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Table of Contents   
ORIGINAL RESEARCH  
Year : 2011  |  Volume : 22  |  Issue : 3  |  Page : 381-384
Awareness among Indian dentist regarding the role of physical activity in prevention of work related musculoskeletal disorders


1 Amity Institute of Physiotherapy, Amity University, Noida, India
2 Shree Bankey Bihari Dental College and Research Center, Ghaziabad, India

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Date of Submission23-Jul-2010
Date of Decision22-Oct-2010
Date of Acceptance26-Dec-2010
Date of Web Publication3-Nov-2011
 

   Abstract 

Background: The prevalence of work-related musculoskeletal complaints in dentists is high and the past two decades have witnessed a sharp rise in the incidence of various disorders. The prevalence of musculoskeletal pain ranges between 64% and 93%. The most effected regions have been back and neck. Various studies have been done to record stress levels and health-related behaviors of dentists in other countries but limited data is available among the Indian dentists.
Materials and Methods: Therefore a questionnaire survey was carried out among 102 Indian dentists belonging to different fields having at least one musculoskeletal disorder in last 6 months.
Results: The total sample consists of 80 males and 22 females. Out of the 102 over 97 of dentists had sought medical advice for these disorders during the previous 06 months and 74 of them also consulted the physiotherapist for exercises and ergonomic advice. The number of sessions taken for regular physical exercises was minimum 6 till 44 the most. The percentage of improvement in symptoms varied between 20% and 80%.
Conclusions: A significant direct correlation between the number of sessions taken for physical activity and the self-perceived improvement in the symptoms was found using the Pearson correlation test. The work-related musculoskeletal disorders among dentists not only decrease their efficiency but also is a major concern among them. Self-awareness and benefits of regular exercise is the need of the hour.

Keywords: Ergonomics in dentistry, musculoskeletal pain, physical activity in dentist

How to cite this article:
Sharma P, Golchha V. Awareness among Indian dentist regarding the role of physical activity in prevention of work related musculoskeletal disorders. Indian J Dent Res 2011;22:381-4

How to cite this URL:
Sharma P, Golchha V. Awareness among Indian dentist regarding the role of physical activity in prevention of work related musculoskeletal disorders. Indian J Dent Res [serial online] 2011 [cited 2019 Nov 17];22:381-4. Available from: http://www.ijdr.in/text.asp?2011/22/3/381/87057
The prevalence of work-related musculoskeletal complaints in dentists is high and the past two decades have witnessed a sharp rise in the incidence of various disorders. The prevalence of general musculoskeletal pain ranges between 64% and 93%. The most effected regions for pain in dentists have been shown to be the back and neck, while the hand and wrist regions were the most common regions for dental hygienists. [1] Prevention of these disorders is becoming crucial and requires the identification and modification of risk factors such as stature, physical condition, strength,work organization, ergonomic hazards, awkward postures, prolonged repetitive movements, intense work schedules or fast work pace, factors connected with professional equipment (such as vibrations, or sharp and hard surfaces causing pressure points) may also contribute.

The frequency of these disorders is also gender related and research supports the higher incidence among female dentists which is nearly double than that of males. Women showed a higher frequency of intense pain involving the cervical, lumbar, dorsal, and wrist areas. A higher incidence of wrist pain was recorded in professionals exclusively dedicated to oral surgery. [2] The musculoskeletal disorders between left- and right-handed dentists also vary with the position adopted by the dentist and was significantly related to the intensity of pain. Research shows that left-handed dentists especially suffered from neck and shoulder pain when compared with right-handed dentists.The modification of work practices appears to be effective in decreasing the prevalence of symptoms.

The various factors are responsible for the stress at work and the most important contributing factor being patient demands (75%). Dentist are among the increasingly group been referred for physical therapy and seeking ergonomic advice in the recent past. There is a scope for further decreasing the prevalence and severity of these disorders by performing regular specific exercises. [3],[4] In most of the studies the dentists are reported to be relatively inactive and very few took some form of physical exercise and acknowledge the benefits of the same. [5] Musculoskeletal complaints had a significant negative impact on dentists' self-reported general health. [6] The best ergonomic working principles should be taught to the students, dental schools should provide a comfortable working environment, those practicing general dentistry. [7]

The work-related musculoskeletal disorders among dentists not only decrease their efficiency but are also a major reason for ill health retirement. The most common cause of ill health retirement was musculoskeletal disorders (55%), followed by mental and behavioral disorders (28%). A majority of respondents (90%) considered that their ill health was work related. [8] It is therefore important to increase health knowledge on occupational hazards and also to emphasize the importance of early diagnosis and treatment for these disorders. Self-awareness and benefits of regular exercise are the needs of the hour. Various studies have been done to record stress levels and self-perceived health and health-related behaviors of dentists in other countries but limited data is available among the Indian dentists indicating the need to evaluate the same.


   Materials and Methods Top


A questionnaire survey was carried out among a sample of convenience of 102 Indian dentists from Delhi NCR belonging to different specialization fields having at least one musculoskeletal disorder in last 6 months. Questions included data on physical workload, general health and the occurrence of musculoskeletal complaints in the past. Dentists were asked about the medical help taken with emphasis on physical therapy treatment.The total sample consists of 80 males and 22 females, with the mean age of 36.2 years. The dentists were contacted during their free hours with consent to fill the data.


   Results Top


The work experience of 102 dentists was evaluated varied between 1 and 17 years of practice. The number of sessions taken for regular physical exercises was 6 as minimum for some dentists and till 44 for few of them [Table 1]. The percentage of improvement in symptoms varied between 20% and 80%. The most prevalent work-related musculoskeletal disorders during the previous 6 months were reported at the lower back, neck and shoulder. Over 97 of dentists had sought medical advice or treatment for these disorders during the previous 06 months and 74 of them also consulted the physiotherapist for exercises and ergonomic advice [Figure 1]. About 80% out of 74 took some form of physical exercise at least three to four times per week and felt that their lack of physical activity was very likely to cause them health problems. The remaining lot of the dentist was relatively inactive due to reasons as lack of time motivation and awareness [Table 2].
Figure 1: Distribution of total sample

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Table 1: Descriptive statistics

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Table 2: Descriptive statistics of improvement of pain with number of sessions

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There is a significant direct correlation between the number of sessions taken for physical activity and the self-perceived improvement in the symptoms as statistically shown by the Pearson correlation test [Table 3], [Figure 2] and [Figuer 3].
Figure 2: Bar diagram to view correlation between mean improvement and number of physical therapy sessions

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Figure 3: Scattered diagram to view correlation between mean improvement and number of physical therapy sessions

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Table 3: Correlation improvement of pain with number of sessions

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   Discussion and Conclusion Top


Recently scientific evidence suggested a relationship between the tasks and musculoskeletal symptoms. A total of 75% of dental practitioners are at a risk for developing work-related musculoskeletal disorders. Results from the study have found that dental students were no exception. [9] The total number of hours they spend for work is directly related to the severity of musculoskeletal disorders.

Most of the dentists in the present study related there symptoms to the awkward posture adapted during working hours. An important risk factor in dental practice is forceful pinching, which occurs during dental scaling. Ergonomically designed dental instruments may help reduce the prevalence of MSDs among dental practitioners. Handle designs of periodontal instruments had significant effects on hand muscle load and pinch force during a manual scaling task. The instrument with a large diameter and a light weight required the least amount of muscle load and pinch force. There was a limit to the effect of handle diameter, with diameters larger than 10 mm having no additional benefit; however, the studies done in this regard did not identify a limit to the effect of reducing the weight of the instrument, and therefore instruments lighter than 15 g may require even less pinch force. Further studies need to focus on task-specific effect on the musculoskeletal systems of the dentists. [10]

Female dentists face unique musculoskeletal demands and inherent gender differences that may place them at higher risk for occupational pain and injury than their male counterparts. By familiarizing themselves with unique muscle imbalances, specific pain syndromes, and positioning challenges to which they are predisposed, female dentists may take pre-emptive action and initiate ergonomic intervention in the operatory and specific exercise at home to reduce the risk of developing musculoskeletal disorders. [11] Although the present study does not clearly focuses on the difference of symptoms and inclination toward the benefits of exercise between males and females, further investigation is needed in this regard.

The prevalence and severity of various musculoskeletal disorders decreased by performing regular specific exercises among large group of the dentists. Most of them were not inclined toward regular exercises but the noticeable benefits of the same increased their interest. There is an increasing trend toward the role of physical activity among the dentists.

There is also a need to evaluate potential risk factors in dentists performing specific type of work and role of physical therapy amongst them for example, increased experience in periodontal scaling leads to the application of less pinch force to accomplish scaling. Recent scientific evidence suggests there is a strong correlation between the type of task performed by the dentists and musculoskeletal symptoms which need further investigations. [12]

Muscular imbalance, neuromuscular inhibition, and pain and dysfunction are amongst the most prevalent problems frequently being observed among oral health practitioners. Paying the necessary attention to occupational and individual risk factors, prevalence, symptoms, and consequences of these disorders, and implementing the recommended health and safety measures can enable a long and healthy career. It is essential to aims to provide background information for OHP regarding the magnitude of the problem, particular risk factors and the available recommendations for prevention. [13]

This study gives an insight into the level of awareness among Indian dentist about the importance of regular physical activity. The physical inactivity among dentists seems to put them at risk for the occurrence of musculoskeletal disorders. Musculoskeletal disorders are major reason leading for loss of work efficiency as well as early ill health retirement among dentists and the prevalence and severity of these disorders decrease by performing regular specific exercises as shown by the present study. There is an increasing trend of dentist being treated by physiotherapist for their musculoskeletal problems. The physical therapy advice included posture correction, ergonomic advise, and stretching exercises. The role of physical activity among the dentists needs to be investigated further on larger group to evaluate specifically the type of activity that reduces their symptoms in future.

 
   References Top

1.Hayes M, Cockrell D, Smith DR. A systematic review of musculoskeletal disorders among dental professionals. Int J Dent Hyg 2009;7:159-65.  Back to cited text no. 1
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2.Harutunian K, Gargallo-Albiol J, Figueiredo R, Gay-Escoda C. Ergonomics and musculoskeletal pain among postgraduatestudents and faculty members of the School of Dentistry of the University of Barcelona (Spain). A cross-sectional study. MedOral Patol Oral Cir Bucal2011;16:e425-9.  Back to cited text no. 2
    
3.Shrestha BP, Singh GK, Niraula SR. Work related complaints among dentists.JNMA J Nepal Med Assoc 2008;47:77-81.  Back to cited text no. 3
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4.Lindfors P, von Thiele U, Lundberg U. Work characteristics and upper extremity disorders in female dental health workers.J Occup Health 2006;48:192-7.  Back to cited text no. 4
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5.Kay EJ, Lowe JC. A survey of stress levels, self-perceived health and health-related behaviours of UK dental practitioners in 2005. Br Dent J 2008;204:E19; discussion 622-3.  Back to cited text no. 5
    
6.Puriene A, Aleksejuniene J, Petrauskiene J, Balciuniene I, Janulyte V. Self-reported occupational health issues among Lithuanian dentists.Ind Health 2008;46:369-74.  Back to cited text no. 6
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7.Tezel A, Kavrut F, Tezel A, Kara C, Demir T, Kavrut R. Musculoskeletal disorders in left- and right-handed Turkish dental students.Int J Neurosci 2005;115:255-66.  Back to cited text no. 7
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8.Brown J, Burke FJ, Macdonald EB, Gilmour H, Hill KB, Morris AJ, et al. Dental practitioners andill health retirement: Causes, outcomes and re-employment. Br Dent J 2010;209:E7.  Back to cited text no. 8
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9.Thornton LJ, Barr AE, Stuart-Buttle C, Gaughan JP, Wilson ER, Jackson AD, et al. Perceived musculoskeletal symptoms among dental students in the clinic work environment. Ergonomics. 2008;51:573-86.  Back to cited text no. 9
    
10.Mamatha Y, Gopikrishna V, Kandaswamy D. Carpal tunnel syndrome: survey of an occupational hazard.Indian J Dent Res 2005;16:109-13.  Back to cited text no. 10
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11.Valachi B. Musculoskeletal health of the woman dentist: Distinctive interventions for a growing population. J Calif Dent Assoc 2008;36:127-32.  Back to cited text no. 11
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12.Dong H, Loomer P, Villanueva A, Rempel D. Pinch forces and instrument tip forces during periodontal scaling. J Periodontol 2007;78:97-103.  Back to cited text no. 12
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13.Yamalik N . Musculoskeletal disorders (MSDs) and dental practice Part 2: Risk factors for dentistry, magnitude of the problem, prevention, and dental ergonomics. Int Dent J 2007;57:45-54.  Back to cited text no. 13
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Correspondence Address:
Pooja Sharma
Amity Institute of Physiotherapy, Amity University, Noida
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-9290.87057

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    Figures

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    Tables

  [Table 1], [Table 2], [Table 3]

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