Ergonomic interventions for preventing musculoskeletal disorders in dental care practitioners

Abstract

Trusted evidence. Informed decisions. Better health. Cochrane Database of Systematic Reviews Main results We included two RCTs (212 participants), one of which was a cluster-randomised trial. Adjusting for the design e ect from clustering, reduced the total sample size to 210. Both studies were carried out in dental clinics and assessed ergonomic interventions in the physical domain, one by evaluating a multi-faceted ergonomic intervention, which consisted of imparting knowledge and training about ergonomics, work station modification, training and surveying ergonomics at the work station, and a regular exercise program; the other by studying the e ectiveness of two di erent types of instrument used for scaling in preventing WMSDs. We were unable to combine the results from the two studies because of the diversity of interventions and outcomes. Physical ergonomic interventions. Based on one study, there is very low-quality evidence that a multi-faceted intervention has no clear e ect on dentists' risk of WMSD in the thighs (RR 0.57, 95% CI 0.23 to 1.42; 102 participants), or feet (RR 0.64, 95% CI 0.29 to 1.41; 102 participants) when compared to no intervention over a six-month period. Based on one study, there is low-quality evidence of no clear di erence in elbow pain (MD −0.14, 95% CI −0.39 to 0.11; 110 participants), or shoulder pain (MD −0.32, 95% CI −0.75 to 0.11; 110 participants) in participants who used light weight curettes with wider handles or heavier curettes with narrow handles for scaling over a 16-week period. Cognitive ergonomic interventions. We found no studies evaluating the e ectiveness of cognitive ergonomic interventions. Organisational ergonomic interventions. We found no studies evaluating the e ectiveness of organisational ergonomic interventions. Authors' conclusions There is very low-quality evidence from one study showing that a multi-faceted intervention has no clear e ect on dentists' risk of WMSD in the thighs or feet when compared to no intervention over a six-month period. This was a poorly conducted study with several shortcomings and errors in statistical analysis of data. There is low-quality evidence from one study showing no clear di erence in elbow pain or shoulder pain in participants using light weight, wider handled curettes or heavier and narrow handled curettes for scaling over a 16-week period. We did not find any studies evaluating the e ectiveness of cognitive ergonomic interventions or organisational ergonomic interventions. Our ability to draw definitive conclusions is restricted by the paucity of suitable studies available to us, and the high risk of bias of the studies that are available. This review highlights the need for well-designed, conducted, and reported RCTs, with long-term follow-up that assess prevention strategies for WMSDs among dental care practitioners.

Systematic Reviews and Meta-analysis in Evidence-based Orthodontics: An Appraisal and Methodology

“…cost of intervention, quality of life, perception) within the review. An illustration of how this is written in the protocol is provided in Table 2, [21] which has been adapted from our Cochrane protocol -"Ergonomic interventions for preventing musculoskeletal disorders in dental care practitioners." [21] Searching for studies After detailing which studies will be included, the protocol has to state how the authors are going to search for them.…”

“…A short version of the sample search strategy for Medline for the protocol on ergonomic interventions is shown in Table 3. [21] Selection of studies to be included in the review Studies retrieved by the search results have to be assessed for their eligibility to be included in the review. The protocol should outline how these decisions will be made by clearly stating the inclusion and exclusion criteria (based on PICO), number of researchers who will screen titles and abstracts and then full papers, and the method for resolving disagreements about study eligibility.…”

“…It could lead to underestimation or overestimation of the true intervention effect and may be due to poor study design or conduct in the collection, analysis, interpretation, publication or review of data. Adapted from the protocol by Mulimani et al [21] (adapted with permission). RCT: Randomized controlled trial Various tools and methods are available to assess quality and risk of bias and which exactly will be used for the particular review has to be highlighted.…”

Relationships between the postures of dentists and chairside dental assistants

“…Due to the postural demands and manipulative precision required of dental professionals, oral healthcare professionals are at higher risk for developing work-related musculoskeletal disorders (WMSDs). [1][2][3][4][5][6][7][8] Musculoskeletal disorders may occur in the back, hips, wrists, shoulders, head, or neck area. 1,2,[5][6][7][8] Dental professionals have been encouraged to maintain their neutral postures throughout their workday in order to maintain a healthy musculoskeletal system.…”

“…[1][2][3][4][5][6][7][8] Musculoskeletal disorders may occur in the back, hips, wrists, shoulders, head, or neck area. 1,2,[5][6][7][8] Dental professionals have been encouraged to maintain their neutral postures throughout their workday in order to maintain a healthy musculoskeletal system. 4,9,10 However, with 4-handed dentistry, maintaining neutral postures becomes more challenging when the dentist and a dental assistant work concurrently alongside the patient to complete dental procedures.…”