Predictors of work-related musculoskeletal disorders among dental hygienists

To cite this article:
Int J Dent Hygiene 10 , 2012; 265–269
DOI: 10.1111/j.1601‐5037.2011.00536.x Hayes MJ, Taylor JA, Smith DR. Predictors of work‐related musculoskeletal disorders among dental hygienists. Abstract: Objectives: Work‐related musculoskeletal disorders (MSD) have been recognized as a considerable problem for the dental hygiene profession, with the majority of professionals reporting musculoskeletal pain. The aim of this study was to investigate which risk factors may help predict MSD among Australian dental hygienists. Methods: A modified version of the Standardised Nordic questionnaire was distributed to registered hygienists throughout Australia. Results: Logistic regression analysis revealed a variety of work‐related and psychosocial factors that correlate with reported MSD, including scaling tasks, type of practice and work interference in home life. Statistical predictors for non‐reporting of MSD included wearing loupes, ergonomics education and wage satisfaction. Concerning is the impact on the profession, with an association between MSD and hygienists considering reducing working hours or even alternate careers. Conclusions: In general, it appears as though the causes of MSD among dental hygienists may be multifactorial, as may be the solutions to this problem. Further research is required to objectively examine whether controllable variables can be implemented as preventive strategies or interventions for MSD.     

A systematic review of musculoskeletal disorders among dental professionals

Abstract:  Musculoskeletal problems have become a significant issue for the profession of dentistry and dental hygiene. This review provides a detailed examination and discussion regarding the prevalence of musculoskeletal disorders (MSD) in dental personnel and possible causative factors. All research studies or literature reviews, which have reported on the prevalence of musculoskeletal symptoms and/or potential risk factors for this problem in dentists, dental hygienists and dental students, were selected for inclusion. Our literature suggests that 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%). Interestingly, we found that studies on MSDs among dental and dental hygiene students are quite limited. Many risk factors have been identified, including static and awkward posture and work practices. Overall, the review suggests that musculoskeletal problems represent a significant burden for the dental profession. More research in the form of larger studies is urgently required, to help more clearly elucidate the development of this important issue for dental hygienists and dental hygiene students.     

Attitudes toward National Health Insurance: dentists, dental students, and dental hygiene students

The attitudes toward National Health Insurance held by 126 second year dental students and 108 second year dental hygiene students enrolled in the state of Wisconsin, U.S.A., were measured and compared with the attitudes held by practicing dentists in the U.S.A. Although some similarities were noted, marked differences were revealed, with students, generally, preferring broader coverage and more government involvement than practicing dentists. There is virtually no published data in this area, and more research is needed, as the success or failure of any National Health Insurance plan depends critically on the altitudes of both health care providers and those studying to become health care providers.     

Impact of a periodontal course on oral hygiene and gingival health among senior dental students

This survey attempted to determine the impact of the periodontal course on oral hygiene and gingival health among 50 senior dental students. The course included the following: patient motivation, instruction in oval hygiene procedures and plaque control, scaling and curellage, temporary splinting and occlusal adjustment. Without advance notice, plaque deposits were scored using the Plaque Index and gingival health was determined using the Gingival Index. The results were collected at the beginning and at the end of the periodontal course (about 2 months). The results were analyzed using the paired t-test. No improvement of either oral hygiene or gingival health was noted at the end of the periodontal course. It seems that even some dental students, who should know the direct relationship between bacterial plaque and periodontal diseases and should be better motivated than the average patient, failed to demonstrate effective oral hygiene. It is difficult to expect an improvement of patient oral hygiene, when the patients have been motivated by students who are unable to perform satisfactory personal oral hygiene themselves. It is suggested that a greater emphasis be placed on patient motivation and instruction in oral hygiene throughout the dental curriculum.     

Attitudes of Italian dental and dental hygiene students toward tobacco-use cessation

Objective:  The aim of this study was to investigate the smoking habits of Italian dental and dental hygiene students and to assess their knowledge on the health effects of cigarette smoking and their attitudes toward tobacco-use cessation (TUC) in dental practice.
Materials and methods:  Data was collected from 220 students attending the Dental and Dental Hygiene Schools (DS and DHS, respectively) at the University of Palermo (Italy).
Results:  The percentage of smokers amongst DS and DHS students was similar (32.78% vs. 32.5%) with 67.77% of DS students and 77.5% of DHS agreeing that the damages to health caused by smoking were covered in their didactic course work. A high percentage of DS (63.33%) and DHS (67.5%) students reported the relationship between smoking and a number of associated health conditions. Both DS and DHS students showed poor knowledge of TUC interventions. Both DS and DHS students reported to be conscious of their own role as a counsellor, with DHS students feeling more comfortable in approaching counselling in clinical practice. Although DS and DHS students reported a positive attitude toward TUC interventions, almost half of the students had some concerns about the effectiveness of smoking cessation activities.
Discussion:  The introduction of a comprehensive tobacco education curriculum in DS and DHS programs could further improve students' perceptions and attitudes and provide knowledge and clinical experience which would lead to the incorporation of TUC into subsequent professional practice.     

An international review of musculoskeletal disorders in the dental hygiene profession

This review of the current literature is aimed at examining musculoskeletal disorders in dental hygienists, and investigates the complex nature of this significant occupational health issue. Musculoskeletal disorders (MSD) have been identified as a significant issue for the profession of dental hygiene. The purpose of this review is to examine and assemble the best evidence on the epidemiology, diagnosis, treatment, interventions, prevention, impact and consequences of MSD among the dental hygiene profession. The prevalence of MSD is alarming, with up to 96% reporting pain, and a number of occupational risk factors have been identified by the literature. Studies investigating interventions are generally limited in their study design, which is concerning given the huge impact MSD can have on the practising dental hygienist. Overall, it is evident from the literature that MSD is a complex and multifactorial problem. However, a complete understanding of the progression of musculoskeletal disorders is still far from being realised, due to the lack of longitudinal studies and standardised research techniques. Future research should implement triangulation methods in longitudinal studies, a strategy which will go a long way in the understanding of this complex occupational health issue.     

Burnout,depression and suicidal ideation in dental and dental hygiene students

Introduction

The aim of this study was to assess the relationship between burnout, depressive symptoms and suicidal ideation in dental and dental hygiene students and to evaluate the influence of gender, programme type and year of study.

Subjects and methods

Third‐ and fourth‐year dental (DS) and first‐ and second‐year hygiene students (DHS) completed the Patient Health Questionnaire (PHQ‐9) and an abbreviated Maslach Burnout Inventory online as measures of depressive symptoms/suicidality and burnout, respectively. The statistical analyses included summary statistics and tests for intergroup comparisons (chi‐square) to evaluate the influence of gender, programme type (DHS or DS) and year of study. Correlations between depression, suicidality and burnout were also conducted.

Results

A total of 32 dental hygiene and 119 dental students participated. 40% of the dental and 38% of the hygiene students met criteria for burnout. No differences were found between years or between programmes. Nine per cent of both dental and hygiene students were above the cut‐off for moderate depressive symptoms, but there were no statistical differences between the third‐ and fourth‐year dental and the first‐ and second‐year hygiene students. Six per cent of the dental and 9% of the dental hygiene students were above the cut‐off for clinically significant suicidal ideation, but there were no statistical differences between dental and hygiene students. There were no differences noted in the dental students based on gender for any of the measures. Depression was significantly associated with all three subscales of burnout. Suicidal ideation was only significantly related to the lack of personal accomplishment subscale of burnout.

Discussion

These findings suggest the need for introducing preventive measures for such affective states in dental and dental hygiene training programmes.     

Oral hygiene and gingival health in Danish dental students and faculty

This survey attempted to determine the status of oral cleanliness and gingival health in 150 dental students and 101 faculty members in a dental school. Without advance notice, plaque deposits were scored, using the Plaque Index System, and gingival health was determined using the criteria of the Gingival Index System. The 1st-year students had the poorest hygiene and gingival health. An improvement (P less than 0.01) was noted in the 2nd-year students who were still not in clinical training but had completed a course in preventive dentistry including oral hygiene techniques. Further improvement (P less than 0.05) was found in students participating in the clinical courses (3rd and 4th years). However, some deterioration of both hygiene and gingival status occurred in the senior 5th year. Among the faculty, the best oral hygiene and gingival state were found in members of departments in which clinical work centered around patient motivation toward prevention and tooth conservation. The scores for plaque and gingivitis were worse in the departments of oral surgery, dental materials, orthodontics and the basic science departments. Almost all departments and every class showed a few individuals with very poor oral hygiene. It is suggested that regular patient contact influences the personal attitude toward oral hygiene, and that professional activity and emphasis on different aspects of the curriculum may be reflected in the attitude of health professionals toward oral health.     

Oral hygiene levels and behaviour in pre-clinical and final-year dental students

The oral hygiene levels and behavior in pre-clinical and final-year dental students attending Birmingham University 1977 were investigated. Gingival inflammation, bacterial plaque and calculus accumulations were clinically recorded. Tooth cleaning habits were assessed by a questionnaire. Oral hygiene habits differed between the two groups and an improvement in oral hygiene levels was evident in the final-year students. Statistically significant differences (P is less than 0.05) were found between the plaque index scored of the pre-clinical and final-year students, and for the gingival and calculus index scores of the male students. Thus in this investigation it was possible to show that improvement in oral hygiene does occur between the pre-clinical and final year of the undergraduate course.     

An assessment of oral self-care level among Japanese dental hygiene students and general nursing students using the Hiroshima University – Dental Behavioural Inventory (HU-DBI): Surveys in 1990/1999

PURPOSE: The purpose of this study was to determine the differences in oral self-care levels between Japanese dental hygiene students and general nursing students in 1999, and compare them with a similar study in 1990. METHODS: The examination was mainly based upon responses to a questionnaire titled "Hiroshima University--Dental Behavioural Inventory (HU-DBI)". Higher scores of the HU-DBI indicate better oral health attitudes/behaviour. RESULTS: The mean HU-DBI score of the 2nd-year dental hygiene students was significantly greater than that of the 2nd-year nursing students (9.56 and 6.65, respectively; p<0.001), and much higher than those of the 1st-year students at each course (dental hygiene course; 6.30, nursing course; 5.88). Except for the 2nd-year dental hygiene class, there were no significant differences in the HU-DBI score between the 1990 and 1999 subgroups of each class. About 1/3 of the 2nd-year nursing students reported a belief that they may eventually require false teeth, while 6% of the 2nd-year dental hygiene students held this belief. More than 60% of this study sample stated that they put off going to the dentist until they had toothache. The 2nd-year dental hygiene students were more likely to have this attitude than their 1990 peers. Flossing was not popular among the nursing students in either 1990 or 1999. CONCLUSION: Although the difference in the HU-DBI score across time was not major, the variation in HU-DBI and the favourable attitudes/behaviour toward oral health appeared to reflect the differences in schooling between student hygienists and student nurses.     

Prevalence of upper extremity symptoms and disorders among dental and dental hygiene students

CONTEXT: Upper extremity musculoskeletal disorders are common among dental professionals. The natural history of these disorders is not well-understood. These disorders are more common in older workers, but the prevalence among younger workers has not been well-studied. OBJECTIVE: The objective of this study was to determine if dental/dental hygiene students had a similar prevalence of upper extremity musculoskeletal disorders compared to age-matched clerical workers. We hypothesize students will have a lower prevalence of upper extremity musculoskeletal disorders compared to clerical workers. DESIGN: This was a cross-sectional design. SETTING: Dental and dental hygiene students from three schools were compared to clerical workers from three locations (an insurance company and two data processing plants). SUBJECTS: There were 343 dental and dental hygiene students and 164 age-matched clerical workers. MAIN OUTCOME MEASURES: Regional discomfort was the primary outcome. The secondary health outcomes were diagnoses of carpal tunnel syndrome and upper extremity tendinitis. RESULTS: Clerical workers had a higher prevalence of hand symptoms (62 percent vs. 20 percent), elbow symptoms (34 percent vs. 6 percent) and shoulder/neck symptoms (48 percent vs. 16 percent) and a higher prevalence of carpal tunnel syndrome (2.5 percent vs. .6 percent) and upper extremity tendinitis (12 percent vs. 5 percent). The clerical workers were more obese, smoked more, exercised less frequently, and had lower educational levels and less control of their work environment. CONCLUSIONS: Dental and dental hygiene students have a very low prevalence of upper extremity musculoskeletal disorders. A longitudinal study is necessary to evaluate ergonomic and personal risk factors.     

广州市大学生牙侵蚀症患病情况与影响因素分析

目的 调查广州市大学生牙侵蚀症患病情况及影响因素,为牙侵蚀症的预防提供必要信息.方法 分层选取广州市6所高等院校,调查16～24岁学生1704人.临床检查是否患牙侵蚀症及其严重程度,问卷调查其社会经济状况、饮食习惯、口腔卫生习惯及其他相关情况.卡方检验和Logistic回归分析牙侵蚀症的影响因素.结果 501人患牙侵蚀症(29.4%).好发牙面以切缘或胎面最常见,占66.1%(5491/8311);唇、颊面次之,占31.0%(2574/8311);舌、腭面少见,占3.0%(246/8311).Logistic回归分析结果 显示,非独生子女、女性、每周喝碳酸饮料1次以卜和每周喝酸性饮料量500 ml以上者患病可能性较大.结论 广州市大学生中非独生子女和女性是牙侵蚀症重点预防人群,减少饮用酸性饮料是重要的预防措施.     

Perceptions of Japanese and Canadian dental hygiene students towards their profession

Abstract: Objectives: The purpose of this study was to investigate perceptions towards the profession and level of self‐esteem of Japanese and Canadian dental hygiene students. Methods: Third year dental hygiene students enrolled in a Japanese and a Canadian dental hygiene programme were asked to participate in a survey study. An instrument was developed to obtain students’ opinions about the profession. The present study also explored dental hygiene students’ levels of self‐esteem, and the relationship with perceptions towards profession. Results: Scores for dimensions including ‘Motivation’, ‘Expectation’ and ‘Environment’ were significantly higher among the Canadian students over Japanese students. The level of explicit self‐esteem of the Canadian students was significantly higher than that of the Japanese students, and it was positively correlated with their expectations of the profession. Conclusions: There were significant differences in perceptions between Japanese and Canadian dental hygiene students. It is suggested that educational strategies should be planned to positively influence the students’ perceptions toward the profession and improve the level of self‐esteem.     

A dialectical analysis of an art of dental hygiene practice

Abstract: Objective: There has been little in the literature to date that speaks of an art of dental hygiene compared to science. Yet, science, conceived as the findings from research, does not apply itself; it is the knowledge, judgement and skill of practitioners to apply these findings in a particular setting that, at its highest level, informs artful dental hygiene practice. The purpose of this paper is to question whether an art of dental hygiene exists, if it is important, and how it relates to science. Methods: The method used in the analysis contained in this paper is a dialectical approach used to examine contrary positions, i.e. whether art exists or does not exist, by outlining the structure of each position and clarifying explicit and implicit similarities and dissimilarities. A framework of conceptualizations of art from nursing has been used to examine dental hygiene literature for evidence of art. Results: A preliminary conceptualization, substantiated within dental hygiene, sees the art of dental hygiene as abilities to grasp meaning in client encounters, establish meaningful connections with clients, perform dental hygiene actions skillfully and proficiently, rationally determine courses of dental hygiene action, and conduct dental hygiene practice morally and ethically. Conclusions: That an art of dental hygiene exists is not in doubt and the analysis is presented. To understand better how dental hygienists make practice decisions to develop this process to its optimum – the pursuit of perfection and excellence in dental hygiene practice, we must pursue understanding the art of dental hygiene practice.