Work related musculoskeletal disorders among dentists

Imagine you are as successful as you ever were. Your practice is the best it has ever been. You are busier than ever, and your finances are looking great. For many of you, that place may be a few years away, and for many, a few more years away.

Now imagine if you know that there’s something that could take it all away from you. Something that could even cause you to stop practicing your profession. What would you do to prevent that?

As dental professionals, we tend to take our body and its mobility for granted, ignoring the occupational hazards that often come with it. Limited mobility within the clinic, long working hours in a particular posture, repetitive movements and exertion are common features of our lives. These are also risk factors that contribute to fatigue, pain, discomfort, and eventually, musculoskeletal disorders. These disorders can not only affect the quality of your life but also potentially reduce your working years, affecting your finances and jeopardizing your family’s future.

Recent research suggests that the prevalence of non-specific work-related musculoskeletal disorders (WMSD) among dental professionals is as high as 49-92%, while site-specific WMSD commonly affects the back (reported among 22.2-91.0% professionals), neck (20-84.9%), and shoulder (18.9-73.5%).

Now that we know the enemy, let’s get to know it better.

What are work-related musculoskeletal disorders?

Occupation-based musculoskeletal disorders or work-related musculoskeletal disorders (WMSD) are injuries affecting the musculoskeletal system of the body (which includes muscles, tendons, ligaments, nerves, discs, and blood vessels). They usually affect the neck, shoulder, hand, wrist, upper and lower back.

Characteristics of WMSD: WMSD usually results from sustained injuries due to the repetitive motion of a particular body part, incorrect posture, or other work-related habits. It develops over time with repeated injuries that are beyond the body’s recovering capacity. It is difficult to diagnose in initial stages as people associate the discomfort or pain with multiple causes.

Signs and symptoms: The most common signs include decreased range of motion, decrease in normal sensation and grip strength, and finally loss of coordination. Symptoms constitute pain in neck, shoulders, and back, tingling and burning sensation in arms, weak grip, numbness and cramping of hands.

Risk factors associated with musculoskeletal disorders among dentists:

  • Poor working posture: Normally, every joint in the body can exhibit motion within a limited range without straining the underlying anatomical structures. When the body is exposed to postures beyond the range of motion, it can strain the underlying muscles and cause discomfort and fatigue. Also, the contraction of the muscle for a prolonged time restricts the flow of blood in the musculature, leading to the formation of trigger points. Professionals often tend to adopt awkward posture due to improper positioning of the equipment, the patients, or the layout of the clinic. Awkward positions such as excessive forward bending of neck, shoulder, and back to gain maximum visibility during a procedure can cause tension. Full flexing or extending of hands/wrist can also contribute to musculoskeletal disorders. Even sitting without back support can flatten the lumbar curve which in turn creates tension in the underlying structures and can strain the lower back. 

  • Repetitive tasks: Most tasks performed in the dental clinic are repetitive in nature. Performing repetitive tasks without adequate rest means that the same muscles and anatomical structures are engaged, preventing the musculoskeletal system from getting the adequate recovery and inducing early fatigue.
  • Forceful exertions: Many times, during dental procedures, either a high amount of force is applied or hand instruments are held for a prolonged time. This creates mechanical pressure on the underlying tissues of the hand causing injury to skin, nerves, muscles and blood vessels. Even holding sharp instruments, which requires a steady hand and precise motions, can create an extensive amount of pressure on palm, thumb, and fingers. The intensity, frequency, and duration of the applied mechanical pressure also play a key role in one’s overall musculoskeletal condition.

  • Prolonged use of vibrating instruments: Prolonged use of vibrating instruments constitutes a major risk for WMSD in upper extremities. Holding a vibrating instrument with a firm grip can transfer more vibrations to the forearm and hand. This can lead to various disorders such as carpal tunnel syndrome, white finger syndrome, and joint disorders of wrist, hand, or elbow.

  • Muscular inactivity: Most of the clinics have limited space and our working conditions require limited mobility, restricting the mobility of our muscles. Muscles, tendons, and bones in the body need activation in order to maintain their functional capacity. In the case of inadequate activation, deconditioning of muscles occurs which further affects the stabilization of joints and ligaments.
  • Environmental factors: Poor lighting and inadequate visual conditions can force one to stretch to attain the better visibility of the area of interest, strain the muscles of neck and shoulder in the process. Dental professionals should also be careful with the air conditioning as the cold temperature can reduce the grip and strength of the hands while holding instruments/tools.
  • Psychosocial factors: Psychosocial factors also play a crucial role in inducing musculoskeletal disorders. Job-related stress, financial insecurities, inhospitable social environment, and time-related pressures can either induce or exaggerate a physical strain.
  • Overall habits: Habits such as lack of exercise, smoking, drinking, etc. can also affect your overall systemic health, causing one to be more prone to musculoskeletal disorders.

Now that you are more aware of the problem, we hope you will take adequate steps to prevent it. Don’t worry, we’ll guide you through the process. Like our Facebook page so you don’t miss the next article in the series.
Till then, remember that precaution is the best insurance. Take care!


About the author

Dr. Shilpy Bhandari is a Hyderabad-based Periodontist and the founder of Dentistry Insider. She has worked extensively across dental clinics of all sizes — from large corporate chains to small, independent setups.

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