Dental Practice and Musculoskeletal Disorders Association: A Look at the Evidence

ABSTRACT

Disorders localized to the musculoskeletal system are a common problem among dental personnel. This study has the aim of surveying epidemiological studies reporting positive associations between dental practice and musculoskeletal disorders (MSKDs). The focus was to evaluate the size of reported risk increase and the extent to what alternative causal explanations were considered. Reports with significant links (p value <.05) were systematically selected from 2 electronic databases. Twenty-five studies were identified. Risk measures were reported in 8 studies, and all of them presented weak associations. The impact of at least 1 competing explanations was analyzed in 32% of studies, but adjustment was considered not adequate in half of them. The evidence on dentistry as a profession with potential risk for development of MSKDs remains questionable. Further research is needed to more carefully elucidate the risk and the impact of MSKDs in this particular occupational group.

KEYWORDS:

• back pain
• dentistry
• dental general practices
• epidemiology
• human engineering
• musculoskeletal diseases
• occupational diseases
• risk factors

Notes

^aPC = prospective cohort; CS = cross-sectional.

^bDH = dental hygienist; DA = dental assistant.

^cRR = relative risk; OR = odds ratio; CI = confidence interval; Adj = adjusted. Results can be described by groups of exposure (eg, only dentists, only DHs, etc) and for many outcomes (e.g., shoulder pain, back pain, muscular strength, etc).

^dStudies reported results adjusted for age (Akesson et al., 1995; Akesson et al., 2000); age, gender, seniority, total work time, work time with patients, total duration of breaks (Finsen, 1998); work years or work hours and musculoskeletal pain in the past 12 months (Chowanadisai, 2000); age, years at work, atopy, orthodontists, office employee, female gender (Kerosuo, 2000); anxiety/depression, manual activity, compressor in the office, job satisfaction, use of direct/indirect vision, productivity, income, age, height, marital status (Santos Filho, 2001); individual characteristics (7 variables), physical (4 variables) and psychosocial (2 variables) load, and health status (2 variables) (Alexopoulos, 2004); marital status, positing and number of years performing current work tasks, fatigue, general health problems, physical load, physical work environment, and psychosocial work characteristics (Lindfors, 2006).

^fNot applicable: it is not possible to calculate risk because there is no comparison group.