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ORIGINAL ARTICLE
1 (
2
); 26-30
doi:
10.25259/DJIGIMS_20220102_26

IMPROPER POSITION A PERPLEXING PROBLEM - A QUESTIONNAIRE STUDY.

Dept. of Oral Medicine & Radiology, People's College of Dental Sciences and Research Centre, Bhopal, India
Dept. of Oral Medicine & Radiology, PCDSRC, Bhopal, India
Dept. of Public Health Dentistry, PCDSRC, Bhopal, India
Dept. of OMR, IGIMS, Patna, India
Dept of Prosthodontics, R.K.D.F Dental College and Research Centre, Bhopal, India
Corresponding Author : Dr. Palak Choudhary
Licence
This open access article is licensed under Creative Commons Attribution 4.0 International (CC BY 4.0). http://creativecommons.org/licenses/by/4.0
Disclaimer:
This article was originally published by Indira Gandhi Institute of Medical Science and was migrated to Scientific Scholar after the change of Publisher.

Abstract

Background:

Dentists have a high prevalence of work-related musculoskeletal issues, and the incidence of numerous illnesses has increased dramatically over the last two decades. In dentistry, the overall frequency of musculoskeletal problems ranges from 63 to 93 percent. Various researches have been conducted to document stress levels and health-related behaviors of dentists in other countries, but data on this topic is scarce in our country.

Methods:

This survey was conducted among 154 dentists from various specialties of dentistry who had at least one musculoskeletal issue in the previous 12 months. Demographic data, work history, risk factors, and ergonomic awareness with job task specifics were all collected using a standardized questionnaire. MS Excel was used to enter data, while SPSS version 18 was used to analyze it.

Results:

More than 63 % and 47 % of the participants reported pain and discomfort in at least one body region in the last 12 months and the last 7 days respectively. The major affected part was neck, followed by lower back, shoulders and hands / wrists.

Conclusion:

This survey found that there is a high prevalence of MSDs and WMSDs among dentists. Hence, Ergonomic awareness, health promotion, medical treatment and physiotherapy exercise need to be integrated with the professional practice for dentists.

Keywords

Ergonomics
dentists
musculoskeletal pain
physical activity
work place.

INTRODUCTION:

"Health" is defined by the World Health Organization as "a condition of complete physical, mental, and social well-being, not only the absence of sickness or infirmity." When employment is linked to health risks, it can lead to occupational sickness, which can influence not only one's physical, psychological, and social well-being, but also one's job capacity, resulting in absences and early retirement1. Dentists are responsible for the diagnosis, prevention, and management of oral problems, thus the profession is not without risks. Dentists are predisposed to a variety of occupational hazards due to the nature of their clinical work2.

Infections such as HIV and viral hepatitis; percutaneous exposure accidents, dental materials, radiation, and noise; musculoskeletal diseases; psychological issues and dermatitis; respiratory illnesses; and eye injuries are just a few examples. Musculoskeletal disorders (MSDs) have been the most commonly documented among these3.

WRMSDs (work-related musculoskeletal diseases) are a sequence of micro traumatic events that collect in the body as a result of workplace and employment characteristics, with the potential to evolve into a more significant musculoskeletal injury in the future3. MSDs, or musculoskeletal disorders, are described by the Centers for Disease Control and Prevention (CDC) as injuries and disorders of the soft tissues (muscles, tendons, ligaments, joints, and cartilage) and neurological system4.

Because to risk factors such as physical conditions of the environment, psychological factors, faulty equipment design with unsuitable anthropometric requirements, and unavoidance of hazardous postures, dentists are the recruits most prone to MSDs4. The primary goal for clinicians is to achieve maximum comfort at work by following ergonomic principles. Ergonomics, or "human factors,” is a "science of work" derived from the Greek words "ergon" (labor) and "nomos" (rules). Its main goal is to reduce the risk of (WRMSDs) through planning, creating, reviewing, and assessing projects, jobs, tools, and systems, which can be accomplished by taking a neutral stance. This concept focuses on preserving the natural curves of the spine, as proper joint alignment and muscle balance are regarded to be essential for a healthy musculoskeletal system5. Because improper ergonomic practices put dentistry at risk, progress is needed in terms of productivity, work engineering, appropriate machinery and tool designs, substitution/modification of equipment and processes, good working practices, better work organization, and individual factor modification5. Also, while minimal intervention may be necessary, the current scenario indicates that a lack of understanding of MSDs, as well as insufficient studies, has an impact on dental professions and slows the stream's progress. As a result, the goal of this survey is to look into MSDs among Peoples University dentists in terms of symptoms and risk factors, as well as to help avoid and mitigate their harmful effects, as the null hypothesis is that there will be no pain among the dentists surveyed.

METHODOLOGY:

A cross-sectional survey of People's University dentists was done with the agreement of the Head of Institute and ethical clearance from the ethical board committee. On the day of the study, 200 questionnaires were sent to dentists who indicated their agreement to participate, and 154 dentists responded. The study's specifics were described, and written informed consent was requested. Demographic information, work-related load, musculoskeletal complaints, and self-adopted pain management measures were all included in the questionnaire. The validity and reliability of the questionnaire were evaluated before to the start of the study, with a kappa statistic value of 87 percent. SPSS software was used for statistical analysis, and statistical significance was defined as a p value of less than 0.05.

RESULTS:

The present study had a response rate of 77%, 154/200 respondents. The average age range being 26-50 yrs of (79%) of the participants whereas (30%) were below 25yrs.(90%) dentists were right handed of which 97% had low back problem, while the remaining (10%) were left handed. More than half of the participants had experienced musculoskeletal symptoms in past 12 months most frequently with neck (72%), lower back/ pelvis (40%), shoulder /arm (40%) and wrist/hand (18%) respectively (Table 1). There was more than two and three region involvement in 41.5% and 12.9% respectively (Table 2). Half of the dentists were involved in clinical practice and had a work experience of less than 5yrs (63%), of which majority had problems in neck (69%) and shoulder (41%) (Table 3). Very less were aware of the Ergonomic principles.

Table 1: Region of symptoms
Neck 111/154 72%
Lower back / pelvis 62/154 40%
Shoulder / arm 62/154 40%
wrist / hand 29/154 18%
Table 2: Work category Vs region of symptom
Neck back shoulder Wrist
Teaching 66.6% 44.4% 38.8% 11%
Clinical 69.5% 36.55 41.4% 25.6%
Both 88.8% 44.45 38.8% 11.1%
Table 3: Clinical experience Vs region of symptom
Neck Back Shoulder Wrist
<5yrs 72% 41% 37.7% 27.5%
5-10yrs 66.6% 41.6% 47.2% 5.5%
>10yrs 80% 30% 40% 0%

DISCUSSION:

Dental surgeons are frequently listed among the professionals at risk of MSDs due to prolonged uncomfortable or strained postures at work and a failure to take preventive measures6. Repetitive movements, extended static postures, and inadequate alignment, according to Karwaski et al7, may be to blame for the symptoms. On the other hand, Ratzen et al8 linked the appearance of these symptoms to the recurrent use of static postures, which typically require more than half of the body's muscles to contract in order to keep the body motionless while resisting gravity. These, in turn, are hypothesized to set off a chain of events that could result in pain, injuries, or the loss of a dentist's profession.

In addition, when compared to previous studies, the response rate for surveys conducted on dentists was greater (77%). Previously, an 88% response rate was recorded9. According to several research, the prevalence of MSDs among dentists ranges from 63 percent to 93 percent worldwide6-10. In line with earlier studies11, more than half of the dentists in the current study reported pain and discomfort in at least one portion of their body in the previous 12 months.

The participants in the study ranged in age from 26 to 50 years old, which was similar to the findings of Nihar Sultana et al8 (28-62 years) and Yemineni et al10 (28-62 years) (35.7 yrs). In line with other studies10, in which the majority of participants were right-handed (89.2%), 90% of dentists in our study were righthanded, with 97% of them having low back difficulties. (63%) of dentists had been in the field for less than 5 years, and the majority had reported MSDs, which was similar with Jianru YI et al2 findings. On the other hand, Anna Kierklo et al11 discovered that the average number of years spent in the dentistry profession was 16.

In addition, 31 percent of dentists have been in practice for more than 20 years, and 23.74% have been in the profession for 11-15 years. While 15.53% has experience ranging from 1 to 5 years and 6 to 10 years11. Harutunian K et al10 discovered a significant link between lack of physical activity and the number of afflicted regions, with two regions in 42% of the sample and more than two in 22% of the sample in our study. Lack of regular physical activity and work-related stress could be the culprits.

According to the research, the majority of dentists had issues with the Neck (26 % -83.8 %),1,8,10,12, while others had issues with the Lower Back (30 % -80 %)1,8,10,11,12 followed by shoulder (18.9% -72.4%)1,8,11,12 and wrist (26 % -49.7%)8,11-15 respectively.

15-16 % of participants reported experiencing paresthesia, pain, or difficulties with movement in the hip/thigh, ankles/foot, knees, feet, or elbows in the previous 12 months, which matches the findings of Emmuanuel et al16 and Kierklo A17. Only 19 % of the respondents were aware of the correct ergonomic posture in clinical practice, which was consistent with Madaan V et al11 and Kanteshwari K, et al13 who reported that fewer than half of the participants were informed, showing that a huge percentage of dentists are unaware.

As therapy modalities, dentists should choose particular exercises and yoga to improve the health and integrity of the spinal column, as well as stretching exercises for the hands, head, and neck, and maintaining appropriate working posture. As stated by Alshammari F et al18, occasional pauses and working in indirect vision should also be conducted as precautionary measures to ease pain and prevent injuries. However, only 5% of the participants in this study stated that they did stretching activities. Also, only 31% of people engaged in regular physical activities, the most popular of which were yoga, walking, and badminton.

66.2 % of respondents, on the other hand, made no steps to avoid such issues10. This was supported by our research, which found that 65 % of dentists did not take any preventive steps. As a result, several ergonomic elements that should be considered include upper-limb supports, the use of large-handled devices, and working with a mechanically adjustable chair with an adjustable backrest. Use of indirect vision and proper patient positioning in the dental chair are also important to minimize awkward or forced neck postures. Proper illumination, as well as technologies like magnifiers and microscopes, can assist reduce tiredness and increase productivity.

Musculoskeletal disease has a multifactorial etiology due to the inclusion of biomechanical, individual, and psychological factors associated to labor. As a result, the preventive strategy must be multifaceted, rather than focusing solely on ergonomics. As a result, any significant study on musculoskeletal problems among dentists should include a review of preventive interventions.19,21

However, despite feeling musculoskeletal discomfort, the professionals in this study did not take steps to prevent or alleviate the symptoms. Only 33.8 % of them claimed to have taken some preventive measures. Even while the key preventive measures should be changing posture, taking breaks, and stretching between subsequent patients - although these procedures were very rarely used by our subjects - these actions were not the best answer.20-23

The results collected in this study hint toward the inappropriate working habits and lack of fundamental knowledge of ergonomics among the surveyed dentists. Findings imply that the risk of MSDs can be minimized by raising alertness of these concerns among dentists. Students should be educated about ideal working postures and healthy work habits from the beginning of their undergraduate studies as a preventive approach to avoid such issues in their future careers.

CONCLUSION:

The most common reason for early retirement in dentists globally is musculoskeletal disorders. Understanding potential risk factors is crucial to preventing musculoskeletal problems. Many, if not all, dentists and faciomaxillary surgeons attribute their neck pain and/or radiculopathy to normal dental procedures, which are rather typical symptoms among dentists. Due to ill health, many dentists may take several sick breaks, change occupations, or even retire. MSDs are the most common cause of ill health retirements in the latter group, accounting for 55 % of all ill health retirements.

REFERENCES:

  1. , . A risk assessment study on work-related musculoskeletal disorders among dentists in Bhopal, India. Indian J Dent Res. 2016;27:236-41.
    [CrossRef] [PubMed] [Google Scholar]
  2. . Primary care in dentistry - An untapped potential. J Family Med Prim Care. 2015;4(1):13-8.
    [CrossRef] [PubMed] [Google Scholar]
  3. . International statistical classification of diseases and related health problems (ICD-10) in occupational health. In: Sustainable Development and Healthy Environments, Protection of the Human Environment. Geneva: World Health Organization; .
    [Google Scholar]
  4. , , , , . Work characteristics and musculoskeletal disorders among postgraduate dental students: A pilot study. J Musculoskelet Pain. 2014;22(1):62-7.
    [CrossRef] [Google Scholar]
  5. , , , . Musculoskeletal disorders in dental workplace: A comprehensive review. International Journal of Applied Dental Sciences. 2018;4(3):140-145.
    [Google Scholar]
  6. , , , . Musculoskeletal symptoms among dentists in relation to work posture. Work. 2000;15:153-8.
    [Google Scholar]
  7. , , , . Musculoskeletal Disorders in Dentists: A Systematic Review Update. Dental College Journal. 2017;7(2)
    [CrossRef] [Google Scholar]
  8. , , . Risk and Exposure of Musculoskeletal Disorders among Dental Surgeons Working in Dhaka City. Update Dental College Journal (UpDCJ). 2019;9(1)
    [CrossRef] [Google Scholar]
  9. . Disorders of the musculoskeletal system among dentists from the aspect of ergonomics and prophylaxis. Ann Agric Environ Med. 2002;9:169-73.
    [Google Scholar]
  10. , , , . Prevalence of musculoskeletal disorders in dental professionals of Andhra Pradesh, India. International Journal of Contemporary Medical Research. 2018;5(3):C7-C10.
    [Google Scholar]
  11. , , , . Work-related musculoskeletal disorders among dentists -a questionnaire survey. Ann Agric Environ Med. 2011;18:79-84.
    [Google Scholar]
  12. , , , , . Work characteristics and musculoskeletal disorders among postgraduate dental students: A pilot study. J Musculoskelet Pain. 2014;22(1):62-7.
    [Google Scholar]
  13. , , , , . Prevalence of work-related musculoskeletal symptoms of the neck and upper extremity among dentists in China. BMJ open. 2014;4(12):e006451.
    [CrossRef] [PubMed] [Google Scholar]
  14. , , . Self-reported musculoskeletal pain among dentists in South Africa: A 12-month prevalence study. SADJ. 2014;69(5):208-13.
    [Google Scholar]
  15. , , . Risk factors and prevalence of musculoskeletal disorders among Jordanian dentists. Jordan Med J. 2011;45(2):195-204.
    [Google Scholar]
  16. , , . Work-Related Musculoskeletal Disorders among Health Workers in a Nigerian Teaching Hospital. TAF Prev Med Bull. 2012;11:583-8.
    [CrossRef] [Google Scholar]
  17. , , , . Work-related musculoskeletal disorders among dentists -a questionnaire survey. Ann Agric Environ Med. 2011;18:79-84.
    [Google Scholar]
  18. , . Prevalence of back and neck pain amongst dentists. Journal of Advanced Medical and Dental Sciences Research. 2020;8(4)
    [Google Scholar]
  19. , , , . Musculoskeletal Disorders in Dentists: A Systematic Review Update. Dental College Journal. 2017;7(2)
    [CrossRef] [Google Scholar]
  20. , , , . Magnetic Resonance Imaging (MRI) finding of Cervical Spine Derangement (CSD) among Iraqi Working Dentists. the Open Dentistry Journal. 2020;14
    [CrossRef] [Google Scholar]
  21. , , . Ergonomics in Dental Practice. Journal of Indian Association of Public Health Dentistry. 2010;16:1-7.
    [Google Scholar]
  22. , , , , , , et al. Dental practitioners and ill health retirement: causes, outcomes and reemployment. British dental journal. 2010;209(5):E7.
    [CrossRef] [PubMed] [Google Scholar]
  23. , , , , . Self-reported risk factors related to the most frequent musculoskeletal complaints among Czech dentists. Ind Health. 2015;53(1):48-55.
    [CrossRef] [PubMed] [Google Scholar]
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