Ergonomic risk factors associated with the practice of dental hygiene: a preliminary study.
Horstman SW; Horstman BC; Horstman FS
Prof Saf 1997 Apr; 42(4):49-53
Dental hygiene procedures were examined in order to determine the occupational risk factors leading to cumulative trauma disorders (CTDs). Three dental hygienists were videotaped during scaling/planing, polishing and flossing. The difficulty of the procedure was scored on a scale of one to four, in which class one represented the least periodontal movement and class four the most. The hygienists also completed a questionnaire. From 49.98 to 86.21% of the average exam involved scaling, which was considered the most manually challenging and stressful task. During scaling, both waving and rotary motion power strokes, incorporating wrist movement with a palm down hand position, were performed. Shoulder abduction, wrist flexion and extension, and back and neck flexion were regarded as the most physically demanding postures during scaling. During polishing, the two power stroke motions were performed as wrist flexion continued. Flossing, generally the shortest procedure, involved all of the motions discussed above. The grip diameters of scalers and probes ranged from 0.35 to 0.7 centimeters (cm). For the profiangle used during polishing, the grip measured 1.5cm and the nose measured 1.1cm. Each subject reportedly experienced pain and numbness of the hands and fingers and occasional to frequent difficulty gripping and handling instruments. One patient was diagnosed with carpal tunnel syndrome. The authors recommend scheduling difficult patients at varied times, ensuring that patients arrive promptly, stretching muscles between patients, frequently employing the cavitron, an ultrasonic scaler, and using tools with larger grip diameters.
NIOSH Publication; NIOSH Cooperative Agreement; Ergonomics; Health care personnel; Task performance; Body mechanics; Risk factors; Risk analysis; Occupational diseases; Hand injuries; Musculoskeletal system; Cumulative trauma disorders;
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