Research Article
Volume 4 Issue 2 - 2016
Prevalence of Musculoskeletal Disorders among Dentists in Aseer Region, Saudi Arabia
Mohammad Shahul Hameed1, Kamran Bokhari2*, Ibrahim Al Shahrani3, Abdel Bagi Mustafa2, Tanveer Alam4 and Sharaz Shaik5
1Department of Dental Education, College of Dentistry, King Khalid University, Kingdom of Saudi Arabia
2Department of Oral & Maxillofacial Surgery, College of Dentistry, King Khalid University, Kingdom of Saudi Arabia
3Department of Pediatric Dentistry & Orthodontic Sciences, College of Dentistry, King Khalid University, Kingdom of Saudi Arabia
4Department of Oral Medicine & Radiology, College of Dentistry, King Khalid University, Kingdom of Saudi Arabia
5Department of Prosthodontics, College of Dentistry, King Khalid University, Kingdom of Saudi Arabia
*Corresponding Author: Kamran Bokhari Syed, Oral & Maxillofacial Surgery, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia.
Received: April 04, 2016; Published: April 21, 2016
Citation: Kamran Bokhari Syed., et al. “Prevalence of Musculoskeletal Disorders among Dentists in Aseer Region, Saudi Arabia”. EC Dental Science 4.2 (2016): 752-757.
Abstract
Background: Musculoskeletal disorders affect the health care of the society in general and dentist in particular. Repeated unnatural, deviated or inadequate working postures, forceful hand movements, inadequate equipment or workplace designs and inappropriate work patterns are likely to be the particular risk factors for these disorders. Physiological changes that accompany these disorders can be related to practices used by today’s operators – primarily being seated for prolonged periods.
Aims and Objectives: This study aims to assess the prevalence of musculoskeletal disorders among dentists in Aseer region, Southern region of Saudi Arabia.
Material and methods: A total of 300 questionnaires were circulated and were given a response time of 5 days. Of the 198 questionnaires, 114 were Saudi nationals and the rest 84 non-Saudis.
Results: Both Saudi and non-Saudi professionals had headache prominently as a leading complaint as compared to shoulder pain, backache, neck discomfort. Males had significantly higher symptoms as compared to females. Age group 2 i.e., 31-45 years had significantly higher symptoms. Headache was the prominent complaint in males whereas neck discomfort was the chiefly the complaint in females. Dentists working in University/academic set up had higher prevalence of musculoskeletal disorders than the private dentists.
Summary: The prevalence of musculoskeletal disorders is high though if not alarming among dentists in Asser region, Kingdom of Saudi Arabia. Results are statistically similar to other studies performed.
Keywords: Musculoskeletal; Disorders; Dentists; Saudi Arabia
Introduction
Musculoskeletal disorders have become increasingly common worldwide during the past decades [1]. It is a common cause of work-related disability among workers with substantial financial consequences due to workers compensation and medical expenses. Dental professionals commonly experience musculoskeletal pain during the course of their careers [2]. The physical load among dentists seems to put them at risk for the occurrence of musculoskeletal disorders [3]. Repeated unnatural, deviated or inadequate working postures, forceful hand movements, inadequate equipment or workplace designs and inappropriate work patterns are likely to be the risk factors.
The prevalence of general musculoskeletal pain ranges between 64% and 93%. The most prevalent regions for pain in dentists have been shown to be the back (36.3-60.1%) and neck (19.8-85%), while the hand and wrist regions were the most prevalent regions for dental hygienists (60-69.5%) [4]. The overall prevalence of musculoskeletal disorders varies with the age, expertise of the dentist and the overall hours of work. Accordingly, the symptoms vary which ranges from back pain to discomfort and neck discomfort. This has been represented in various studies i.e., prevalence of back pain as 57 percent, while the prevalence of low-back pain as 35.5 percent [5,6]. Musculoskeletal disorders affects the younger generation more. As such, musculoskeletal disorders represent a major occupational health issue [7].
This study aims to assess the prevalence of musculoskeletal disorders among dentists in Aseer region, Southern region of Saudi Arabia. No similar studies so far have been conducted in the southern part of Saudi Arabia. Results of similar studies conducted elsewhere have been compared in this study.
Aims and Objectives
1. To assess the prevalence of musculoskeletal problems among dentists in Aseer Province, Saudi Arabia.
2. To assess the most common symptom among dentists (shoulder pain, back ache/back pain, neck discomfort, headache).
3. To assess the age group and gender with higher prevalence.
4. To assess the specialty and type of work with higher prevalence of symptoms.
5. To suggest recommendations in teaching curriculum to create awareness of musculoskeletal disorders and thereby reduce them.
Materials and Methods
A self-administered questionnaire was designed. This was circulated among dental students, interns, specialists. Both governments, academic and private dentists were involved in the study. A total of 300 questionnaires were circulated and were given a response time of 5 days. 260 questionnaires were answered; of which only 198 were acceptable in terms of data entered.
The respondents are expected to give details of demographic data, work history and questions related to symptoms of musculoskeletal problems.
Results
Of the 198 questionnaires, 114 were Saudi nationals and the rest 84 non-Saudis. Both Saudi and non-Saudi professionals had headache prominently as a leading complaint as compared to shoulder pain, backache, neck discomfort. Males had significantly higher symptoms as compared to females (Graph 1).

Graph 1: Musculoskeletal Disorders in relation to Gender.

1. Male

2. Female

Graph 2: Musculoskeletal Disorders in relation to Age Group.

1 – 15 – 30 years

2 – 31 – 45 years

3 – 46 – 60 years

As shown in Graph 2, age group 2 i.e., 31-45 years had significantly higher symptoms. In this age group, again headache was the prominent symptom. In the age group 1. i.e., 15 - 30 years, neck discomfort was the prominent symptom. Headache was the prominent complaint in males whereas neck discomfort was the chiefly the complaint in females. Dentists working in University/academic set up had higher prevalence of musculoskeletal disorders than the private dentists (Graph 3).

Graph 3: Musculoskeletal Disorders in relation to Type of Work.

1- Government

2- Private

3- Academic

Among the specialists and students, headache was the prominent symptom. However, general dentists had significantly higher complaint of neck discomfort (Graph 4).

Graph 4: Musculoskeletal Disorders in relation to Type of Specialty.

1 -Specialists

1 -Specialists

3-Students

Discussion
Musculoskeletal problems have become a significant issue for profession of dentistry and dental hygiene [4]. These disorders develop over a period of time and are responsible for significantly affecting the working capacity of a dentist. Moreover, musculoskeletal disorders affect the health care of the society in general and dentist in particular. MSDs can affect the body’s muscles, joints, tendons, ligaments, and nerves from the neck to the feet [8]. Repeated unnatural, deviated or inadequate working postures, forceful hand movements, inadequate equipment or workplace designs and inappropriate work patterns are likely to be the particular risk factors for these disorders [9]. According to Sartorio F., et al. there is a sharp rise in the incidence of work-related musculoskeletal disorders (WMSD) [10]. There have been reports that the physical burden of clinical work is strongly associated with MSDs in dental health workers [11,12]. Stress, tension, and postural practices are other contributing factors which causes back and neck problems [13]. Abdul Jabbar TA conducted a study among Saudi population involving 140 dentists from the public dental service clinics in Dammam and Riyadh cities [3]. He was of the opinion that the high frequency of musculoskeletal disorders probably reflects the specific work load in dentistry, with high demands on vision and precision and fine manipulative hand movements and working with unsupported, elevated arms.
According to Hayes M., et al. the most prevalent regions for pain in dentist’s have been shown to be the back and neck [4]. In the present study, headache was the prominent symptom. Santos Filho SB and Barreto SM conducted a study among dentists in Brazil through a self-administered questionnaire and concluded that 58% reported with upper limb pain [14]. Akesson I., et al. conducted a study among Nordic population over a period of 5 years through questionnaire and stated that the symptoms of pain in elbows/wrists/hands increased over a period of time [15]. Alexopoulos EC., et al. conducted a study involving 430 dentists in Greece and concluded that the physical load among dentists seems to put them at risk for the occurrence of musculoskeletal disorders [1]. The present study did not evaluate the reason for symptoms such as headache or backache. But, certainly it is due to long appointments/physical strain, improper ergonomic posture along with psychosocial and other personal characteristics. Physiological changes that accompany these disorders can be related to practices used by today’s operators - primarily being seated for prolonged periods [16]. Turp JC and Werner EP discussed the pathophysiological mechanisms which are responsible for damages in detail and suggested gymnastic training program for dentists [17]. In a specific study to assess the musculoskeletal disorders among dentists in Saudi Arabia, apart from a questionnaire, other specific points were recorded. These included ergonomic examination, the sitting work postures, the clock-related working position, use of dental mirror and active neck mobility [3].
In the present study, headache was the prominent symptom. This must be related to longer periods of work, improper ergonomic posture, use of dental mirror and non-scheduled appointments. Age group 31 to 45 years had higher frequency of symptoms and these decreased with increasing age. This is related to higher work load and stress at this age group as pointed out in many studies. Males in our study had a more frequent complaint of headache whereas females complained more of neck pain closely followed by headache. Private practitioners were the least affected by any of the symptoms. University dentists had the highest complaints. This is obviously related to more number of patients in the university setup and the students and interns involved who ignore or are not aware of the musculoskeletal disorders in the long term practice. This is one basic reason why we suggest that the subject of musculoskeletal disorders be incorporated in the teaching schedule and a clinical demonstration be given for the ergonomic postures. Further, we recommend that specific percentage of marks be allotted in the examinations for dental graduate students. This must be followed by active interactive sessions by the interns who must present and demonstrate the impact of musculoskeletal disorders in community camps and CME programs.
Conclusion
1. The prevalence of musculoskeletal disorders is high though if not alarming among dentists in Asser region, Kingdom of Saudi Arabia. Results are statistically similar to other studies performed elsewhere.
2. The most common symptom was headache. This is in contrast to pain as primary symptom in other studies.
3. Age group 31-45 years complained of higher complaints. Males had a higher frequency of complaints than females.
4. University group had more prevalence of symptoms. Private Practitioners reported the least. This must be related to increased patient load in University set up and younger age group of students.
5. We recommend allotting specific percentage of marks related to musculoskeletal disorders in the teaching curriculum. Further, active interactive sessions by the interns and dental graduates are required. They must present and demonstrate the impact of musculoskeletal disorders in community camps and CME programs.
Bibliography
  1. Alexopoulos EC., et al. “Prevalence of musculoskeletal disorders in dentists”. Bio Med Central 5 (2004): 16.
  2. Valachi MS and Valachi K. “Mechanisms leading to musculoskeletal disorders in dentistry”. JADA 134 (2003): 1344-1350.
  3. Abdul jabbar TA. “Musculoskeletal disorders among dentists in Saudi Arabia”. Pakistan oral & Dental Journal28.1 (2008): 135-144.
  4. Hayes M., et al. “A systematic review of musculoskeletal disorders among dental professionals”. International Journal of Dental Hygiene 7.3 (2009): 159-165.
  5. Diakow PR and Cassidy JD. “Back pain in dentists”. Journal of Manipulative and Physiological Therapeutics 7.2 (1984): 85-88.
  6. Rundcrantz BL., et al. “Cervical pain and discomfort among dentists. Epidemiological, clinical and therapeutic aspects. Part 1”. A survey of pain and discomfort 14.2 (1990): 71-80.
  7. Leggat PA and Smith DR. “Musculoskeletal disorders self-reported by dentists in Queensland, Australia”. Australian Dental Journal 51.4 (2006): 324-327.
  8. Tzu-Hsien Lin., et al. “Prevalence of and risk factors for musculoskeletal complaints among Taiwanese dentists”. Journal of Dental Sciences 32.11 (1988): 1735-1737.
  9. Yamalik N. “Musculoskeletal disorders (MSDs) and dental practice Part 2. Risk factors for dentistry, magnitude of the problem, prevevntion, and dental ergonomics”. International Dental Journal 57.1 (2007): 45-54.
  10. Santorio F., et al. “Work-related musculoskeletal diseases in dental professionals. Prevalence and risk factors”. Giornale italiano di medicina del lavoro ed ergonomia 27.2 (2005): 165-169.
  11. Smith DR and Leggat PA. “Prevalence and distribution of musculoskeletal complaints among medical students”. Journal of Musculoskeletal Pain 15 (2007): 39-46.
  12. Smithg DR., et al. “Upper body musculoskeletal disorders among Australian occupational therapy students”. British Journal of Occupational Therapy 69 (2006): 365-372.
  13. Al Wazzan KA., et al. “Back and Neck Problems Among Dentists and Dental Auxiliaries”. The Journal of Contemporary Dental Practice 2.3 (2001): 017-030.
  14. Santos Filho SB and Barreto SM. “Occupational activity and prevalence of osteomuscular pain among dentists in Belo Horizonte, Minas Gerais State, Brazil: a contribution to the debate on work-related musculoskeletal disorders”. Cadernos de Saúde Pública 17.1 (2001): 181-193.
  15. Akesson I., “Musculoskeletal disorders among female dental personal - clinical examination and a 5-year follow-up study of symptoms”. International Archives of Occupational and Environmental Health 72.6 (1999): 395-403.
  16. Valachi B and Valachi K. “Mechanisms leading to musculoskeletal disorders in dentistry”. The Journal of the American Dental Association134.10 (2003): 1344-1350.
  17. Turp JC and Werner EP. et al. “Neck, shoulder and back problems in dentists”. ZWR 99.10 (1990): 807-808.
Copyright: © 2016 Kamran Bokhari Syed., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PubMed Indexed Article


EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005


EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777


EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347


EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478


EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253


EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033


EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992


EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505


EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793


EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211


EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047


EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560


EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318


EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819


EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840


EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344


EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476


EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658


EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489


EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278


EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108


EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571


EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333


EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883


EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001


EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937


EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723


EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726


EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603


EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646


EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616


EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290


EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226


EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812


EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268


News and Events


November Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the November issue of respective journals and can be viewed in the current issue pages.

Submission Deadline for January Issue

Ecronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the January issue of respective journals. Submissions are accepted on/before December 03, 2020.

Certificate of Publication

Ecronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

Ecronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.

Immediate Assistance

The prime motto of this team is to clarify all the queries without any delay or hesitation to avoid the inconvenience. For immediate assistance on your queries please don't hesitate to drop an email to editor@ecronicon.uk