dent Hyg 7:159–165. doi:10.1111/j.1601-5037.2009.00395.x
Horstman SW, Horstman Breca C, Horstman Freya S (1997) Ergonomic risk factors associated with the practice of dental hygiene: a preliminary study. Am Soc Safety Eng Prof Saf 49–53
Åkesson I, Lundborg G, Horstmann V, Skerfving S (1995) Neuropathy in female dental personnel exposed to high frequency vibrations. Occup Environ Med 52:116–123
Jonker D, Rolander B, Balogh I (2009) Relation between perceived and measured workload obtained by long-term inclinometry among dentists. Appl Ergon 40:309–315. doi:10.1016/j.apergo.2008.12.002
Karasek R, Brisson C, Kawakami N, Houtman I, Bongers P, Amick B (1998) The job content questionnaire (JCQ): an instrument for internationally comparative assessments of psychosocial job characteristics. J Occup Health Psychol 3:322–355. doi:10.1037/1076-8998.3.4.322
Karpansalo M, Lakka TA, Manninen P, Kauhanen J, Rauramaa R, Salonen JT (2003) Cardiorespiratory fitness and risk of disability pension: a prospective population based study in Finnish men. Occup Environ Med 60:765–769. doi:10.1136/oem.60.10.765
Kuorinka I, Johnsson B, Kilbom A, Vinterberg H, Biering-Sørensen, Andersson G, Jørgensen K (1987) Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon 18:233–237. doi:10.1016/0003-6870(87)90010-X
Leggat PA, Smith DR (2006) Musculoskeletal disorders self-reported by dentists in Queensland, Australia. Aust Dent J 51:324–327. doi:10.1111/j.1834-7819.2006.tb00451.x
Leggat PA, Chowanadisai S, Kedjarune U, Kukiattrakoon B, Yapong B (2001) Health of dentists in southern Thailand. Int Dent J 51:348–352
Leggat P, Kedjarune U, Smith D (2007) Occupational health problems in modern dentistry: a review. Ind Health 45:611–621. doi:10.2486/indhealth.45.611
Lincoln AE, Smith GS, Amoroso PJ, Bell NS (2003) The effect of cigarette smoking on musculoskeletal-related disability. Am J Ind Med 43:337–349. doi:10.1002/ajim.10195
Lindfors P, von Thiele U, Lundberg U (2006) Work characteristics and upper extremity disorders in female dental health workers. J Occup Health 48:192–197. doi:10.1539/joh.48.192
Lomi Κ (2005) Risk factors and prevention of work-related MSDs in dental personnel. Elinyae- Work Health Saf 23:19–24
Melis M, Abou-Atme YS, Cottogno L, Pittau R (2004) Upper body musculoskeletal symptoms in Sardinian dental students. J Can Dent Assoc 70:306–310
Milerad E, Ericson MO (1994) Effects of precision and force demands, grip diameter, and arm support during manual work: an electromyographic study. Ergonomics 37:255–264. doi:10.1080/00140139408963643
Milerad E, Ericson MO, Nisell R, Kilbom A (1991) An electromyographic study of dental work. Ergonomics 34:953–962. doi:10.1080/00140139108964837
Morken T, Magerøy N, Moen BE (2007) Physical activity is associated with a low prevalence of musculoskeletal disorders in the Royal Norwegian Navy: a cross sectional study. BMC Musculoskelet Disord 8:56. doi:10.1186/1471-2474-8-56
Nermin Y (2006) Musculoskeletal disorders (MSDs) and dental practice, part 1: general information-terminology, aetiology, work-relatedness, magnitude of the problem and prevention. Int Dent J 56:359–366
Palliser CR, Firth HM, Feyer AM, Paulin SM (2005) Musculoskeletal discomfort and work-related stress in New Zealand dentists. Work Stress 19:351–359
Palmer KT, Syddall H, Cooper C, Coggon D (2003) Smoking and musculoskeletal disorders: findings from a British national survey. Ann Rheum Dis 62:33–36. doi:10.1136/ard.62.1.33
Parkes KR et al. (2005) Musculo-skeletal disorders, mental health and the work environment. Research report, Department of Experimental Psychology, University of Oxford, Oxford, UK, 316 pp
Ratzon NZ, Yaros T, Mizlik A, Kanner T (2000) Musculoskeletal symptoms among dentists in relation to work posture. Work 15:153–158
Reising DW, Bennett BC, Hursch K, Plesh O (2005) Reports of body pain in a dental student population. J Am Dent Assoc 136:81–86
Rolander B, Jonker D, Karsznia A, Öberg T (2005) Evaluation of muscular activity, local muscular fatigue, and muscular rest patterns among dentists. Acta Odontol Scand 63:189–195
Rundcrantz BL, Johnsson B, Moritz U (1991a) Occupational cervico-brachial disorders among dentists: analysis of ergonomics and locomotor functions. Swed Dent J 15:105–115
Rundcrantz BL, Johnsson B, Moritz U (1991b) Pain and discomfort in the musculoskeletal system among dentists. a prospective study. Swed Dent J 15:219–228
Russel BS (2008) Carpal tunnel syndrome and the “double crush” hypothesis: a review and implications for chiropractic. Chiropr Osteopat 16:2. doi:10.1186/1746-1340-16-2
Bassett S (1983) Back problems among dentists. J Can Dent Assoc 49:251–256
Szymanska J (2002) Disorders of the musculoskeletal system among dentists from the aspect of ergonomics and prophylaxis. Ann Agric Environ Med 9:169–173
Tezel A, Kavrut F, Tezel A, Kara C, Demir T, Kavrut R (2005) Musculoskeletal disorders in left- and right-handed Turkish dental students. Int J Neurosci 115:255–266. doi:10.1080/00207450590519517
Thornton LJ, Barr AE, Stuart-Buttle C, Gaughan JP, Wilson ER, Jackson AD, Wyszynski TC, Smarkola C (2008) Perceived musculoskeletal symptoms among dental students in the clinic work environment. Ergonomics 51:573–586. doi:10.1080/00140130701728277
Treaster DE, Burr D (2004) Gender differences in prevalence of upper extremity musculoskeletal disorders. Ergonomics 47:495–526. doi:10.1080/00140130310001638171
van Veldhoven M, Broersen S (2003) Measurement quality and validity of the “need for recovery scale”. Occup Environ Med i3-9. doi:10.1136/oem.60.suppl_1.i3
Vehmas T, Solovieva S, Riihimäki H, Luoma K, Leino-Arjas P (2005) Hand workload and the meta carpal cortical index: a study of middle-aged teachers and dentists. Osteoporos Int 16:672–680. doi:10.1007/s00198-004-1742-y
Wüst RCI, Morse CI, de Haan A, Rittweger J, Jones DA, Degens H (2008) Skeletal muscle properties and fatigue resistance in relation to smoking history. Eur J Appl Physiol 104:103–110. doi:10.1007/s00421-008-0792-9
Ylipää V, Arnetz BB, Preber H (1999) Predictors of good general health, well-being and musculoskeletal disorders in Swedish dental hygienists. Acta Odontol Scand 57:277–282
Yoser AJ, Mito RS (2000) Injury prevention for the practice of dentistry. J Calif Dent Assoc 30:170–6
Acknowledgments
The authors would like to thank all the dentists who participated into the study and the scientific committee of the postgraduate programme “Environmental and Occupational Health Risk Assessment and Management” of the Medical School University of Athens for facilitating the data collection.
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Zoidaki, A., Riza, E., Kastania, A. et al. Musculoskeletal disorders among dentists in the Greater Athens area, Greece: risk factors and correlations. J Public Health 21, 163–173 (2013). https://doi.org/10.1007/s10389-012-0534-7
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DOI: https://doi.org/10.1007/s10389-012-0534-7