Background: Dentists are at a higher risk of suffering from musculoskeletal disorders (MSD) than the general population. However, the latest study investigating MSD in the dental profession in Germany was published about 20 years ago. Therefore, the aim of this study was to reveal the current prevalence of MSD in dentists and dental students in Germany. Methods: The final study size contained 450 (287 f/163 m) subjects of different areas of specialization. The age of the participants ranged from 23 to 75 years. The questionnaire consisted of a modified version of the Nordic Questionnaire, work-related questions from the latest questionnaire of German dentists, typical medical conditions and self-developed questions. Results: The overall prevalence showed that dentists suffered frequently from MSD (seven days: 65.6%, twelve months: 92%, lifetime: 95.8%). The most affected body regions included the neck (42.7%–70.9%–78.4%), shoulders (29.8%–55.6%–66.2%) and lower back (22.9%–45.8%–58.7%). Overall, female participants stated that they suffered from pain significantly more frequently, especially in the neck, shoulders and upper back. Conclusion: The prevalence of MSD among dentists, especially in the neck, shoulder and back area, was significantly higher than in the general population. In addition, women suffered more frequently from MSD than men in almost all body regions.

Traditional ergonomic risk assessment tools such as the Rapid Upper Limb Assessment (RULA) are often not sensitive enough to evaluate well-optimized work routines. An implementation of kinematic data captured by inertial sensors is applied to compare two work routines in dentistry. The surgical dental treatment was performed in two different conditions, which were recorded by means of inertial sensors (Xsens MVN Link). For this purpose, 15 (12 males/3 females) oral and maxillofacial surgeons took part in the study. Data were post processed with costume written MATLAB® routines, including a full implementation of RULA (slightly adjusted to dentistry). For an in-depth comparison, five newly introduced levels of complexity of the RULA analysis were applied, i.e., from lowest complexity to highest: (1) RULA score, (2) relative RULA score distribution, (3) RULA steps score, (4) relative RULA steps score occurrence, and (5) relative angle distribution. With increasing complexity, the number of variables times (the number of resolvable units per variable) increased. In our example, only significant differences between the treatment concepts were observed at levels that are more complex: the relative RULA step score occurrence and the relative angle distribution (level 4 + 5). With the presented approach, an objective and detailed ergonomic analysis is possible. The data-driven approach adds significant additional context to the RULA score evaluation. The presented method captures data, evaluates the full task cycle, and allows different levels of analysis. These points are a clear benefit to a standard, manual assessment of one main body position during a working task.

The occupation of dental assistants (DAs) involves many health risks of the musculoskeletal system due to static and prolonged work, which can lead to musculoskeletal disorders (MSDs). The aim of the study was to investigate the prevalence of MSDs in DAs in Germany. Methods: For this purpose, an online questionnaire analyzed 406 (401 female participants and 5 male participants, 401w/5m) DAs. It was based on the Nordic Questionnaire (lifetime, 12-month, and seven-day MSDs’ prevalence separated into neck, shoulder, elbow, wrist, upper back, lower back, hip, knee, and ankle), and occupational and sociodemographic questions as well as questions about specific medical conditions. Results: 98.5% of the participants reported complaints of at least one body region in their lives, 97.5% reported at least one complaint in the last 12 months and 86.9% affirmed at least one complaint in the last seven days. For lifetime, 12-month and seven-day prevalence, the neck was the region that was most affected followed by the shoulder, the upper back and the lower back. Conclusion: The prevalence of MSDs among German (female) DAs was very high. The most affected area is the neck, followed by the shoulder, the lower back, and the upper back. It, therefore, seems necessary to devote more attention to ergonomics at the working practice of DAs as well in education and in dental work.

Background Musculoskeletal disorders (MSD) are common among dental professionals. The most common areas affected are the trunk, neck, shoulders and wrists. Current evidence suggests that the causes of MSD can be found in the physical demands of the profession. Posture and movement during treatment is influenced by the arrangement of the treatment concept (patient chair, equipment and cabinets). It has not been investigated whether the ergonomic risk differs between the treatment concepts. Methods To evaluate the prevalence of MSD in dental professionals, 1000 responses will be collected from a nationwide (Germany) online questionnaire (mod. Nordic Questionnaire and mod. Meyer questionnaire). In order to assess the ergonomic risk of the treatment techniques used in the four treatment concepts, 3D movement analyses are carried out with inertial sensors. For this purpose, 20 teams of dentists and dental assistants from four dental fields of specializations (generalists, orthodontists, endodontists and oral surgeons) and a student control group will be recruited. Each team will execute field specific standardized treatments at a dummy head. Measurements are carried out in each of the four treatment concepts. The data will be analyzed using the Rapid Upper Limb Assessment (RULA) which will be modified for the evaluation of objective data. Conclusions On the basis of these investigations, a substantial gain of knowledge regarding work-related MSD in the field of dentistry and its potential biomechanical causes is possible. For the first time, objective and differentiated comparisons between the four treatment concepts are possible for different fields of dental specialization. Up to now, statically held positions of the trunk and proximal upper extremities, but also the repetitive movements of the hands have been considered a risk for MSD. Since both are included in the RULA, dental activities can be assessed in a detailed but also global manner with regard to ergonomic risks.

Musculoskeletal disorder (MSD) is already prevalent in dental students despite their young age and the short duration of dental practice. The current findings state that the causes of MSD are related to posture during dental work. This study aims to investigate the ergonomic risk of dental students. In order to analyze the ergonomic risk of dental students, 3D motion analyses were performed with inertial sensors during the performance of standardized dental activities. For this purpose, 15 dental students and 15 dental assistant trainees (all right-handed) were measured in a team. Data were analyzed using the Rapid Upper Limb Assessment (RULA), which was modified to evaluate objective data. Ergonomic risk was found for the following body parts in descending order: left wrist, right wrist, neck, trunk, left lower arm, right lower arm, right upper arm, left upper arm. All relevant body parts, taken together, exhibited a posture with the highest RULA score that could be achieved (median Final Overall = 7), with body parts in the very highest RULA score of 7 for almost 80% of the treatment time. Dental students work with poor posture over a long period of time, exposing them to high ergonomic risk. Therefore, it seems necessary that more attention should be paid to theoretical and practical ergonomics in dental school.

Possible biological side effects of exposure to X-rays are stochastic effects such as carcinogenesis and genetic alterations. In recent years, a number of new studies have been published about the special cancer risk that children may suffer from diagnostic X-rays. Children and adolescents who constitute many of the probands in forensic age-estimation proceedings are considerably more sensitive to the carcinogenic risks of ionizing radiation than adults. Established doses for X-ray examinations in forensic age estimations vary from less than 0.1 microSv (left hand X-ray) up to more than 800 microSv (computed tomography). Computed tomography in children, as a relatively high-dose procedure, is of particular interest because the doses involved are near to the lower limit of the doses observed and analyzed in A-bombing survivor studies. From these studies, direct epidemiological data exist concerning the lifetime cancer risk. Since there is no medical indication for forensic age examinations, it should be stressed that only safe methods are generally acceptable. This paper reviews current knowledge on cancer risks associated with diagnostic radiation and aims to help forensic experts, dentists, and pediatricians evaluate the risk from radiation when using X-rays in age-estimation procedures.

Background: In general, the prevalence of work-related musculoskeletal disorders (WMSD) in dentistry is high, and dental assistants (DA) are even more affected than dentists (D). Furthermore, differentiations between the fields of dental specialization (e.g., general dentistry, endodontology, oral and maxillofacial surgery, or orthodontics) are rare. Therefore, this study aims to investigate the ergonomic risk of the aforementioned four fields of dental specialization for D and DA on the one hand, and to compare the ergonomic risk of D and DA within each individual field of dental specialization. Methods: In total, 60 dentists (33 male/27 female) and 60 dental assistants (11 male/49 female) volunteered in this study. The sample was composed of 15 dentists and 15 dental assistants from each of the dental field, in order to represent the fields of dental specialization. In a laboratory setting, all tasks were recorded using an inertial motion capture system. The kinematic data were applied to an automated version of the Rapid Upper Limb Assessment (RULA). Results: The results revealed significantly reduced ergonomic risks in endodontology and orthodontics compared to oral and maxillofacial surgery and general dentistry in DAs, while orthodontics showed a significantly reduced ergonomic risk compared to general dentistry in Ds. Further differences between the fields of dental specialization were found in the right wrist, right lower arm, and left lower arm in DAs and in the neck, right wrist, right lower arm, and left wrist in Ds. The differences between Ds and DAs within a specialist discipline were rather small. Discussion: Independent of whether one works as a D or DA, the percentage of time spent working in higher risk scores is reduced in endodontologists, and especially in orthodontics, compared to general dentists or oral and maxillofacial surgeons. In order to counteract the development of WMSD, early intervention should be made. Consequently, ergonomic training or strength training is recommended.

When the inventory is arranged in a dental practice, a distinction can be made between four different dental workplace concepts (DWCs). Since the prevalence of musculoskeletal diseases in dental professionals is very high, preventive solution need to be investigated. As the conventionally used DWCs have, to date, never been studied in terms of their ergonomics, this study aims to investigate the ergonomic risk when working at the four different DWCs. In total, 75 dentists (37 m/38 f) and 75 dental assistants (16 m/59 f) volunteered to take part in this study. Standardized cooperative working procedures were carried out in a laboratory setting and kinematic data were recorded using an inertial motion capture system. The data were applied to an automated version of the Rapid Upper Limb Assessment (RULA). Comparisons between the DWCs and between the dentists and dental assistants were calculated. In all four DWCs, both dentists and dental assistants spent 95–97% of their working time in the worst possible RULA score. In the trunk, DWCs 1 and 2 were slightly favorable for both dentists and dental assistants, while for the neck, DWC 4 showed a lower risk score for dentists. The ergonomic risk was extremely high in all four DWCs, while only slight advantages for distinct body parts were found. The working posture seemed to be determined by the task itself rather than by the different inventory arrangements.