Background: Previous evidence indicated that musculoskeletal disorders (MSDs) are highly prevalent among dentists. However, limited data are available on the prevalence and predictors for cervical and lumbar pain, the two most common subtypes of MSDs reported internationally.
Aim and objective: The aim and objective of this nationwide cross-sectional study was to assess the prevalence and predictors of cervical and lumbar pain among dental interns in Saudi Arabia.
Materials and methods: Data were collected using an online survey that was distributed to dental interns who graduated during the 2018–2019 academic year from all dental schools in Saudi Arabia. The survey included questions related to sociodemographic characteristics, symptoms of MSDs, and ergonomic preventive practices. Bivariate and multivariate logistic regression analyses were performed to assess several predictors of cervical and lumbar pain among our sample population.
Results: Of the 1,552 eligible interns, 889 (57%) completed the survey (mean age: 24.8 years, 55% female), with 65% enrolled at public universities. The overall prevalence of cervical pain was 41%, and the corresponding prevalence for lumbar pain was 32%. Female participants had significantly higher odds of reporting cervical pain [odds ratio (OR): 2.02, p <0.001]. Participants who typically avoid excessive bending and twisting were significantly less likely to report cervical pain and lumbar pain (OR: 0.51, p <0.001, and 0.46, p <0.0001, respectively).
Conclusion: Cervical pain and lumbar pain are highly prevalent among Saudi dental interns. Female sex was identified as a potential risk factor for cervical pain, and avoiding bending and twisting during dental work was identified as a protective factor for cervical and lumbar pain.
Clinical significance: Our results indicate that cervical and lumbar pain represent relevant health issues for dental students. Our data add further support to the notion that dental schools should consider enhancing training on dental ergonomics, enabling healthier careers for future dentists in Saudi Arabia.
Hoy D, March L, Brooks P, et al. The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis 2014;73(6):968–974. DOI: 10.1136/annrheumdis-2013-204428.
Hoy D, March L, Woolf A, et al. The global burden of neck pain: estimates from the global burden of disease 2010 study. Ann Rheum Dis 2014;73(7):1309–1315. DOI: 10.1136/annrheumdis-2013-204431.
Dagenais S, Caro J, Haldeman S. A systematic review of low back pain cost of illness studies in the United States and internationally. Spine J 2008;8(1):8–20. DOI: 10.1016/j.spinee.2007.10.005.
Gedin F, Alexanderson K, Zethraeus N, et al. Productivity losses among people with back pain and among population-based references: a register-based study in Sweden. BMJ Open 2020;10(8):e036638. DOI: 10.1136/bmjopen-2019-036638.
Carregaro RL, Tottoli CR, Rodrigues DD, et al. Low back pain should be considered a health and research priority in Brazil: lost productivity and healthcare costs between 2012–2016. PLoS One 2020;15(4):e0230902. DOI: 10.1371/journal.pone.0230902.
Martin BI, Deyo RA, Mirza SK, et al. Expenditures and health status among adults with back and neck problems. JAMA 2008;299(6):656–664. DOI: 10.1001/jama.299.6.656.
Roseen EJ, Rajendran I, Stein P, et al. Association of back pain with mortality: a systematic review and meta-analysis of cohort studies. J Gen Intern Med 2021:1–1. DOI: 10.1007/s11606-021-06732-6.
Buchbinder R, van Tulder M, Öberg B, et al. Low back pain: a call for action. Lancet 2018;391(10137):2384–2388. DOI: 10.1016/S0140-6736(18)30488-4.
Hayes MJ, Cockrell D, Smith DR. A systematic review of musculoskeletal disorders among dental professionals. Int J Dent Hyg 2009;7(3):159–165. DOI: 10.1111/j.1601-5037.2009.00395.x.
Valachi B, Valachi K. Mechanisms leading to musculoskeletal disorders in dentistry. J Am Dent Assoc 2003;134(10):1344–1350. DOI: 10.14219/jada.archive.2003.0048.
Gaowgzeh RA, Chevidikunnan MF, Al Saif A, et al. Prevalence of and risk factors for low back pain among dentists. J Phys Ther Sci 2015;27(9):2803–2806. DOI: 10.1589/jpts.27.2803.
Vijay S, Ide M. Musculoskeletal neck and back pain in undergraduate dental students at a UK dental school—a cross-sectional study. Br Dent J 2016;221(5):241–245. DOI: 10.1038/sj.bdj.2016.642.
Leggat PA, Kedjarune U, Smith DR. Occupational health problems in modern dentistry: a review. Ind Health 2007;45(5):611–621. DOI: 10.2486/indhealth.45.611.
Von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Bull World Health Org 2007;85(11):867–872. DOI: 10.2471/BLT.07.045120.
Kuorinka I, Jonsson B, Kilbom A, et al. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon 1987;18(3):233–237. DOI: 10.1016/0003-6870(87)90010-x.
Hayes MJ, Smith DR, Cockrell D. Prevalence and correlates of musculoskeletal disorders among Australian dental hygiene students. Int J Dent Hyg 2009;7(3):176–181. DOI: 10.1111/j.1601-5037.2009.00370.x.
Rising DW, Bennett BC, Hursh K, et al. Reports of body pain in a dental student population. J Am Dent Assoc 2005;136(1):81–86. DOI: 10.14219/jada.archive.2005.0032.
Milerad E, Ericson MO, Nisell R, et al. An electromyographic study of dental work. Ergonomics 1991;34(7):953–962. DOI: 10.1080/00140139108964837.
Jonker D, Rolander B, Balogh I. Relation between perceived and measured workload obtained by long-term inclinometry among dentists. Appl Ergonom 2009;40(3):309–315. DOI: 10.1016/j.apergo.2008.12.002.
Katano K, Nakajima K, Saito M, et al. Effects of line of vision on posture, muscle activity and sitting balance during tooth preparation. Int Dent J 2021;S0020-6539(20)36556-4. DOI: 10.1016/j.identj.2020.12.025.
Rollman GB, Lautenbacher S. Sex differences in musculoskeletal pain. Clin J Pain 2001;17(1):20–24. DOI: 10.1097/00002508-200103000-00004.
Wijnhoven HA, De Vet HC, Picavet HS. Prevalence of musculoskeletal disorders is systematically higher in women than in men. Clin J Pain 2006;22(8):717–724. DOI: 10.1097/01.ajp.0000210912.95664.53.
Kumar DK, Rathan N, Mohan S, et al. Exercise prescriptions to prevent musculoskeletal disorders in dentists. J Clin Diagn Res 2014;8(7):ZE13. DOI: 10.7860/JCDR/2014/7549.4620.
Peros K, Vodanovic M, Mestrovic S, et al. Physical fitness course in the dental curriculum and prevention of low back pain. J Dent Educ 2011;75(6):761–767. DOI: 10.1002/j.0022-0337.2011.75.6.tb05103.x.
Pîrvu C, Pătraşcu I, Pîrvu D, et al. The dentist's operating posture–ergonomic aspects. J Med Life 2014;7(2):177. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4151237/
De Sio S, Traversini V, Rinaldo F, et al. Ergonomic risk and preventive measures of musculoskeletal disorders in the dentistry environment: an umbrella review. Peer J 2018;6:e4154. DOI: 10.7717/peerj.4154.