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

Abstract

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.

Intervenciones ergonómicas y su impacto en la profesión odontológica

“…Un estudio clínico aleatorizado reciente que incluyó sesenta odontólogos y que analizó un progra-ma de intervención ergonómica (PIE) con instrucciones y entrenamiento ergonómico, constató un 63% de reducción en la prevalencia de posturas nocivas en el grupo experimental (p<0.001) (31).…”

Ergonomics problems in dental profession-dentists working position

“…The subject of ergonomics is the human-machine system, and adaptation to human biopsychosocial capabilities, in order to make work and the work process more efficient, safer and more productive 5 . The goal and contribution of ergonomics as a science is to improve work performance, to reduce injuries and illnesses related to work through the modification of work space and instruments as well as through the reduction of incorrect position and movement 6 . Harmful factors in the dental profession are classified as physical, biological, chemical, organizational and psychosocial.…”

Back pain prevention program: An evaluation after a 10‐year implementation amongst dental students

“…These findings lead the dental education community to affirm that there is a need to determine effective interventions and to restructure educational program in order to reduce back pain prevalence and its intensity 3,4,12,18 . Knowing that regular physical activity is correlated with positive back health, 19 some dental education teams have worked to integrate chair‐side stretching or physical fitness course in the dental curriculum 7,12,20 …”

“…3,4,12,18 Knowing that regular physical activity is correlated with positive back health, 19 some dental education teams have worked to integrate chair-side stretching or physical fitness course in the dental curriculum. 7,12,20 Aware of this back pain problem amongst dentists and dental stu- It is an opportunity to recall all the notions of prevention of back pain, as well as to discuss further on the spatial organisation of a dental practice. At this point, a summary is given to the students, which presents common exercises that can easily be practiced in the dental setting between each care session with a patient, and without a particular equipment.…”

“…3,4,12,18 Knowing that regular physical activity is correlated with positive back health, 19 some dental education teams have worked to integrate chair-side stretching or physical fitness course in the dental curriculum. 7,12,20 Aware of this back pain problem amongst dentists and dental stu- year. It is an opportunity to recall all the notions of prevention of back pain, as well as to discuss further on the spatial organisation of a dental practice.…”