Back and neck musculoskeletal symptoms associated with the level of postural risk experienced by dentists

doi:10.21203/rs.3.rs-2081436/v1

Download PDF

Research Article

Back and neck musculoskeletal symptoms associated with the level of postural risk experienced by dentists

https://doi.org/10.21203/rs.3.rs-2081436/v1

This work is licensed under a CC BY 4.0 License

Version 1

posted

You are reading this latest preprint version

Objective

Musculoskeletal discomfort is a health problem prevalent among dentists which negatively affects their daily living activities. Dentistry is a profession that requires great precision and concentration, and it is generally associated with a high prevalence of musculoskeletal disorders. The purpose of this study was to determine the musculoskeletal symptomatology of the back and neck associated with the level of postural risk in dentist’s work.

Methodology

In this cross-sectional observational study, 187 dentistry from the cities of Palmira and Neiva were included. The researchers applied a validated questionnaire, the Nordic Kuorinka questionnaire and the Rapid Entire Body Assessment (REBA) method through recordings and photographs; additional questions were included considering the total duration of work experience in dental practice. Qualitative variables were analysed using proportions to determine the prevalence of neck and back musculoskeletal symptomatology, whereas quantitative variables were analysed using central and dispersion tendency measures. An ordinal logistic regression was applied to show the relationship between musculoskeletal symptomatology and the level of postural risk of the REBA method.

Result

Results show 71.1% prevalence of back musculoskeletal symptomatology and 60% prevalence of neck symptomatology. Dentists were affected when performing their activities in the last 12 months due to musculoskeletal discomfort in the back (58.2%) and neck (17.2%). The possible causes of these discomforts were distributed as follows: 35.9% was claimed to long working hours and 23.5% to bad posture. The REBA score indicates an average level of postural risk with a prevalence of 59.8%. A statistically significant relationship between prolonged time at the workplace was identified (odd ratio = 1.3; p = 0.03; 95% confidence interval = 1.1–2.9) with the average postural risk level of the REBA method between bad posture (χ² = 48.41; p = 0.000).

Conclusion

The study determined a high prevalence of musculoskeletal symptomatology in the neck and back and a score level of the REBA method equivalent to the average risk level; that is why, task changes may be required. Occupational health education programs could be effective in reducing these discomforts.

occupational risks

musculoskeletal disorders

ergonomics

occupational health

physical load

Work-related musculoskeletal discomforts are a significant issue within the health care field (1), they refer to a range of inflammatory and degenerative disorders initiated or aggravated to a large extent by work performance (2, 3). According to the US National Institute of Occupational Safety and Health (NIOSH), work-related musculoskeletal alterations include a great number of injuries to muscles, tendons, nerves, or joints, occurring in any anatomical region. Dentistry is a demanding profession that requires great precision and concentration since the oral cavity is limited in vision and space for dentists to perform dental procedures (4). As a result, dentists are forced to assume body postures for long periods of time to develop their work, maintain static postures and perform repetitive movements (5) which are collectively responsible for causing deterioration in the health of these professionals.

According to the World Health Organization (WHO) and the NIOSH, the causes of musculoskeletal discomforts are multifactorial in origin, which are related to workplace conditions (6) and workplace exposures, but also organizational, psychosocial and socio-cultural variables (7). Accordingly, it is important to consider this issue, since musculoskeletal discomfort in dentistry could contribute considerably to sick leave, productivity reduction and a very likely possibility of quitting the profession at an early age, which might lead to subsequent effects on the professional general health and well-being (8, 9),

Work-related musculoskeletal discomforts are more common in dental professionals (10) and there are several studies that evaluate these disorders in both students and professionals. In Indonesia, for example, studies on musculoskeletal disorders on students and practitioners reported 63.5% cases in which the neck was the most affected region (10). By the same token, modern dentistry studies have shown a systematic review of occupational health problems (11). In Czech dentists reported that about 96.9% of respondents have suffered at least one type of musculoskeletal problem mainly in the back and neck (4). A cross-sectional study in Saudi Arabia shows a 77,9% of anatomical region disorders incidence, where the lumbar area is the most affected part (73.5%), followed by the neck (66%) (12). In Colombia, a similar situation exists. Studies in Cartagena de Indias presented a 67% of dentists with neck discomfort and 65% with lumbar back region problems (2). Finally, in Medellín the prevalence of musculoskeletal discomfort was reportedly 81% for men and 88% for women. The anatomical regions of the neck (men 44%, women 59%) and lower lumbar area (men 63%, women 51%) were the most affected (13).

The postural load in dentists can be controlled by improving the tasks they perform, their working conditions and increasing their functional capacity of the musculoskeletal system. Thus, for the country the application of Nordic kuorinka questionnaire in relation to the positions adopted by dentist at work through the REBA method, one of the most widely used approaches in health professionals and in dentistry, would be sensitivity to demonstrate that that the anatomical regions of the neck and back are the most vulnerable among dentistry professionals (14). Furthermore, results will also be possible to influence the planning of preventive measures, the use of ergonomic principles, training in postural hygiene and raising awareness of the importance of the workplace. Therefore, the aim of this multicentre study was to determine the musculoskeletal symptoms of the neck and back in relation to the level of postural risk experienced by dentists while performing their everyday practice.

Study Design

An observational, descriptive, cross-sectional study was designed, considering dentists from two cities: Neiva and Palmira, Colombia.

Participants

A probability sampling of 187 dentists from the city of Neiva and Palmira, Colombia was selected according to the following inclusion criteria:

Dentists registered with the Ministry of Health who agreed to participate.
Dentists, whose clinical practice is greater or equal to a year.
Dentists, whose clinical practice is more than 4 hour per day.

Exclusion criteria were:

Dentists, who were previously diagnosed with musculoskeletal disorders.
Pregnant dentists.

Instrument

A Nordic Kuorinka questionnaire was applied. This survey was published in 1987 (15) and it is a validated and standardised questionnaire used to detect and analyse musculoskeletal symptoms. It is also relevant in the field of ergonomic or occupational health studies to identify the existence of initial symptoms and it can be used to proactively obtain information to estimate risk. The survey is ´structured with 10 closed response items which evaluate neck, shoulder, dorsal or lumbar (back), elbow or forearm, and wrist or hand regions.

The REBA method was also applied, which divides the body into two groups as follows: Groups A that comprises legs, trunk and neck and group B that includes upper limbs (arms, forearms and wrists). Using the tables associated with the method, a score is assigned to each body zone and, accordingly, global values are assigned to each of the groups.

Data Collection Procedure

Initially, researchers applied the Nordic kuorinka questionnaire to the population under study; later, video recordings were made by using professional Canon t6i cameras in order to obtain frames. The operator was observed and the angle of hemibody was captured, as this facilitated capturing the position to perform the angulation. Video footage of 2 minutes was captured three times. Recordings were made while operators were developing resins, endodontic and exodontic procedures.

Recordings were entered into the Free Video JPG Converter v5.0.101 build 201 software, where they were converted into photos. 10 photos were obtained for each second of video; Subsequently a folder was created with the total number of photos per video. Pictures were imported into the Image Comparer 3.8 software to select ten photos with the greatest similarity. Once the photos were obtained, the images with the greatest percentage similarity were chosen to determine the longest working position adopted by the dentist during patient care.

Photos selected were imported into the AutoCAD program to accurately record measurements and obtain angulation according to the lines drawn in the data analysis. The, RULER tool was then used which allowed to record measurements on the digital photographs of the angles formed by the different body segments (16).

Once the image with the established angles was obtained, the data was filled in the field sheet according to the REBA method, which divides the body into two groups: Group A, which includes the legs, trunk and neck, and Group B, which includes the upper limbs (arms, forearms and wrists). Using the tables associated with the method, a score is assigned to each body zone and, on the basis of these scores, overall values are assigned to each group.

Once the image with the established angles was obtained, a field sheet is completed with the data according to the REBA method, which divides the body into two groups: Group A, that includes legs, back and neck, and Group B, which comprises the upper limbs (arms, forearms and wrists). Neck and back measures were taken and assigned a score to each body zone. The force exerted when adopting the task is then assessed in order to modify the Group A and B scores according to the load handled. Scores are increased according to the type of muscular task developed and thus the final score is obtained.

The final score suggests the postural risk levels on the workstation. The score of the level of action is in ranges and each one establishes a level of risk and recommends an action on the evaluated posture which indicates, in each case, the urgency of the intervention as follows: 0: Invaluable: action is not necessary, 1. Low: Action may be necessary, 2. Medium: Action is necessary, 3. High: Action is necessary as soon as possible and 4. Very high: Immediate action is necessary (17).

Statistical analysis

After data collection, a descriptive analysis of the data was initially performed, using proportions for qualitative variables and central and dispersion tendency measures for quantitative variables. The normality distribution was checked by using the Shapiro-Wilk and Kolmogorov-Smirnov tests and a non-parametric distribution was identified. Consequently, in the bivariate analysis, the Chi2 and Kruskall Wallis test were used according to the case. This analysis allowed to identify the variables that suggest a statistically significant relationship between musculoskeletal symptomatology and postural risk level. Once the variables related to musculoskeletal symptomatology were identified, a multivariate analysis was designed by means of an ordinal logistic regression. The P values of 0.05 were considered statistically significant. Analyses were performed with Stata 15.

Ethical Considerations

According to Resolution 8430 of 1993 (18) which establishes the scientific, technical and administrative standards for health research in Colombia, this study is classified in the research category with minimum risk according to Article 11. The present research was performed in accordance with relevant guidelines and regulations the Declaration of Helsinki. The approval of the ethics committee from the Dentistry Faculty of the Antonio Nariño University was obtained. All participants signed an informed consent form agreeing to participate in the study.

A total of 187 dentists participated. According to the demographic characteristics, the gender presented a statistically significant difference since most participants were women (87.7%) and 12.3% were men. One in two of the participants was 30 years old and had a working time experience from 1 to 3 years (Table 1.).

Table 1

Dentist demographic characterisation and working time
Sex (n = 187)	Frequency (%)	χ²	p
Women	164 (87.7)	11.68	0.003
Men	23 (12.3)	11.68	0.003
	Me (Q1–Q3)*	KW⁺	p
Age (years)	25 (21–30)	2.152	0.341
	Me (Q1–Q3)*	KW⁺	p
working time (years)	2 (1–3)	3.235	0.198
*Me: Median, Q1: Quartile 1, Q3: Quartile 3
⁺ Kruskal–Wallis

The incidence of musculoskeletal symptomatology was 87.1% for the neck, with a length of less than a year (51.3%); however, none of the participants required to change workstations. The incidence of musculoskeletal symptoms was 71.0% for the back; 35.3% of the participants lasted less than a year with the discomfort and only 4.3% of them required changing the workstation. The level of action of the REBA method in the neck and back was 2 which corresponds to an average risk level (Table 2.).

Table 2

Distribution by musculoskeletal symptomatology and level of action of the REBA Method
		Neck (n = 187) (%)							Back (n = 187) (%)
		0*	1*	2*	3*	4*	χ²	p	0*	1*	2*	3*	4*	χ²	p
Musculoskeletal discomfort	Yes	0	0	96 (51,3%)	37 (19,8%)	30 (16,0%)	12,345	0,002	0	0	73 (39,0%)	30 (16,0%)	30 (16,0%)	5,005	0,082
Musculoskeletal discomfort	No	0	0	16 (8,6%)	0	8 (4,3%)	12,345	0,002	0	0	39 (20,9%)	7 (3,7%)	8 (4,3%)	5,005	0,082
Length of discomfort (years)	< 1	0	0	96 (51,3%)	37 (19,8%)	22 (11,8%)	41,38	0,000	0	0	66 (35,3%)	37 (19,8%)	30 (16,0%)	21,43	0,002
	> 1	0	0	0	0	8 (4,3%)			0	0	0	0	0
	No	0	0	16 (8,6%)	0	8 (4,3%)			0	0	46 (24,6%)	0	8 (4,3%)
Change of jobs	Yes	0	0	0	0	0	--	--	0	0	0	8 (4,3%)	0	27,44	0,000
Change of jobs	No	0	0	112 (59,8%)	37 (19,8%)	38 (20,4%)	--	--	0	0	112 (59,9%)	29 (15,5%)	38 (20,3%)	27,44	0,000
0: Not significant, 1. Low risk, 2. Medium risk, 3. High risk and *4. Very high risk.

In the last 12 months discomforts remain in neck region (12.9%) and in the back mainly with 43.3% of dentists, with a length of 1 to 7 days and with less than 1 hour episode. With respect to neck pain, 8.6% of the participants presented a discomfort length of 1 to 7 days and with less than 1-hour episodes. No participant reported any inconvenience prevented him or her from doing the job. In the last 7 days, the back was the most affected region with 35.8%. Participants rated the discomfort 3 for the back (41.3%) and neck (17.2%) as it is presented in Table 3.

Table 3

Distribution by musculoskeletal symptomatology in the last 12 months and level of REBA performance.
		Neck (n = 187) (%)							Back (n = 187) (%)
		0*	1*	2*	3*	4*	χ²	p	0*	1*	2*	3*	4*	χ²	p
Discomfort in the last 12 months	Yes	0	0	16 (8,6%)	8 (4,3%)	0	12,345	0,002	0	0	51 (27,3%)	15 (8,0%)	15 (8,0%)	0,571	0,752
Discomfort in the last 12 months	No	0	0	96 (51,3%)	29 (15,5%)	38 (20,3%)	12,345	0,002	0	0	61 (32,6%)	22 (11,8%)	23 (12,3%)	0,571	0,752
Length of time with discomfort in the last 12 months	1–7 days	0	0	0	0	16 (8,6%)	41,38	0,000	0	0	58 (31,0%)	13 (7,0%)	10 (5,3%)	36,53	0,000
	8–30 days	0	0	0	8 (4,3%)	0			0	0	0	0	0
	> 30 days	0	0	0	0	0			0	0	0	0	0
	No	0	0	112 (59,9%)	29 (15,5%)	22 (11,8%)			0	0	54 (28,9%)	24 (12,8%)	28 (15,0%)
Lenght of each episode	< 1 hour	0	0	0	0	16 (8,6%)	71,93	0,000	0	0	58 (31,0%)	16 (8,6%)	7 (3,7%)	21,48	0,000
	1–24 hour	0	0	8 (4,3%)	0	0			0	0	0	0	0
	1–7 days	0	0	0	0	0			0	0	0	0	0
	No	0	0	104 (55,6%)	37 (19,8%)	22 (11,8%)			0	0	54 (28,9%)	21 (11,2%)	31 (16,6%)
How long has this discomfort prevented you from doing your job?	0 days	0	0	16 (8,6%)	0	8 (4,3%)	12,345	0,002	0	0	38 (20,3%)	21 (11,2%)	22 (11,8%)	21,48	0,000
	1–7 days	0	0	0	0	0			0	0	0	0	0
	1–4 weeks	0	0	0	0	0			0	0	0	0	0
	No	0	0	96 (51,3%)	37 (19,8%)	30 (16,0%)			0	0	74 (39,6%)	16 (8,6%)	16 (8,6%)
Discomfort in the last 7 days	Yes	0	0	8 (4,3%)	0	0	8,44	0,015	0	0	44 (23,5%)	8 (4,3%)	15 (8,0%)	4,3	0,110
Discomfort in the last 7 days	No	0	0	104 (55,6%)	37 (19,8%)	38 (20,3%)	8,44	0,015	0	0	68 (36,4%)	29 (15,5%)	23 (12,3%)	4,3	0,110
Rate your discomfort between 0 (no discomfort) and 5 (very strong).	2	0	0	0	0	0	8,44	0,015	0	0	29 (15,5%)	7 (3,7%)	7 (3,7%)	43,7	0,000
	3	0	0	16 (8,6%)	0	16 (8,6%)			0	0	39 (20,9%)	22 (11,8%)	16 (8,6%)
	4	0	0	0	0	0			0	0	0	0	0
	5	0	0	0	0	0			0	0	0	0	0
	No	0	0	88 (47,1%)	37 (19,8%)	22 (11,8%)			0	0	68 (36,4%)	29 (15,5%)	23 (12,3%)
0: Not significant, 1. Low risk, 2. Medium risk, 3. High risk and *4. Very high risk.

According to the participants who reported musculoskeletal discomfort, it was possible to identity that the cause of the greatest proportion was extended time at the workstation with 40.5% for dentists with neck discomfort and 30,7% for those who indicated discomfort in the back (Table 4.) In line with the characterization of the level of action of the REBA method, 59.8% of the sample population presented an average postural risk (2) which indicates: action is necessary, so they could require changes in the task and 20,4% require urgent changes (Table 5.).

Table 4

Distribution by possible causes of musculoskeletal symptomatology and level of action of the REBA Method
Cause of these discomforts	Neck (n = 163) (%)							Back (n = 133) (%)
Cause of these discomforts	0*	1*	2*	3*	4*	χ²	p	0*	1*	2*	3*	4*	χ²	p
Bad posture	0	0	15 (9,2%)	15 (9,2%)	0	48,41	0,000	0	0	15 (9,2%)	15 (9,2%)	8 (4,9%)	36,90	0,000
Chair position	0	0	14 (8,6%)	15 (9,2%)	8 (4,9%)			0	0	14 (8,6%)	15 (9,2%)	8 (4,9%)
Overexertion	0	0	0	0	0			0	0	8 (4,9%)	0	0
Long working hours at the workstation	0	0	52 (31,9%)	0	14 (8,6%)			0	0	36 (22,1%)	0	14 (8,6%)
None	0	0	15 (9,2%)	7 (4,3%)	8 (4,9%)			0	0	0	0	0
0: Not significant, 1. Low risk, 2. Medium risk, 3. High risk and *4. Very high risk.

Table 5

Characterisation of the performance level of the REBA method
Level of performance – REBA Method (n = 187)	Frecuency (%)
0. Invaluable: no action needed	0
1. Low risk: action may be required	0
2. Medium risk: action is needed	112 (59,8%)
3. High risk: action is needed as soon as possible	37 (19,8%)
4. Very high risk: immediate action is needed	38 (20,4%)

Table 6

Ordinal logistic regression of the predictor variables of musculoskeletal symptomatology and level of performance of the REBA Method.
Musculoskeletal Simptomatology	OR adjusted	p	IC 95%
1 to 7 days time with back discomfort during last 12 months	2,1	0,000	1,2–3,9
Length of each episode (greater than 1 hour)	2,0	0,000	1,1–3,1
Extended time on the workstatin	1,3	0,03	1,1–2,9

In the ordinal logistic regression analysis (Table 6.) we found more probability of a higher postural risk level of the REBA method when the following musculoskeletal symptomatology variables are present: back discomfort from 1–7 days in the last 12 months (OR–2.1 [95% CI 1.2–3.9] p–0.000), episodes greater than an hour (OR–2.0 [95% CI 1.1–3.1] p–0.000) and extended working times (OR–1.3 [95% CI 1.1–2.9] p–0.03). The other variables lost significance when they were integrated into the ordinal multivariate model (data not shown).

Work-related musculoskeletal disorders are a major problem in people’s health and are estimated to be the second most frequent cause of lost-year injuries (19, 20). Dentistry is a profession that requires a good ability to maintain occupational postures for extended periods of time (21, 22). The aim of the study was to determine the relationship between musculoskeletal symptomatology and the level of postural risk experienced by dentists during their everyday activities, using validated instruments such as the Nordic kuorinka questionnaire and the REBA method. A high incidence was obtained in the musculoskeletal symptoms record of the neck and back.

The results show 87.1% incidence of neck musculoskeletal symptomatology; this finding was the highest according to the dentists surveyed, in comparison to Aghahi et. al. studies in Iran (23) (24), or the research developed by the University of Missouri-Kansas School of Dentistry, whose incidence was 54% and 68,5% (24). By the same line, Yamalik et. al. for example, reports that approximately two-thirds of dentists have neck pain (25) whereas Felemban et. al. reports 69,2% and Al-Mohrej et. al. 68% (26). In addition, a 71,1% musculoskeletal symptomatology was identified in the back. Similarly, 39.8% was reported by Yizengaw et. al among health professionals (19), 64% in Australia (27), 39% was reported by Kapitan et al. (28), 81% for men and 88% for women in Medellín, Colombia (13), and 79% in the United States (24).

Participating dentists most frequently indicated that they were affected for the last 12 moths to come by back (43.3%) and neck (12.9%) musculoskeletal discomfort during their activity’s performance. This result is comparable to Åkesson et al. (29), in the incidence study and predictors of musculoskeletal discomfort in Saudi Arabia (5). This is also manifested in the systematic review by Pierre Côté et al. (30) and Haye et al. (31), in which around 50% of dentists’ working time is reported to be in back and neck flexion; this is a considerable complex, multifactorial and worrying concern due to the impact it has on the professional practice (31).

According to the distribution by possible cause of these discomforts, 40.5% of the participants, who presented neck ache and 30.7% of those who presented backache indicate that it is due to extended times at the workstation, which lead to bad postures and in many of these cases these injuries are also related to theories already pointed out. For example, Kumar et al. describes how the interruption of the mechanical order of the biological system depends on the individual components, incidentally affected by genetic endowment, morphological characteristics, each person’s psychosocial composition and occupational risks (32, 33). The biomechanics of postures during sitting work (34) and repeated unidirectional torsion of the trunk produces pain along with other types of repetitive movements, the use of instruments (5, 35), static postures, physical stressors, tasks and work environments (31, 36), generating traumas that negatively affect work and related activities of daily life. These risks should be addressed to reduce symptomatology and musculoskeletal discomfort (37). Studies have shown that physical exercise decreases the prevalence of musculoskeletal pain (10, 28). Additionally, lumbar spine stabilization exercises and walking relieve pain, prevent chronic ailments and improve muscle endurance (38).

The REBA method score in dentists indicates an average postural suggesting that action is necessary and task changes may be required with an incidence of 59,8%, comparable data with a study by Vidya Raman et al. in which 64% of the population presented an average risk (39). Furthermore, a statistically significant relationship was also found between extended time at the workstation and the level of REBA method scores. This was consistent with a study developed by Kim et al. (40), who also shows that these risks cause musculoskeletal discomfort, which must be monitored with education, exercise, improving work environments, equipment and devices used in the development of the work activity.

The present study reflects a record with a high incidence of musculoskeletal symptoms of neck and back; therefore, the implementation of contingency plans is recommended to generate postural awareness, sessions on postural hygiene, workstation positioning strategies, and stress management techniques for participants. Likewise, the promotion of individual studies is also recommended, whose focus should be addressed to evaluate preventive behavioural interventions such as training and education, ergonomic interventions and exercise programs (41). However, more studies on the assessment of possible ergonomic interventions in dentists are needed (42).

This study has certain limitations including the possibility of bias information since respondents may not be aware of the length they have been or have suffered the discomfort in the last 12 months, so the incidence is given by the record of musculoskeletal symptomatology. At the time of the evaluation, the type of dental treatment or specialty was not differentiated, which may contribute to the presence of more symptomatology given the type of instruments used in each procedure. Moreover, in terms of sex, the sample of respondents may not be considered representative as there were more women than men; however, the results are deemed relevant since it is a multicenter study and one of the first studies in the regions involved. Some of the main strengths is the use of Nordic kuorinka questionnaire, which shows good psychometric properties (43), and was applied by researchers, which allow to obtain a high response rate. Additionally, implementing the REBA method allows to use recordings, its analysis through software to measure angles, evaluate in real time to demonstrate that one of the most vulnerable anatomical areas in dental professionals are the neck and back (14).

The study demonstrated a high and worrying incidence of musculoskeletal symptoms in neck and back and a medium postural risk, which suggest that dentists may require changes in the task performance. Results also show a statistically significant relationship with extended time on the workstation among the surveyed dentists. Studies have illustrated that physical exercise, education, ergonomic intervention plans, spinal stabilization exercises and walking relieve pain and prevent musculoskeletal symptoms.

Ethics approval and consent to participate

The present research was performed in accordance with relevant guidelines and regulations the Declaration of Helsinki. Approval was obtained from the ethics committee (No. 2020-2) of the Faculty of Dentistry of the Antonio Nariño University. All participants signed an informed consent form agreeing to participate in the study.

Consent for publication

Not applicable in this section.

Availability of data and materials

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. All data generated or analysed during this study are included in this published article.

Competing interests

The authors declare that they have no competing interests.

Funding

Not applicable in this section.

Authors contributions

C.G., A.R., and A.P. wrote the main manuscript text

W.L., D.R. and C.O. prepared in statistical analysis

All authors reviewed the manuscript

Acknowledgements

Not applicable in this section.

Gupta D, Batra R, Mahajan S, Bhaskar DJ, Jain A, Shiju M, et al. Comparative Evaluation of the Complementary and Alternative Medicine Therapy and Conventional Therapy Use for Musculoskeletal Disorders Management and Its Association with Job Satisfaction among Dentists of West India. J Traditional Complement Med. 2014;4(4):263–7. doi:10.4103/2225-4110.126632.
Cogollo MZ, dlRB, Espinosa FJ, et al. Prevalencia de molestias músculo-esqueléticas en odontólogos de odontoclínicas universitarias de Cartagena de Indias (Colombia). Revista Cubana de Salud y Trabajo. 2019;20(1):30–7.
Armijo-Olivo S, Woodhouse LJ, Steenstra IA, Gross DP. Predictive value of the DASH tool for predicting return to work of injured workers with musculoskeletal disorders of the upper extremity. Occup Environ Med. 2016;73(12):807–15. doi:10.1136/oemed-2016-103791.
Felemban RA, Sofi RA, Alhebshi SA, Alharbi SG, Farsi NJ, Abduljabbar FH, et al. Prevalence and Predictors of Musculoskeletal Pain Among Undergraduate Students at a Dental School in Saudi Arabia. Clin Cosmet Investig Dent. 2021;13:39–46. doi:10.2147/CCIDE.S292970.
Dable RA, Wasnik PB, Yeshwante BJ, Musani SI, Patil AK, Nagmode SN. Postural Assessment of Students Evaluating the Need of Ergonomic Seat and Magnification in Dentistry. J Indian Prosthodont Soc. 2014;14(Suppl 1):51–8. doi:10.1007/s13191-014-0364-0.
Graham C. Ergonomics in dentistry, Part 1, editors. Dent Today. 2002. p. 98–103.
Kanteshwari K, Sridhar R, Fau - Mishra AK, Mishra Ak Fau - Shirahatti R, Shirahatti R, Fau - Maru R, Maru R, Fau - Bhusari P, Bhusari P. Correlation of awareness and practice of working postures with prevalence of musculoskeletal disorders among dental professionals. Gen Dent. 2011;59(6):476–83.
Phedy P, Gatam L. Prevalence and Associated Factors of Musculoskeletal Disorders among Young Dentists in Indonesia. Malays Orthop J. 2016;10(2):1–5. doi:10.5704/MOJ.1607.001.
Grubišić F. Are ergonomic interventions effective for preventing musculoskeletal disorders in dental care practitioners? - A Cochrane Review summary with commentary. Musculoskelet Sci Pract. 2019;44:102061. doi:10.1016/j.msksp.2019.102061.
Hodacova L, Sustova Z, Cermakova E, Kapitan M, Smejkalova J. Self-reported risk factors related to the most frequent musculoskeletal complaints among Czech dentists. Ind Health. 2015;53(1):48–55. doi:10.2486/indhealth.2013-0141.
Limaye V, Limaye D, Desai R, Sheth J, Prabhu S, Fortwengel G. Prevalence of musculoskeletal disorders among dentists from Mumbai, India. Curr Therapeutic Res. 2016;78:11. https://doi.org/10.1016/j.curtheres.2016.05.024.
Leggat PA, Kedjarune U, Fau - Smith DR, Smith DR. Occupational health problems in modern dentistry: a review. Ind Health. 2007;45(5):611–21. doi:10.2486/indhealth.45.611.
Aljanakh M, Shaikh S, Siddiqui AA, Al-Mansour M, Hassan SS. Prevalence of musculoskeletal disorders among dentists in the Hail Region of Saudi Arabia. Ann Saudi Med. 2015;35(6):456–61. doi:10.5144/0256-4947.2015.456.
Ramírez-Sepúlveda KA, Gómez-Arias MY, Agudelo-Suárez AA, Ramírez-Ossa DM. Musculoskeletal disorders and related factors in the Colombian orthodontists’ practice. Int J Occup Saf Ergon. 2022;28(1):672–81. doi:10.1080/10803548.2020.1857975.
Valverde J. Risk level of the work positions adopted by the students during their training in the dental clinic of the José Carlos Mariátegui Moquegua University. Summary of the "I International Conference on Science, Development and Innovation of the UJCM" Science and Technology for Development Magazine-UJCM. 2018;4:58–64.
Ministry of Health. Resolution 8430 of 1993. Scientific, technical and administrative standards for health research in Colombia. https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/DIJ/RESOLUCION-8430-DE-1993.PDF.
Yizengaw MA, Mustofa SY, Ashagrie HE, Zeleke TG. Prevalence and factors associated with work-related musculoskeletal disorder among health care providers working in the operation room. Annals of Medicine and Surgery. 2021;72:102989. https://doi.org/10.1016/j.amsu.2021.102989.
Boucaut R, Knobben L. Occupational health and safety incidents at a university school of nursing: A retrospective, descriptive appraisal. Nurse Educ Pract. 2020;44:102776. doi:10.1016/j.nepr.2020.102776.
Marx JL. Ergonomics. Back to the Future. Ophthalmology. 2012;119(2):211–2. doi:10.1016/j.ophtha.2011.09.001.
Marshall ED, Duncombe Lm Fau - Robinson RQ, Robinson Rq Fau - Kilbreath SL, Kilbreath SL. Musculoskeletal symptoms in New South Wales dentists. Aust Dent J. 1997;42(4):240–246. doi: 10.1111/j.1834-7819.1997.tb00128.x.
Musculoskeletal disorders in dental hygienists. Dent Abstracts. 2011;56(4):192–5. doi.org/10.1016/j.denabs.2011.03.017.
Yamalik N. Musculoskeletal disorders (MSDs) and dental practice Part 2. Risk factors for dentistry, magnitude of the problem, prevention, and dental ergonomics. Int Dent J. 2007;57(1):45–54. doi:10.1111/j.1875-595x.2007.tb00117.x.
Al-Mohrej OA, AlShaalan NS, Al-Bani WM, Masuadi EM, Almodaimegh HS. Prevalence of musculoskeletal pain of the neck, upper extremities and lower back among dental practitioners working in Riyadh, Saudi Arabia: a cross-sectional study. BMJ Open. 2016; 20;6(6):e011100. doi: 10.1136/bmjopen-2016-011100.
Åkesson I, Johnsson B, Rylander L, Moritz U, Skerfving S. Musculoskeletal disorders among female dental personnel – clinical examination and a 5-year follow-up study of symptoms. Int Arch Occup Environ Health. 1999;72(6):395–403. doi:10.1007/s004200050391.
Côté P, van der Velde G, Cassidy JD, Carroll LJ, Hogg-Johnson S, Holm LW, et al. The Burden and Determinants of Neck Pain in Workers: Results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. Spine (Phila Pa 1976). 2008;15(4Suppl):60–74. doi:10.1097/BRS.0b013e3181643ee4. 33 ) .
Hayes MJ, Smith DR, Cockrell D. An international review of musculoskeletal disorders in the dental hygiene profession. Int Dent J. 2010;60(5):343–52.
Keyserling WM. Workplace risk factors and occupational musculoskeletal disorders, Part 1: A review of biomechanical and psychophysical research on risk factors associated with low-back pain. AIHAJ. 2000;61(1):39–50.
LaPorta LD. Occupational Stress in Oral and Maxillofacial Surgeons: Tendencies, Traits, and Triggers. Oral and Maxillofacial Surgery Clinics of North America. Oral Maxillofac Surg Clin North Am. 2010;22(4):495–502. doi:10.1016/j.coms.2010.07.006.
Raman V, Ramlogan S, Sweet J, Sweet D. Application of the Rapid Entire Body Assessment (REBA) in assessing chairside ergonomic risk of dental students. Br Dent J. 2020; 14. doi:10.1038/s41415-020-1855-5.
Kim JA-O, Park BA-O, Mun SA-O, Shim JA-O, Choi EA-O, Noh HA-O. Differences in plantar pressure by REBA scores in dental hygienists. Int J Dent Hyg. 2019;17(2):177–82. doi:10.1111/idh.12375.
Pieper CA-O, Schröer S, Eilerts AL. Evidence of Workplace Interventions-A Systematic Review of Systematic Reviews. Int J Environ Res Public Health. 2019;23(19):3553. doi:10.3390/ijerph16193553. 16 ) .
Vijay S, Ide M. Musculoskeletal neck and back pain in undergraduate dental students at a UK dental school - a cross-sectional study. Br Dent J. 2016;221(5):241–5. doi:10.1038/sj.bdj.2016.642.
Wännström I, Peterson U, Fau - Asberg M, Asberg M, Fau - Nygren A, Nygren A, Fau - Gustavsson JP, Gustavsson JP. Psychometric properties of scales in the General Nordic Questionnaire for Psychological and Social Factors at Work (QPS): confirmatory factor analysis and prediction of certified long-term sickness absence. Scand J Psychol. 2009;50(3):231–44. doi:10.1111/j.1467-9450.2008.00697.x.
Hita-Gutiérrez M, Gómez-Galán M, Díaz-Pérez MA-O, Callejón-Ferre. Á JA-O. An Overview of REBA Method Applications in the World. Int J Environ Res Public Health. 2020;17(8):2635. doi:10.3390/ijerph17082635.

No competing interests reported.

Download PDF

Version 1

posted

You are reading this latest preprint version

Back and neck musculoskeletal symptoms associated with the level of postural risk experienced by dentists

Status:

Version 1

Abstract

Objective

Methodology

Result

Conclusion

Introduction

Methodology

Study Design

Participants

Instrument

Data Collection Procedure

Statistical analysis

Ethical Considerations

Result

Discussion

Conclusion

Declarations

References

Additional Declarations

Status:

Version 1