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10.5005/jp-journals-10015-1310
Prevalence of Musculoskeletal Disorders among Indian Dentists: A Pilot Survey with Assessment
Original research
ABSTRACT Introduction
Introduction: Musculoskeletal disorders (MSDs) are increa Numerous events have transformed the practice of
singly becoming a nuisance for dental professionals. Nearly,
dentistry into one that is more efficient, comfortable for
2 million workers across the world suffer from MSDs each
year, with dentists facing an increased risk of developing these the patient and more productive for the dentist. Until
ailments. reasonably recently, dentistry was exclusively practiced
This study is an attempt to assess the risk of MSDs among in a standing posture. 1960s changed the face of dentistry
dental professionals, and eventually to spread awareness regar to four-handed practice, and sitting became the preferred
ding the importance of good posture and proper ergonomics. way of rendering treatment.1,2 In 1954, a group of dentists,
Objectives: To determine the presence of MSDs among Indian including Dr Sanford S Golden, met to develop a reclin
dentists. ing chair for the patient that would allow the dentist to
sit while operating.3 The introduction of the Dental-Ez
Materials and methods: A research survey was conducted
among dental professionals practicing in and around Maha
chair, by John Naughton 1958, was the event that ushered
rashtra state, India. The questionnaire for the study included in the era of modern sit down, four-handed dentistry.3
a series of questions, when coupled with the rapid entire body Though modern dentistry has evolved substantially
assessment (REBA) scale, allows one to assess his/her posture today, dental professionals are commonly exposed to a
during work and eventually determines the need to improve the variety of occupational hazards. The back has long been
same. Two hundred dentists completed the questionnaire given. affected by the postures adapted by the dentists, caus
Result: The study revealed a high prevalence of musculoskeletal ing musculoskeletal disorders (MSDs). Because of MSDs,
pain among dental professionals. dentists have often had to limit or even abandon their
professional practice.4
Conclusion: A relation was observed between the severity
of the pain experienced by the dentists and their REBA score
Different researchers with different methodologies
indicating that dentists with a higher REBA score need to adapt investigated musculoskeletal disorders among dentists.
their working postures and employ proper ergonomics. Musculoskeletal disorders have been associated with
several risk factors, like prolonged static posture, repeated
Keywords: Backache, Dental professionals, Indian dentists,
performance of same actions, poor illumination, incor
Musculoskeletal disorders, REBA.
rect position of the patient on the dental chair, genetic
How to cite this article: Bhagwat S, Hegde S, Mandke predisposition, work pressures, stress, lack of exercise
L. Prevalence of Musculoskeletal Disorders among Indian and age. The overall prevalence of MSDs in dentistry
Dentists: A Pilot Survey with Assessment by Rapid Entire Body
differs from 63 to 93% worldwide.4
Assessment. World J Dent 2015;6(1):39-44.
The aim of this pilot survey was to assess the preva
Source of support: Nil lence of MSDs among dentist in India by surveying a
representative sample size.
Conflict of interest: None
Materials and Methods
1 2
Professor and Postgraduate Guider, Senior Resident
3 A cross-sectional questionnaire-based contact survey
Professor and Head
was carried out among 200 dentists in and around
1-3
Department of Conservative Dentistry and Endodontics Maharashtra, as a representative pool for dentists in
Padmashree Dr DY Patil Dental College and Hospital, Navi
Mumbai, Maharashtra, India
India. The representative pool consisted of private and
public practitioners, with general good health.
Corresponding Author: Sumita Bhagwat, Professor and
Postgraduate Guider, Department of Conservative Dentistry and
Questionnaire and Data Collection
Endodontics, Padmashree Dr DY Patil Dental College and Hospital
Nerul, Navi Mumbai, Maharashtra, India, Phone: 022-21713763 The questionnaire was divided into different sections
9819876828, e-mail: sumita1572@gmail.com
so as to understand and assess the different variables
40
WJD
Prevalence of Musculoskeletal Disorders among Indian Dentists: A Pilot Survey with Assessment
Fig. 1: Most commonly adopted neck position: 74.5% (149) Fig. 2: Most commonly adopted trunk position: 41% (82)
Fig. 3: Most commonly adopted leg Fig. 4: Most commonly adopted leg position Fig. 5: Most commonly adopted
positionsitting: 60% (45) standing: 59% (98) upper arm position: 57% (114)
Fig. 6: Most commonly adopted lower arm position: 56% (112) Fig. 7: Most commonly adopted wrist position: 57.50% (115)
The study examined the presence, distribution and Our study included dental practitioners around age
factors affecting MSDs among a cross-section of dentists group of 35 5 years. Among the different age groups, we
practicing in private and hospices. The sample was a found that the presence of painful sites were maximum
representative sample for a pilot study. in the above 40 years group, 70.8%, also seen in Graph 3,
Graph 2: Division of contributors into three main risk groups Graph 3: Age group wise presence of pain in participants [using
according to their REBA scores Chi-square test, p-value is 0.029 (<0.05), i.e. there is a relation
between incidence of pain and age group]
Graph 4: Correlation between presence of pain and gender in Graph 5: Correlation between presence of pain and breaks taken
participants [using Chi-square test, p-value is 0.068 (> 0.05), i.e. by participants [using Chi-square test, p-value is 0.043 (<0.05),
there is no relation between incidence of pain and gender] i.e. there is a relation between incidence of pain and breaks taken]
and there was a significant relationship between age and pain which signifies that they did not relax their strained
pain incidence. The investigation revealed that more than muscles during this time (Graph 5). Though four-handed
half the sample size suffered from some painful sites of dentistry was being practised by 49.50% dentists, 56.7% of
which females (59.5%) suffered more compared to men those still suffered from pain while 57.6% of practitioners
(54.5%), depicted in Graph 4. We found the back and the without assistance also suffered from pain. Chi-square
neck were the most painful regions but males and females test revealed a correlation between the two (Graph 6).
had different regions of pain (Table 1). More than half of We compared our findings with those of other inves
the dental professionals did not perform any exercise or tigators in similar studies7-19 all around the world with
indulge in any sport on daily basis and this increased site specific pain results (back, neck and shoulders). It was
their risk of having musculoskeletal disorders. Although found that work-related MSDs among dental professions
a lot of professionals, 71% (133) took breaks in between were present worldwide (Tables3 to 5), and our findings
appointments; nevertheless 56% still suffered pain from were relatively in agreement with the findings of most
musculoskeletal disorders. Even after the evolution to researchers.
seated four-handed dentistry and ergonomic equipment, Many researchers have determined that the mecha
studies found that back, neck, shoulder or arm pain was nisms leading to work-related musculoskeletal pain are
present in up to 81% of dental operators.6 In our survey, multifactorial.20,21 This pain can be related with several
we found that 66% (133) of the dentist did take breaks in risk factors like extended static posture, repeated per
between appointments, however, 55.6% of them still had formance of same actions, poor illumination, incorrect
42
WJD
Prevalence of Musculoskeletal Disorders among Indian Dentists: A Pilot Survey with Assessment
undergraduate training of a dental student so that inci 12. Alexopoulos EC, Stathi IC, Charizani F. Prevalence of
dence of work-related MSDs can be greatly reduced in musculoskeletal disorders in dentists. BMC Musculoskelet
Disord 2004;5:16.
the future.
13. Kierklo A, Kobus A, Jaworska M, Botuliski B. Work-related
musculoskeletal disorders among dentistsa questionnaire
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