Ergonomic risk and preventive measures of musculoskeletal disorders in the dentistry environment: an umbrella review

Abstract

IntroductionDental practitioners are exposed to different occupational hazards during the course of their professional activity, such as physical, chemical, biological, ergonomic factors. The ergonomic hazards, caused by strained posture and prolonged repetitive movements, can induce musculoskeletal disorders. It occurs in 54–93% of dental professionals and involve the spine, shoulder and hand-wrist tract. Through a systematic review of international literature, we analyzed specific ergonomic risk factors and preventive measures of musculoskeletal disorders in professional dental activity.MethodsThis systematic review is coherent with the PRISMA statement. The scientific research on the major online databases was based on the following keywords: dentist, prevention, ergonomic, dentistry, musculoskeletal, neck pain, posture, ergonomics, work and occupational. The studies included in this review focus on disorders related to ergonomics and on the most effective preventive measures to be adopted. No restrictions were applied for language or publication type. We excluded reports not related to ergonomic prevention in dentistry, reports of minor academic significance, editorial articles, individual contributions, and studies published in scientific conferences.ResultsOnline research indicated 4188 references: PubMed (2919), Scopus (1257) e Cochrane Library (12). We excluded 3012 of these, because they were unrelated to ergonomics theme and 187 due to duplication. From the remaining 989 studies, 960 papers did not meet inclusion criteria and they were excluded. Therefore, we analyzed 29 articles, including 16 narrative reviews and 13 original article. The main risk factor for the development of musculoskeletal disorders found in our analysis is static posture adopted during work, highlighted in 87.5% of reviews and 84% of original articles. With regard to preventive measures, 75% of the reviews highlighted the importance of stretching after each working session and at the end of the working day, while 61.5% of the original articles emphasized the use of modern and ergonomic instruments.DiscussionThis review showed that static postures are strongly responsible in the etiology of musculoskeletal disorders. The awkward postures more frequently identified among dental professionals are: extreme forward-head and neck flexion; trunk inclination and rotation towards one side; lifting one or both shoulders; increased curvature of the thoracic vertebral column; incorrect positioning of the lower limbs with thigh-leg angle of less than 90°. It is really important to use of a modern workstation with appropriate ergonomic supports. Among the preventive ergonomic measures, literature has widely recognized the role of physical activity and of a neutral and balanced posture. The present review has some limits: a large part of the selected studies did not have a high methodological quality score and an inadequate statistical analysis.

Musculoskeletal disorders among dental hygienist and students of dental hygiene

“…Serval studies have discussed specific ergonomic risk factors and preventive measures in the dentistry field . However, among the students that participated in the present study only 14% reported that they received ergonomic education, and the numbers were higher among the experienced dental hygienists but were still relatively low (40%).…”

Work related muskuloskeletal disorders among dentists at the university dental clinic in Skopje

“…Muskuloskeletni poremećaji su jedno od najčešćih oboljenja koje nastaje kao posledica rada kod većine zdravstvenih radnika, a naročito stomatologa. Postoji više faktora koji dovode do muskuloskeletnih poremećaja kod stomatologa [4]: neprekidno kretanje, nedovoljno osvetljenja, nepravilno držanje tela tokom rada, psihološki stres, genetika, fizički uslovi, starost i težina [5,6].…”

“…Musculoskeletal disorders are one of the most common types of work-related diseases that affect health workers, especially dentists. There are multiple factors that contribute to development of musculoskeletal disorders among dentists [4]: continuous movements, insufficient lighting, improper body position during work, psychological stress, genetics, physical conditions, age and weight [5,6].…”

The correlation between low back pain and disability index with lumbar lordosis among dentists

“…Workrelated musculoskeletal disorders have been reported as the most important reason for early retirement among dentists, among which the lower back pain (LBP) is the most prevalent [2,3]. The main reason for undesirable and non-ergonomic positions among dentists is with the aim of achieving an ideal view of the patient's mouth and providing a comfortable position for the patient [1,4].…”