Pain and discomfort in the musculoskeletal system among dentists.

The dentists in the Public Dental Service were found to have a high prevalence of pain and discomfort in the locomotor system. Only 60 (17%) dentists reported no pain or discomfort in the study in 1987. Of 359 dentists 72 per cent reported headache and pain and discomfort in the neck and shoulders. Female dentists had a higher prevalence of pain and discomfort. Younger dentists had pain and discomfort in the neck, shoulders and headaches to a greater extent than older dentists. Male dentists, who positioned their patient carefully to gain a direct view suffered less from headache. Furthermore, dentists who used the mirror reported less headache and pain and discomfort in the shoulders. Differences in working position in a simulated case were analysed during a visit to the workplace of 143 dentists. The ergonomic examination showed that dentists without symptoms applied a wedge cushion under the upper part of the patient's back to obtain an optimum view when they examined tooth 2 6 d. They also made use of the pauses intrinsic in the work. The dentists with symptoms experienced the workload as more unsatisfactory, were more burdened by anxiety, had poorer psychosomatic health and less confidence in the future than the dentists without symptoms. Specialists, both with and without cervico-brachial symptoms, were more satisfied with their personal control over their work and the stimulation from their work than were general practitioners. The specialists also had more self-confidence, and experienced less anxiety than general practitioners and head dentists. Physiotherapy with a psychosomatic approach and individual ergonomic instruction gave better relief from pain and discomfort and an increased feeling of mental well-being than did ergonomic instruction only. In the prospective study it was found that the prevalence of musculoskeletal pain and discomfort had increased since 1987, except with respect to low back pain and headache. However, the only significant difference was found with respect to the shoulders. As in 1987, female dentists had a higher prevalence of pain and discomfort in the neck and shoulders than their male colleagues in 1990. It can be concluded that pain and discomfort in the locomotor system among dentists had a high incidence. The high incidence among dentists could not be explained by the ergonomic risk factors such as positioning of the patient, use of the mirror or alteration of the dentist's position. Regression analysis showed that personal harmony and age had the highest value for explaining the number of painful sites in the musculoskeletal system.