Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jan 15:6:e4154.
doi: 10.7717/peerj.4154. eCollection 2018.

Ergonomic risk and preventive measures of musculoskeletal disorders in the dentistry environment: an umbrella review

Simone De Sio  1 , Veronica Traversini  2 , Francesca Rinaldo  3 , Valerio Colasanti  2 , Giuseppe Buomprisco  2 , Roberto Perri  2 , Federica Mormone  2 , Giuseppe La Torre  4 , Fabrizio Guerra  3
Affiliations

Ergonomic risk and preventive measures of musculoskeletal disorders in the dentistry environment: an umbrella review

Simone De Sio et al. PeerJ. .

Abstract

Introduction: Dental practitioners are exposed to different occupational hazards during the course of their professional activity, such as physical, chemical, biological, ergonomic factors. The ergonomic hazards, caused by strained posture and prolonged repetitive movements, can induce musculoskeletal disorders. It occurs in 54-93% of dental professionals and involve the spine, shoulder and hand-wrist tract. Through a systematic review of international literature, we analyzed specific ergonomic risk factors and preventive measures of musculoskeletal disorders in professional dental activity.

Methods: This systematic review is coherent with the PRISMA statement. The scientific research on the major online databases was based on the following keywords: dentist, prevention, ergonomic, dentistry, musculoskeletal, neck pain, posture, ergonomics, work and occupational. The studies included in this review focus on disorders related to ergonomics and on the most effective preventive measures to be adopted. No restrictions were applied for language or publication type. We excluded reports not related to ergonomic prevention in dentistry, reports of minor academic significance, editorial articles, individual contributions, and studies published in scientific conferences.

Results: Online research indicated 4188 references: PubMed (2919), Scopus (1257) e Cochrane Library (12). We excluded 3012 of these, because they were unrelated to ergonomics theme and 187 due to duplication. From the remaining 989 studies, 960 papers did not meet inclusion criteria and they were excluded. Therefore, we analyzed 29 articles, including 16 narrative reviews and 13 original article. The main risk factor for the development of musculoskeletal disorders found in our analysis is static posture adopted during work, highlighted in 87.5% of reviews and 84% of original articles. With regard to preventive measures, 75% of the reviews highlighted the importance of stretching after each working session and at the end of the working day, while 61.5% of the original articles emphasized the use of modern and ergonomic instruments.

Discussion: This review showed that static postures are strongly responsible in the etiology of musculoskeletal disorders. The awkward postures more frequently identified among dental professionals are: extreme forward-head and neck flexion; trunk inclination and rotation towards one side; lifting one or both shoulders; increased curvature of the thoracic vertebral column; incorrect positioning of the lower limbs with thigh-leg angle of less than 90°. It is really important to use of a modern workstation with appropriate ergonomic supports. Among the preventive ergonomic measures, literature has widely recognized the role of physical activity and of a neutral and balanced posture. The present review has some limits: a large part of the selected studies did not have a high methodological quality score and an inadequate statistical analysis.

Keywords: Dentistry; Ergonomic risk; Musculoskeletal disorders; Occupational medicine; Preventive measures; Umbrella review.

PubMed Disclaimer

Conflict of interest statement

The authors declare there are no competing interests.

Figures

Figure 1
Figure 1. Flow chart for studies selection.
See this image and copyright information in PMC

References

    1. Abichandani S, Shaikh S, Nadiger R. Carpal tunnel syndrome-an occupational hazard facing dentistry. International Dental Journal. 2013;63(5):230–236. doi: 10.1111/idj.12037. - DOI - PMC - PubMed
    1. Anghel M, Argesanu V, Talpos-Niculescu C, Lungeanu D. Musculoskeletal disorders (MSDs) consequence of prolonged static posture. Journal of Experimental Medical & Surgical Research. 2007;4:167–172.
    1. Ayatollahi J, Ayatollahi F, Ardekani AM. Occupational hazards to dental staff. Dental Research Journal. 2012;9(1):2–7. doi: 10.4103/1735-3327.92919. - DOI - PMC - PubMed
    1. Biswas R, Sachdev V, Jindal V, Ralhab S. Musculoskeletal disorders and ergonomic risk factors in dental practice. Indian Journal of Dental Sciences. 2012;4(1):70–74.
    1. Bravo IM, Correnti M, Escalona L. Prevalence of oral lesions in HIV patients related to CD4 cell count and viral load in a Venezuelan population. Medicina Oral, Patologia Oral y Cirurgia Bucal. 2006;11(1):E33–E39. - PubMed

LinkOut - more resources