Muskuloskeletal disorders among dental surgeons at selected private dental hospitals in dhaka city *

a. Senior lecturer, Department of Paediatics dentistry, Update Dental College and hospital b. Dental Surgeon, Aesthetic Dental Clinic, Dhaka. c. Associate professor and Head, Department of Prosthodontics, Update Dental College and hospital. d. Assistant professor and Head, Department of Paediatics dentistry, Update Dental College and hospital. e. Medical Officer, Institute of epidemiology disease control and research (IEDCR.) f. Associate Professor, Department of conservative dentistry, Update Dental College and hospital.


Introduction
Musculoskeletal disorders are common in several professions.It is considered one of the major occupational hazards and dentistry is one of them.A dental surgeon has a little area for intervention.So, he needs to be cautious all the time.Besides, the dentists have to sit a long time at a stretch or sometimes need to stand in a little bit odd position.So, their vertebral column as well as weight transmitting bones becomes exhausted.Oral cavity space is so narrow that if concentration is lost then severe injury may occur at any time.Pressure on eyes, brain, hands and accordingly vertebral column, waist and hip becomes exhausted in dental activities. 1,2ometimes mental pressure is also become a factor for the dentist, which causes fatigue, depression and deliberate self harm.Musculoskeletal disorders like pain, weakness are commonly found among dental surgeon.When dentistry changed from a standing job to a sit down task, musculoskeletal pain in the neck and shoulder region became more prevalent.This may explain the eventual focus on these areas. 7,8,9owever, musculoskeletal pain in the lower back, regardless of occupation, remains a constant cause of loss of work for dentists and should be equally examined.Because dentists spend long hours hunched over their patients with their arms raised and their hands positioned relative to their patients' mouths, supported stress is placed on the muscles of the lower back.The scenario of Bangladesh has no differences than the other parts of the world. 3,4,5,6There are a lot of studies on pain disorders of dentists all over the world, but the life style and pattern of daily dental treatment procedures such as posture, gesture etc is not changed a lot, so that the suffering are remaining.This study aimed to find out the musculoskeletal disorders among the dentists working in different level of private dental hospitals of Dhaka city.

Materials and methods:
Simple random sampling method was used as sampling technique for this current study.In Dhaka city (North) there were five private dental colleges were selected purposively.A list dental surgeons working in these dental colleges was prepared.Around 130 dental surgeons were included as per inclusion criteria.Dental surgeons, practicing minimum for five years in private dental hospitals of Dhaka city (North).Those who were not physically or mentally fit for participating in the study.

Results:
A cross-sectional study was conducted to determine the musculoskeletal disorders among dental surgeons at selected private dental hospitals in Dhaka city.Data was collected by using pre-tested, semi structured questionnaire.The interview was done in face to face with respondents.After collecting the data, it was cleaned accordingly and later analyzed by SPSS version 16.The overall results of the study have been presented in tabular form thereby interpreting the results in this chapter the following main headings.

Socio-demographic
Characteristics, Ergonomics Related Issues, Work Related Health Problems.

Discussion
A cross-sectional study was conducted to find out the musculoskeletal disorders among dental surgeons at selected private dental hospitals in Dhaka city.Among the respondents of the current study majority (43.8%) of the both male and female respondents were of in the age group of 36-40 years age followed by one-fifth in the age group of over 50 years, another fifth in the age group of up to 35 years, thirteen percent in the age group of 41-45 years (Mean 41.34±7.658years).Among the respondents two-third was male.By professional educational near about sixty percent were post graduate and eighty five percent general practitioners with male predominance. 15,16,17,18ong the respondents two-third were found working for more than 8 hours per day (Mean 8.80±1.646hours) and half of the respondents are practicing for up to 10 years (Mean 14.21±8.971years). 19 physical movement the current study reported that 46.9% respondents have to work in sitting posture for more than 6 hours per day, 50% in standing position for 3 hours per day.Repetitive hand movements need in 46.9% respondents during their works for 4 hours per day and with bent trunk for 3 hours, and 75% have to work for 3 hours with turned shoulder. 10,11,12,13The current study revealed that among the respondents ninety percent are suffering from pain during work in last 3 months.Study conducted in Polland 20 found that over 92% of the surveyed dentists experienced MSDs. 14The prevalence of MSDs stated in other studies was slightly lower than presented here.For example only 62% of Greek dentists 21 and 54-92% of Italian dentists 22 reported at least one musculoskeletal complaint.By severity of pain more than half had moderate pain, near about forty percent had mild pain.For pain more than half miss their practice.
By site of pain ninety percent respondents mentioned that they are suffering from pain at neck & shoulder, forty five percent at elbow, two-third at wrist & hand, eighty percent at upper back and at Lower back.In study in Polland 20 MSD pain was found in the neck (47%) and lower back (35%), 20%

Conclusion
The current study concludes that around ninety percent of dental surgeons of the current study are suffering from MSDs.By site of pain ninety percent had from pain at neck & shoulder, forty five percent at elbow, twothird at wrist & hand, eighty percent at upper back and at Lower back.The severity of pain more than half had moderate pain, near about forty percent had mild pain.For pain more than half miss their practice.The symptoms of MSDs increase with the number of years of practice.

Table 5 : Distribution of respondents by suffering from pain during work in last 3 months
23sociation between missing in practice due to MSD was found more among the respondents who work more than 8 hours per day (69.2%) and who had professional experience more than 10 years or less (29.2%).Statistically it was found significant (p<0.05).23