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Indian Journal of Contemporary Dentistry, January-June 2014, Vol. 2, No. 1 81
ABSTRACT
Musculoskeletal disorders are one of the major problems affecting health care professionals and IT
professionals. 20-30% of the world population is affected by work related musculoskeletal disorder
at any given time. This review gives a detailed discussion regarding musculoskeletal disorders among
healthcare professionals especially dentists. Research studies and literature reviews that report
musculoskeletal disorders in dental professionals have been reviewed. Most developed countries
report a prevalence of musculoskeletal disorders of more than 50% which is still lesser compared to
that in developing countries probably due to better ergonomic factor and less number of working
hours in developed countries. Dentists usually report with neck, shoulder, back pain. Endodontists
and Orthodontists are most commonly affected whereas Oral pathologists and Oral medicine
specialists are least commonly affected. Musculoskeletal disorders can be prevented by adopting
preventive measures and by knowing the ill effects of incorrect positioning and ergonomics. At present
scenario, there is a need for more research work and awareness among dentists regarding
musculoskeletal disorders and better ergonomics. Emphasis must be given on its prevention rather
than its cure.
Study by Kwai Yee Chew et al in a dental school in hygienists showed that 75.2% of general dental
Malaysia, showed that 93% of the clinical year students practitioners and 40.5% of dental specialists suffered
reported with work related musculoskeletal disorders. from musculoskeletal disorders. 70.2% of dental
Among the 93%, higher number of females reported specialists were orthodontists. Their mean age was 30-
with pain. The neck and lower back pain were more 39yrs. Excessive hand scaling and removal of heavy
frequently reported with prevalence rate of 82% and calculus was associated with hand and shoulder
64% respectively. Majority of them (92%) did not symptoms19.
participate in workshops related to ergonomics in
dentistry and around 77% of them did not know about Karmen et al in his study showed that 79.8%
the treatment for work related musculoskeletal dentists in Barcelona (Spain) experienced
disorders13. musculoskeletal disorders. Women were more severely
affected. Only 34% took preventive measures20.
Dajpratham et al conducted a study on the
prevalence and associated factors of musculoskeletal Study in Colombia, South America showed that
pain among the dental personnel in a dental school in 63% of female dentists were affected and 37% males
Bangkok and concluded that cervicobrachial type of were affected. 80% of them were in clinical practice.
musculoskeletal pain was most common among dental 89% of them varied the working posture, 67%
personnel in Bangkok with the mean age of 33+/- 9 frequently changed positions, 13% did stretching
years old. The results were as follows: shoulder pain exercise. 15% reported with neck pain, 13% cervical
72.2%, neck pain 70.3%, lower back pain 50.6%14. dorsal pain, 6% arm and forearm pain21.
A study by Abiodun solanke et al in Nigeria Dayakar et al showed that 93.87% of the dentists
showed that in males the prevalence of neck pain was reported with atleast one symptom of musculoskeletal
83.2% and back pain was 86.9%. In females the disorders. Limitations to work were caused by 45.83%
prevalence of neck Pain was 80.6% and back pain was of males. The prevalence of back pain was 67.34%, neck
89.3%. Working hours of females were more affected (59.81%), hand (34.69%), shoulder (32.65%), wrist
than that of males due to musculoskeletal disorders15. (30.61%), hip/thigh (20.40%), ankle (18.36%) and knee
(16.32%) 3.
A study conducted on the prevalence of
musculoskeletal disorders in dentists in Greece The prevalence of musculoskeletal disorders
showed that lower back pain was most frequently among dentists in Denmark is (50%)3, United States is
reported (46%). Complaints of neck and shoulder pain (53%)3, Saudi Arabia is (59.2%)2, Australia (87.2%)2,
were less prevalent than back pain. The dentists had Lithuania (86.5%)2,8 and Turkey (94%)2 .
worked for 18.5 years approximately. Age was not a
factor and females were more affected as they CONCLUSION
commonly took leave from work16.
Musculoskeletal disorders are one of the major
Rundcrantz BL, in his study, pain and discomfort problems affecting health care professionals. 20-30%
in the musculoskeletal system among dentists showed of the world population is affected by work related
that female dentists were more commonly affected musculoskeletal disorders 1 and the prevalence of
than male dentists. Only 17% of dentists reported with musculoskeletal pain ranges from 64% - 93% in
no pain or discomfort17. general4,22,23. Musculoskeletal disorders are the most
common reason for early retirement age (29.3%) of
A five year follow up study on musculoskeletal dentists throughout the world24. The prevalence of
disorders among female dental personnel showed that shoulder pain is 20.1%-72.2%, neck pain 15%-85%,
dentists commonly reported with shoulder, wrist and upper back pain 18.65%-46.5%, lower back pain 35.1%-
hip pain. People who left the profession showed 91%, wrist and arm pain 6%-73.13%, hip discomfort
higher prevalence of combined symptoms from several 20.40%- 29.84% and ankle and feet pain is 12-15%
body regions. Those who remained in the profession approximately from the above reviewed articles.
had increased risk of developing symptoms in
shoulders and hands18. Endodontists and Orthodontists are most
commonly affected whereas Oral pathologists and Oral
Review by S J Booyens et al on the musculoskeletal medicine specialists are least commonly affected7. It
disorders among practicing South African oral can affect the performance of work. In dentistry
musculoskeletal problems arise due to incorrect lacking. Dentists must be educated about the
standing or sitting posture or due to standing in the importance of ergonomics, correct posture, prevention
same posture for long time. The victims to and treatment of musculoskeletal pain. “Prevention is
musculoskeletal disorders were predominantly always better than cure”.
females. Majority of the dentists who suffered from
musculoskeletal disorders didn’t have an assistant and ACKNOWLEDGEMENTS
worked without any break12. Most disorders were
reported after 10 years of practice. The number of We would like to thank Dr. N.M. Veeraiyan,
hours spent on work is directly proportional to the Cancellor, Saveetha Dental College and Hospitals and
severity of musculoskeletal pain23. Diabetes mellitus, Dr. Deepak Nallaswamy, Director of Academics,
rheumatoid arthritis, recent pregnancy, hormonal and Saveetha Dental College and hospitals for their
anti-inflammatory medications can contribute to early encouragement and support in completion of this
development of musculoskeletal disorders19. The use article.
of hand piece and vibratory instruments with pinch
Conflict of Interest: There is no conflict of interest as
grip, force, number of patients treated per day, number
this is a review article.
of years of experience, monotonous work, visual
fixation, posture, psychological stress, ergonomic Source of Funding: There is no source of funding as
factors, presence or absence of assistants are this is a review article.
predisposing factors to musculoskeletal disorders19.
Necks flexed to 60 degrees or more, trunk flexed to 30 Ethical Clearance: Ethical clearance is not required as
degrees or more and one shoulder abducted caused a this is a review article.
mechanical disadvantage of muscles with respect to
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