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Year : 2017  |  Volume : 15  |  Issue : 1  |  Page : 48-52

Occupational Hazards Among Western Indian Private Dental Practitioners: A Questionnaire-Based Descriptive Study

1 Public Health Dentistry, Rajasthan Dental College and Hospital, Jaipur, Rajasthan, India
2 Oral Medicine and Radiology, Rajasthan Dental College and Hospital, Jaipur, Rajasthan, India

Date of Web Publication14-Mar-2017

Correspondence Address:
Jitender Solanki
Public Health Dentistry, Rajasthan Dental College and Hospital, NH-8, Ajmer Road, Bagru Khurd, Jaipur 302026, Rajasthan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2319-5932.201926

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Introduction: Occupational hazards among oral health care providers are becoming a major problem. Aims: To assess various occupational hazards and assess the musculoskeletal problems and their association with the work pattern. Materials and Methods: A questionnaire-based descriptive study was conducted among 525 private dental practitioners of Jodhpur city. Self-administered questionnaire was distributed and obtained immediately after the participants filled it. The data collected were tabulated and subjected to statistical analysis using the Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL, USA) version 18 software. Chi-square test was used to find the association. Results: Among the study group of 525 dentists, 300 were males and 225 females. Sitting dentistry was practiced by 61.7% and only 18.8% practiced standing dentistry. Dentists suffering from back pain were 40.7% whereas only 4.1% of dentists had shoulder pain. A highly significant correlation was observed between posture of dentists and musculoskeletal problems (P = 0.001). When chi-square test was used to assess the correlation among years of working experience and musculoskeletal problems, a significant relation was observed (P = 0.000). Conclusion: Almost all the private dental practitioners were suffering from the occupational hazards. Back problems were common. Regular training and workshops can help lower such problems.

Keywords: Dental practitioners, musculoskeletal problems, occupational hazard, standing dentistry

How to cite this article:
Solanki J, Gupta S. Occupational Hazards Among Western Indian Private Dental Practitioners: A Questionnaire-Based Descriptive Study. J Indian Assoc Public Health Dent 2017;15:48-52

How to cite this URL:
Solanki J, Gupta S. Occupational Hazards Among Western Indian Private Dental Practitioners: A Questionnaire-Based Descriptive Study. J Indian Assoc Public Health Dent [serial online] 2017 [cited 2022 Jan 18];15:48-52. Available from: https://www.jiaphd.org/text.asp?2017/15/1/48/201926

  Introduction Top

In the 18th century, the role of occupation in health and disease was recognized by Bernadino Ramazzini, the “Father of Occupational Medicine.” Occupational hazard can be defined as the risk to the health of a person usually arising out of employment. It can also refer to work, material, substance, process, or situation that predisposes or itself causes accidents or disease at work place.[1] Dental practitioners are at a great risk of occupational hazards, as they perform dental procedures due to which they come in direct contact with the blood and other oral fluids which in case of an infected patient can be a source of several infections. Because of limited accessibility in the oral cavity, the dentists perform the dental procedure in awkward posture which is not recommended and are at risk of musculoskeletal problems.[2],[3]

The other big problem faced by the dentists is the musculoskeletal problems due to long working hours while sitting or standing in one position only. The various hazards associated with dentistry are infectious (viral and bacterial), psychological (stress), allergic (latex gloves, dental materials, detergents, lubricants, solvents, and X-ray processing chemicals), and physical (musculoskeletal, radiological exposure, and anesthetic gases).[4],[5],[6],[7],[8],[9],[10],[11],[12],[13],[14],[15]

Various studies have been conducted in the past on the risk of viral infections, still one of the biggest problems faced by the dentists, the musculoskeletal disorders, remains neglected. Therefore, a need was felt to conduct a study to assess the various occupational hazards among the private dental practitioners and assess the musculoskeletal problems and their association with the working style, years of working, and hours of working per week of private dental practitioners in western Indian population.

  Materials and Methods Top

A questionnaire-based descriptive study was conducted among private dental practitioners of western Rajasthan in India. A list of private dental practitioners was obtained from the local Indian Dental Association (IDA) office. From the list, 525 private dental practitioners were selected randomly based on the inclusion and exclusion criteria. After selection, the participants’ prior appointment was obtained, and individual participants were visited at their work place. The study was conducted over a period of 2 months between February and March 2014. The reliability of the questionnaire was assessed by using Cronbach’s alpha (0.8). The questionnaire was distributed and obtained immediately after the participants filled them.

The data were obtained using a self-administered questionnaire that included questions on personal data (name, age, and sex), number of years of private practice experience, awareness of occupational hazards, safety measures practiced, type of occupational hazard experienced while practicing, working hours per week, and working style (standing or sitting).

The data collected were then tabulated and subjected to statistical analysis using the Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL, USA) version 18 software, and P < 0.05 was considered as statistically significant. Chi-square test was used to find association between the variables.

  Results Top

The study was done to assess occupational health problems in private dental practice in western Rajasthan population. Among the total study group of 525 dentists, 300 were males and 225 females. The participants were of the age of 26–68 years and based on the inclusion and the exclusion criteria. Maximum dentists practiced sitting dentistry (61.7%) and only 18.8% practiced standing dentistry.

Maximum number of dentists had the experience of 5–10 years (34.6%) and only 5.7% had the experience of more than 20 years of dental practice [Table 1]. 25.9% of the dentists were working 52 h per week and 11.07% of the dentists 60 h per week [Table 2].
Table 1: Working experience of the dentists

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Table 2: Number of hours dentists work per week

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Majority of the dentists (40.7%) were suffering from back pain whereas 4.1% of the dentists had shoulder pain; 2.4% of the dentists did not have any musculoskeletal problems [Table 3]. It was found that every dentist had experienced some or the other occupational hazards, 512 dentists were suffering from musculoskeletal problems, followed by stress in 264 dentists, and hazards due to nitrous oxide gas were seen only in a single dentist [Table 4].
Table 3: Musculoskeletal problems experienced by dentists

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Table 4: Occupational hazards experienced by dentists

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Regarding safety measures taken by the dentists during their dental practice, it was found that there were two dentists who did not sterilize their instruments before use, only 12.7% of the dentists used protective eyewear during their dental practice, and only 5.1% of the dentists disposed the dental waste properly [Table 5].
Table 5: Safety measures taken during dental practice

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A highly significant association was observed between posture of dentists and musculoskeletal problems (P = 0.001) [Table 6]. Similarly, a significant association was observed among years of working experience and musculoskeletal problems (P = 0.001) [Table 7]. A significant association was observed among working hours per week and musculoskeletal problems (P = 0.001) [Table 8].
Table 6: Association between posture and musculoskeletal disorders

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Table 7: Years of working and musculoskeletal disorders

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Table 8: Working hours and musculoskeletal disorders

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  Discussion Top

In the present study, it was observed that the sitting dentistry was practiced by 61.7% of the dentists and 18.8% preferred practicing dentistry by standing. Similar results of 59.5 and 20.1%, respectively, were obtained by a study done by Fasunloro and Owotade.[1]

Number of hours a dentist works directly affects his health, especially the strained posture the dentist is in while treating a patient, which causes stress on the spine and limbs and is a major cause for musculoskeletal problems that dentists face.[16] In the present study, 25.9% of the dentists worked for 52 h per week which is a considerable amount of time and due to uncomfortable posture, bent head, and movements of head and neck repeatedly lead to musculoskeletal problems.[17] Stress during working dental practice is also a matter of concern in the present study; 50.2% of the dentists had stress while working on patients. Various clinical procedures such as unanticipated emergency situations, anesthetization of patients, if the patient is not satisfied with the treatment, and unskillful treatment planning contribute to development of situations, which lead to high blood pressure, fatigue, tiredness, and increased stress.[18]

Musculoskeletal problems are the most commonly seen ones in dentists when they start practicing dentistry that affect their neck, back, spine, shoulder, and waist.[19] It was observed in the present study that almost every dentist had the musculoskeletal problems and only 2.4% of dentists were free from musculoskeletal problems. Similar results were obtained by studies done in Finland; it reports musculoskeletal symptoms from the back and neck of 30% of the dentists.[19] It has been proven that postures, which may exert a higher pressure on intervertebral disk as well as prolonged spinal hypomobility, are among important factors leading to degenerative changes in the lumbar spine and subsequent lower back pain.[20]

Gloves and mask are integral parts of dentistry without which dentistry is impossible. The gloves and mask form an inbuilt barrier against various pathogens, and as recently shown, they also provide a very good barrier against viruses, bacteria, and various infectious agents provided that the gloves and mask are intact. Latex gloves have been worn routinely in dental profession for more than two decades and are the basis of good infection control strategies. However, the residual or integral chemical components pose a potential health hazard to some dental staff and patients.[21] In the present study, 3.4% of the dentists were found to be hypersensitive to latex. A study from Thailand reported one-fifth of the dentists suffering from contact dermatitis.[22] Approximately one-third of the dentists and dental hygienists reported hand dermatoses in few other studies.[22],[23]

A study reported that atopy was 2.2–4.5 times more frequent in those health service employees who were allergic to latex than in those who were not allergic. It is estimated that 2.8–17% of the employees of health service are allergic to latex. 8.8% of the dentists were found to be allergic.[24] Latex-free gloves are the material of choice for such patients.

Percutaneous incidents are very common among the heath care providers and dentists are one among them, mainly the needle prick and injury by a scalpel. Dentists work in a limited-access and restricted-visibility field and frequently use sharp devices. Percutaneous exposure incidents facilitate transmission of blood-borne pathogens such as human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus (HBV).[25] In the present study, 9.1% of the dentists had experienced needle prick or cut through sharps. Martins et al. reported 19.2% of such incidents. Any such incident should be treated immediately with full precautions.

Infectious diseases such as HIV, HCV, and HBV as well as bacterial and fungal diseases can be transmitted during dental procedures. They may be present in saliva, blood, and exhaled air by the patient or infected individual; needle prick and injuries due to sharp objects are also among the leading causes of transmission of such infections. In the present study, 16.3% of the dentists had some form of infection during their practice experience. There are various ways of protection from such infections that include personal hygiene, wearing of glove, masks, and eye protection devices during the dental procedures. Sterilization together with disinfection is one of the important methods to prevent infections from patient to dentist or vice versa.[26],[27]

Personal protection is an important aspect for the health care providers, as they are on every step to get the infection from the patient. In the present study, all 99% of the dentists use gloves and face mask during dental procedures, and similar results were obtained in a study done in Thailand where all the dentists wear gloves and face mask all the time during dental procedures and eye protection sometimes.[28] The use of personal protective measures is particularly important, as it is not always possible to determine HBV or HIV status from a patient’s self-reported history and/or clinical examination. Vaccination for these fatal diseases is a very important step that every dentist can take. In the present study, 52.9% of the dentists were vaccinated for hepatitis and similar results were obtained in a study done by Leggat et al.[28]Proper waste disposal during the dental procedures is also a very important step which most of the dentists ignore; waste during the treatment of infectious patient is also a potential source of infectious disease.

In this study, academicians should have been included, as they will correct the incorrect sitting positions for the students; more sample size and wider geographical area should have been considered. Increased awareness needs to be created among the dentists to prevent the hazards. All the dentists should practice a healthy waste disposal method and protect themselves. Dentists should practice proper posture so as to overcome the back problems and to provide proper training to alleviate musculoskeletal health problems. Regular workshops and seminars on occupational hazards should be organized for all dental practitioners time to time.

  Conclusion Top

The study showed that almost all the private dental practitioners were suffering from the occupational hazards. Backache was the most common form of occupational hazard seen among the dental practitioners. The practical steps to prevent occupational hazards among them need to be reinforced.

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Conflicts of interest

There are no conflicts of interest.

  References Top

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Ayatollahi J. Needle-stick injuries in a general hospital: Continuing risk and under reporting. Ann Iran Med 2006;3:47-50.  Back to cited text no. 4
Kumar RS, Manish GN, Ferreira AM. Occupational hazards among dental surgeons. Indian J Occup Environ Med 2000;4:139-41.  Back to cited text no. 5
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Henderson KA, Matthews IP. Environmental monitoring of nitrous oxide during dental anaesthesia. Br Dent J 2000;188:617-9.  Back to cited text no. 15
Chopra SS, Pandey SS. Occupational hazards among dental surgeons. Med J Armed Forces India 2007;63:23-5.  Back to cited text no. 16
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Gortzak RA, Stegeman A, Ten Brinke R, Peters G, Abraham-Inpijn L. Ambulant 24-hour blood pressure and heart rate of dentists. Am J Dent 1995;8:242-4.  Back to cited text no. 18
Diaz-Caballero AJ, Gómez-Palencia IP, Díaz-Cárdenas S. Ergonomic factors that cause the presence of pain muscle in students of dentistry. Med Oral Patol Oral Cir Bucal 2010;15:e906-11.  Back to cited text no. 19
Marshall ED, Duncombe LM, Robinson RQ, Kilbreath SL. Musculoskeletal symptoms in New South Wales dentists. Aust Dent J 1997;42:240-6.  Back to cited text no. 20
Hamann CP, Turjanmaa K, Rietschel R, Siew C, Owensby D, Gruninger SE et al. Natural rubber latex hypersensitivity: Incidence and prevalence of type I allergy in the dental professional. J Am Dent Assoc 1998;129:43-54.  Back to cited text no. 21
Leggat PA, Chowanadisai S, Kedjarune U, Kukiattrakoon B, Yapong B. Health of dentists in southern Thailand. Int Dent J 2001;51:348-52.  Back to cited text no. 22
Sinclair NA, Thomson WM. Prevalence of self-reported hand dermatoses in New Zealand dentists. N Z Dent J 2004;100:38-41.  Back to cited text no. 23
Turjanamaa K, Alenius H, Mäkinen-Kiljunen S, Reunala T, Palosuo T. Natural rubber latex allergy. Allergy 1996;51:593-602.  Back to cited text no. 24
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  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8]


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