Analysis of spine loads in dentistry—impact of an altered sitting position of the dentist

Max Wunderlich, Thomas Eger, Thomas Rüther, Andreas Meyer-Falcke, Dieter Leyk

.

DOI: 10.4236/jbise.2010.37090                

Abstract

Neck and low back pain causes highest disability rates in industrialized countries. Apart from blue-collar occupations dentists and dental care personnel are also strongly affected by work related back pain. However, due to missing analysing systems spine exposure could not be adequately estimated for sitting and non load bearing tasks. Therefore, a new biomechanical measurement system was developed to analyze spine and trunk kinematics. To explore the potential kinematics impact on the spine two days of periodontology care have been examined. Moreover, to asses the influence of an altered sitting position data was collected in 9 (day 1) and 12 (day 2) o’clock position. Data were collected and analyzed by the new 3D-SpineMoveGuard. The systems analyze postures and movements of spine and trunk by ultrasound and inclinometer. Two days of routine non-surgical periodontal treatment were recorded by a frequency of 10 Hz. Moderate awkward postures could be assessed for 90% of the treatment. Up to 85% of the working days were spent in isometric position. Movements were rare and of small amplitude. There were no relevant differences between 9 and 12 o’clock position. The frequently reported back pain in dentists is not only related to severe body postures rather than to the high amount of isometric spine loads. Moreover, an altered sitting position did not reduce this physiological stress. Therefore, dentist specific interventions concepts should pay more attention to physical training during and off work. Ergonomic investments should be carefully evaluated before implemented.

Keywords

Occupational Medicine; Periodontal Treatment; Back Pain, Ergonomics; 3D-SpineMoveGuard

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Schneider, S., Schmitt, H., Zoller, S. and Schiltenwolf, M. (2005) Workplace stress, lifestyle and social factors as correlates of back pain: A representative study of the German working population. International Archives of Occupational and Environmental Health, 78(4), 253-269.
[2]	Schneider, S. and Schiltenwolf, M. (2006) Occupations associated with a high risk of self-reported back pain: Representative outcomes of a back pain prevalence study in the Federal Republic of Germany. European Spine Journal, 15(6), 821-833.
[3]	Kumar, S. (2001) Theories of musculoskeletal injury causation. Ergonomics, 44(1), 17-47.
[4]	Juniper, M., Le, T.K. and Mladsi, D. (2009) The epidemiology, economic burden, and pharmacological treatment of chronic low back pain in France, Germany, Italy, Spain and the UK: A literature-based review. Expert Opinion on Pharmacotherapy, 10(16), 2581-2592.
[5]	Harkness, E.F., Macfarlane, G.J., Nahit, E.S., Silman, A.J. and McBeth, J. (2003) Risk factors for new onset low back pain amongst cohorts of newly employed workers. Rheumatology, 42(8), 959-968.
[6]	Hoogendoorn, W.E., Bongers, P.M., Vet, H.C.W., de Douwes, M., Koes, B.W., Miedema, M.C. Ari?ns, G.A. and Bouter, L.M. (2000) Flexion and rotation of the trunk and lifting at work are risk factors for low back pain: Results of a prospective cohort study. Spine, 25(23), 3087-3092.
[7]	Guay, A.H. (1998) Commentry: Ergonomically related disorders in dental practice. Journal of the American Dental Association, 129(2), 184-186.
[8]	Thornton, L.J., Barr, A.E., Stuart-Buttle, C., Gaughan, J.P., Wilson, E.R., Jackson, A.D., Wyszynski, C.T. and Smarkola, C. (2008) Perceived musculoskeletal symptoms among dental students in the clinic work environment. Ergonomics, 51(4), 573-586.
[9]	Wassan, A.L., Almas, K.A. and Shethri, S.E. (2001) Rückenund Nackenbeschwerden bei Zahn?rzten und zahnmedizinischem Personal. Journal of Contemporary Dental Practice, 2(3), 17-30.
[10]	Wunderlich, M., Rüther, T., E?feld, D., Rohde, U., Eger, T., Leyk, D. (2009) Rückenschmerzen und Wirbels- ?ulenbelastungen – Befragung des zahnmedizinischen Personals in der Bundeswehr. Wehrmed Mschr, 53(1), 230-234.
[11]	Leggat, P.A., Kedjarune, U. and Smith, D.R. (2007) Occupational health problems in modern dentistry: A review. Industrial Health, 45(5), 611-621.
[12]	Morita Europe GmbH, J. (2008) Dr. Beach ergonomic concept. Warum sich intuitive Arbeitswege lohnen und Rückenschmerzen nicht sein müssen. DDZ, 117(4), 188-189.
[13]	Marklin, R.W. and Cherney, K. (2005) Working postures of dentists and dental hygienists. CDA Journal, 33(2), 133-136.
[14]	Baum, K., Hoy, S. and Essfeld, D. (1997) Continuous monitoring of spine geometry: A new approach to study back pain in space. International Journal of Sports Medicine, 18(Suppl 4), 331-333.
[15]	Friedrich M (2002) Measuring lumbar sagittal posture in sewgae workers using an ultrasonic device. Journal of Musculoskelet Research, 6(3-4), 135-145.
[16]	Waddell, G. and Burton, A.K. (2001) Occupational health guidelines for the management of low back pain at work: evidence review. Occupational Medicine, 51(2), 124- 135.
[17]	Sj?gaard, G., Lundberg, U. and Kadefors, R. (2000) The role of muscle activity and mental load in the development of pain and degenerative processes at the muscle cell level during computer work. European Journal of Applied Physiology, 83(2-3), 99-105.
[18]	Leyk, D. (2009) The preventive and therapeutic roles of regular physical activity. Deutsches Aerzteblatt international, 106(44), 713-714.
[19]	Baum, K., Selle, K., Leyk, D. and Essfeld, D. (1995) Comparison of blood pressure and heart rate responses to isometric exercise and passive muscle stretch in humans. European Journal of Applied Physiology, 70(3), 240-245.
[20]	Davis, K.G. and Marras, W.S. (2000) The effects of motion on trunk biomechanics. Clinical Biomechanics, 15(10), 703-717.
[21]	Finsen, L., Christensen, H. and Bakke, M. (1998) Musculoskeletal disorders among dentists and variation in dental work. Applied Ergonomics, 29(2), 119-125.
[22]	Ratzon, N.Z., Yaros, T., Mizlik, A. and Kanner, T. (2000) Musculoskeletal symptoms among dentists in relation to work posture. Work, 15(4), 153-158.