Musculoskeletal disorders among female dental personnel - clinical examination and a 5-year follow-up study of symptoms

Objectives: To explore the natural course of musculoskeletal disorders duri ng a 5-year period among dental personnel, to survey findings and diagnoses according to a standardized protocol, and to compare and evaluate differen t methods for the detection of musculoskeletal disorders in a population. M ethods: In a 5-year follow-up study, dental personnel (n = 90) and referent s (n = 30) were studied. The Nordic questionnaire (years 0 and 5), the pres ent pain rating according to the Borg category ratio scale, and physical ex amination (year 5) were used. Results: In year 0 the prevalence of symptoms in the shoulders, the wrists/hands, and, unexpectedly, the hips was higher in the dental personnel as compared with the referents. Furthermore, those (16%) who had left the dental profession during the observation period sho wed a higher prevalence of and, often, combined symptoms from several body regions in year 0 than did those who stayed. Dental personnel who remained in the profession tended to have an increased risk of developing more sympt oms in the shoulders and the elbows/wrists/hands in year 5 as compared with year 0 and at year 5 were in more pain and had received more diagnoses for the neck/shoulder region relative to the referents. Furthermore, there was a considerable variation in symptoms during the follow-up period. The sens itivity of the pain rating and of the Nordic questionnaire in detecting mus culoskeletal disorders was high for the neck and shoulders but was not as h igh for the elbow, wrists/hands, or hips. The association was better for di agnoses than for findings. The opposite patterns were observed for specific ity. Conclusions: Dental personnel had an increased risk of developing musc uloskeletal disorders as verified by symptoms and diagnoses and more painfu l or persistent conditions. This led to a selection out of work. The questi onnaire and the present pain rating gave a relatively good picture of the p revalence of musculoskeletal disorders arising from the neck, shoulders, an d hips and would be useful as screening tools. Their sensitivity in detecti ng disorders was higher for diagnoses than for findings. However, these met hods were not as sensitive for disorders involving the elbows/wrists/hands. Physical examinations gave more detailed information.