16 June 2023

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Dental hygienists and musculoskeletal disorders

Lara Figini

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Musculoskeletal disorders (MSDs) are occupational pathologies that affect different classes of professionals and are a concern due to several reasons, primarily absenteeism at work.

The imbalance of muscle tone causes musculoskeletal tensions that not only alter the physical but also the psychological sphere.

Factors causing MSDs include heavy lifting, repetitive movements, incorrect or static postures, vibrations, and intense work routines. These biomechanical risk factors, combined with psychosocial stress, are thought to contribute to the development and progression of MSDs.

Usually, the muscle areas most affected are the neck, back and upper limbs, although in some rare cases the lower limbs may also be affected.

Symptoms of MSDs include discomfort, pain, numbness, tingling, burning, stiffness and fatigue. Signs include decreased range of motion and grip strength, loss of sensation, and normal movement and coordination. MSD pain can occur in the neck, shoulder, arm, wrist, hands, upper and lower back, hips, knees, and feet. Back pain has been found to be a major health problem for dentists.

Carpal tunnel syndrome (CTS) is one of the most severe MSDs common in dental hygienists and causes numbness, tingling and pain in the hand and wrist (Mulimani, 2018).

Compared to dentists, dental hygienists are at a higher risk of developing MSD in the upper extremities and lower back due to repetitive root planing treatments over long hours (Noh, 2013).

Studies in the literature have shown that dental hygienists have a higher prevalence of MSDs in the wrists and hands than dentists (Moodley, 2018; Hayes, 2013).

Other specific MSDs affecting dental hygienists are tense neck syndrome, thoracic outlet compression syndrome, pronator syndrome, tendonitis, lateral epicondylitis, snap thumb, De Quervain's tenosynovitis, osteoarthritis metacarpal joint and vibration-induced neuropathy.

All the above leads to a loss of working time, reduced work performance, the need for medical tests and possible early retirement. Neck pain has been specifically identified as a common complaint of dental hygienists, with a reported 12-month prevalence of between 54% and 69%.

Materials and methods

In a study published in the International Journal of Dental Hygiene in May 2022, the authors evaluated the prevalence of musculoskeletal disorders and the significance of symptoms in a sample of dental hygienists. The sample was subjected to a questionnaire of 20 questions, via social networks.

The variables taken into consideration were personal data, hours of sport, working habits, years of professional activity, number of working hours and number of patients per week, presence or absence of pain. 

Data were evaluated using standard statistical analysis software, and a database was created in Excel. Variable descriptive statistics were calculated for each of them.

Group comparison was evaluated by chi-square test of homogeneity and Fisher's exact test (p-value <0.05 as significant).

Results

The research team reviewed 468 questionnaires from 396 females (85%) and 72 males (15%). The prevailing age was between 25 and 35 years. 

Of the respondents to the questionnaire, 91% reported suffering or having suffered from MSD musculoskeletal disorders.

The most relevant muscle areas affected were the neck (30.6%), the shoulders (25.0%) and the lumbosacral region (23.3%); the remaining 21.1% concerned other regions of the body.

The association and statistical analysis between the various variables showed how the presence of musculoskeletal disorders influences absenteeism and work performance.

Conclusions

From the data of this study, it can be concluded that the diffusion of musculoskeletal disorders among dental hygienists is particularly high mainly due to the lack of information. Most of the interviewees, in fact, showed low awareness leading to a lack of effort to address or possibly prevent these conditions.

For more information: "Musculoskeletal disorders related to dental hygienist profession."

See also a recent study on hand pain and dental students: "Survey about hand pain: NYU College of Dentistry students."