What is the importance and how to prevent occupational diseases suffered by dentists?

Dentistry imposes on dentists factors that are capable of changing working conditions from a psycho-physiological and organizational point of view, which can cause occupational diseases.

Both men and women dentists have occupational diseases of musculoskeletal origin associated with work in sedation. Among work activities, dentistry stands out for being a health activity that imposes on professionals several factors predisposing to socio-psycho-physiological and organizational changes in their work.

International literature reports that dentists report less pain and discomfort than women. Health and organization issues related to work have been researched due to pathologies found among different categories of workers.

Among these factors predisposing to these occupational diseases in dentists are: the demand for precision and concentration, psycho-physiological and postural workload related to the hours worked and the handling of chemical and biological elements.

As a consequence of these factors, there is an overload in the shoulders and cervical provided by the static postures and positioning of the professional. This overload can develop orthopedic and postural disorders and it is necessary to vary the postures and decrease static work, such as preventing musculoskeletal disorders in dentists.

Occupational diseases suffered by dentists (WMSD or RSI)

WMSD (work-related osteoarticular diseases) or RSI (repetitive strain injuries) are disorders of muscles, tendons, synoviums, nerves, fascias and ligaments, in isolated or combined forms, with or without tissue degeneration. .

These occupational diseases usually affect mainly the upper limbs, the scapular region and the cervical region. It has an occupational origin, resulting from the excessive and repetitive use of muscles and the maintenance of inadequate posture.

The cervical and dorsal spine are the regions that suffer the main overloads, causing orthopedic conditions. In addition to overload of blood vessels, mainly in the venous return to the heart.

Due to the presence of several concomitant symptoms or not, such as pain, paraesthesia, feeling of heaviness and fatigue, they are usually causes of temporary or permanent work disability.

WMSDs are considered a public health problem due to their high prevalence in several professions. The best form of control is through prevention. Dentists are in the risk group for RSI / WRMSD.

RSI or WMSD are listed as the second cause of morbidity in the adult population in several countries, including Brazil. Dental surgeons are among the professionals most affected by these diseases, as well as typists, nurses, secretaries, laboratories and writers.

These injuries are found in dentists because of the characteristics of their activities, because they often work in inadequate postures, without rest periods and under strong emotional tension.

Currently, dentistry has been considered a stressful profession, commonly associated with damage to health. It is subject to several mechanical risks: incorrect working postures, prolonged repetitive movements.

Risk factors for WMSD

Among the risk factors of this type of occupational diseases are cold, vibration, mechanical pressures located in the tissues, degree of adequacy of the workstation to the attention area and the vision, inadequate postures, musculoskeletal load, static load, task invariability, cognitive demands, organizational and psychosocial factors linked to work and without necessary pauses between one patient and another.

Risk factors associated with the appearance of disorders can be related to the physical environment, biomechanical factors (furniture equipment at the workplace), organizational factors (form of work organization) and psychosocial factors (social psychic environment and relationship at work).

The subject continues to be of increasing interest, but the finding is an old phenomenon. It has become a public health case due to the significant increase in cases. It can lead the professional to temporary or even permanent disability.

Most professionals are unaware of the disease and do not know the risks they are subject to. Therefore, studies on this subject are needed, emphasizing that the preventive side is of fundamental importance in these conditions.

Occupational diseases (LERT / WMSD) that affect dentists

Among the occupational diseases that most affect dentists we can mention:
- Tendonitis: Inflammation of the tendon tissue;
- Lateral and medial epicondylitis: Caused by rupture or stretching of the insertion points of the flexor or extensor muscles of the carpus in the elbow;
- Bursitis: Inflammation of the bursa (acute or chronic or chronic inflammation of the fluid-filled sac under the tendons;
- Tendinitis of the supraspinatus and bicipital;
- Carpal tunnel and ulnar syndrome: Compression of the median nerve at the carpal level;
- Cervical syndrome: Degeneration of the cervical disc;
- Thoracic outlet syndrome: compression of the brachial plexus in its passage called thoracic outlet;
- Painful Shoulder;
- Herniated disc.

Female dentists have more discomfort and pain with greater concentration than men. With high frequency of headaches, pain in the neck, shoulders and lumbar spine. Absenteeism is related to chest and lumbar pain.

Men suffer less wear and feel less discomfort and pain than women in general. Low back pain affects both men and women, they suffer more spinal injuries and stay away from work for longer.

There is also a prevalence of impaired vision in the upper limbs, of long-term neuroperipheral symptoms due to vibration due to the instruments used.

How to prevent occupational diseases

Dentists continue to become victims of RSI / WRMD by remaining in the same position for a long time to better visualize their patient causing poor posture, muscle tension and joint inflammation.

The posture adopted by the professional, usually in the consultations, is with the cervical and the thoracic flexion. The abducted shoulder, flexed elbow. The lower back often runs out of support. In addition, it performs trunk rotation, a frequent movement during visits to the dental office. Most dental surgeons are in the same position when they care for their patients.

These professionals should seek to organize themselves at work, observing the appropriate ergonomic standards, providing greater comfort and thus improving their work quality. In addition, the professional must also adopt a lifestyle with physical activities, avoid sedentary lifestyle, perform postural corrections and perform attitudes that contribute to a healthier life.

For the prevention of occupational diseases, it is necessary to know two points, one the choice of equipment and the other are related to the correct ergonomics of the professional's work position.

Importance of prevention

The word prevention refers to care, or even eliminating the causes of an event before it happens. Preventing work-related musculoskeletal injuries consists of preserving the worker's physical structure.

Physical activity during working hours plays an important role in the prevention of occupational diseases. The good physical condition of the worker guarantees effectiveness and efficiency, in addition to reducing the risks of disability resulting from the job or of retiring early due to degenerative diseases. Occupational gymnastics alone does not have magical effects in the solution of occupational diseases, it can bring psychological and physical benefits, but if it is applied individually with pre- and post-exercise accompaniments.

Physical activity has a fundamental role in improving the quality of life, regardless of the worker's area of ​​activity. Any and all physical activity properly applied is advantageous. The prevention of physical inactivity and cardiovascular diseases would already be sufficient reasons to affirm that occupational gymnastics under the character of physical activity, produces a better quality of life. In the business environment, performance and productivity can be increased. Pilates has numerous benefits, preventing and reducing pain, especially for a professional who stays for hours in an uncomfortable posture.

Ergonomics and guidelines

Some basic rules of ergonomics:
- The body must work with zero torque;
- Choose the best posture to work according to the requirement of the task;
- Workbenches must be structured so that the body works in an upright position, without bending the trunk and avoiding the elevation of the upper limbs.

Guidelines for improving dentists' pain and posture:
- Postural control: The better the postural / proximal stabilization, the better the distal / peripheral mobility;
- Maintaining posture during procedures;
- Improvement of manual dexterity with combined training of aerobic and anaerobic exercises;
- Correction of posture and work ergonomics;
- Corrections of addictions and postural manias. Adjustment of equipment.

For the prevention of occupational diseases, it is necessary to know two points, one the choice of equipment and the other are related to the correct ergonomics of the professional's work position.

The practice of physical activity

Exercises are essential among these:
- Isometric exercises to strengthen deep spine muscles.
- Pilates, weight training, dancing, walking, running, tennis, swimming and biking.
- Performing hand exercises during the day, except if the pain worsens with exercise.
- During the working day, get up every hour and walk for 1 min.
- Find a physiotherapist when you realize that these pains are hindering the journey.

Labor gymnastics is also indicated for dental surgeons. This gym consists of a set of stretches and physical exercises oriented during office hours.

Workplace gymnastics and ergonomics have brought a lot of benefits to workers when they enter the job market. Pauses between one patient and another become effective for preventing pathologies related to the RSI / WRMS group.

When professionals are motivated and satisfied, they will also be developing their work with more quality, reconciling the circle of complete satisfaction with the chosen career. There is a need for prevention programs against RSI / WMSDs, where biomechanical care, such as stress and physical inactivity are of great importance.

Occupational gymnastics presents primary benefits to the worker in the prevention of occupational diseases, however, it is linked to a more personalized program, associated with ergonomic improvements and the employee's voluntary participation in therapy. Occupational gymnastics is an effective alternative for preventing occupational diseases.

Physiotherapist's role in treatment

The quality of life from the third millennium onwards has become an objective to be achieved by man following the guidelines of bodily harmony and the interrelationship between the professional, social, physiological, emotional and spiritual spheres.

Health is a result of a vital dynamic balance. Fatigue due to long periods of work without a break can cause pain and muscle spasms.

Faced with cases of RSI / WMSD diagnoses, physiotherapy has had a prominent place in several business segments through preventive therapeutic programs being an alternative treatment and prevention.

Labor gymnastics is one of those physical therapy programs that seeks to relieve the tension caused by the routine activity of workers and that can be practiced before, during and / or after office hours, targeting people at work. Then reducing the impacts of sedentary lifestyle and promotes socializing among workers.

Occupational gymnastics should be performed during mandatory breaks and aim to reduce the installation of postural vices, in the face of which the individual is obliged to remain during their usual activities.

Proper posture aims at orderly work with minimal loss of time and energy and maximum precision.

The exchange of a bigger movement for a smaller one decreases the mandatory time, increases the concentration, decreases the fatigue and improves the performance.

Factors such as difficulty in visualizing the operative field and postural addiction are causal aspects related to the peculiar work position, concentrating physical effort in a single field of work, thus the professional tilts the spine laterally, in addition to performing flexions and extensions.

The abusive use of these movements can cause postural defects, involving several syndromes and leading to fatigue.

The fight against stress, the ergonomically adapted work environment and the worker prepared for daily muscular demands will reflect on a good life proposal, where prevention is of paramount importance in these activities. Depending on that prevention is the best alternative to obtain stable health.

Conclusion

Many professionals seek help when the dysfunction is already installed. In dentists, these diseases are caused by incorrect posture and / or repetition of movements, as well as by the static position without support of upper limbs and joints outside the neutral zone.

Psychological pressure and unsatisfactory rest time are cited as aggravating factors. Unfortunately, there is no way to have an adequate office, where the dentist does not assume a risky position for joints.

With the exercises applied to combat occupational diseases for dentists, it is possible to strengthen and condition important muscle groups to stabilize the lumbar and cervical spine, also the shoulder girdle and upper limbs.

Prevention is certainly the best choice, with these exercises it is possible to obtain muscle balance and the conditioning that the body needs. Even assuming an inadequate posture, a stable spine, strong and flexible muscles, dentists can better cope with extreme situations.

Source: Blog Fisioterapia. Available at: https://blogfisioterapia.com.br/doencas-ocupacionais/. Access on: 04/15/2021.