Das Zusammenspiel von stress- und arbeitsbedingten muskuloskelettalen Erkrankungen bei Zahnärzten

Objectives: Prevalence of work-related musculoskeletal disorders (WRMSDs) among general dental practitioners and orthodontists is approximated to range between 64% and 93%. Etiology of WRMSDs in the mentally and physically demanding occupation remains unclear, for which reason the aim of the study was to clarify the interplay of physical, psychological, and mental factors on WRMSDs. Design & Methods: A questionnaire was created using the Subject Matter Experts Technique [1]. When using the Subject Matter Experts Technique, questions are conceptualized by experts in the field. The Subject Matter Experts Technique had to be implemented since no questionnaire designed to meet the needs of the study could be determined. Using Delphi methodology, a consensus between all experts involved was reached for 61 questions [2]. The questions could be sub-grouped into different domains. Starting with demographic information, the questionnaire addressed working conditions, the use of ergonomic aids, preferred and/or required physical positions during treatment of patients, experienced stress, and factors associated with stress such as high time pressure, physical complaints. The questionnaire for the online survey was sent digitally via an invitation link to practicing dentists and orthodontists, who in turn forwarded the link to other practitioners. This made it possible to implement a rapid response system for the cross-sectional study. Observations & Results: Of 94 orthodontists and 187 general dental practitioners (mean age = 35 years) questioned using an online survey, 84% reported persisting tension or pain in the back, neck, or shoulders. While 71% of females were employed (29% self-em ployed), only 39% of male participants were employed. Cluster analysis was used to characterize dental practitioners according to their movement profile and the moderating effect of stress on certain WRMSDs. Three movement profiles of general dental practitioners and orthodontists were significantly predictive of WRMSD. The minority could be characterized as healthy (n = 45), whereas twice as many reported nearly twice as much pain (n = 90). Stress proved to be a strong, significant moderator of WRMSDs in relation to sex, employment status, and body mass index. Conclusion: The prevalence of WRMSDs found was alarming. Given the feminization of dentistry, and that being female, stressed, and an employee (rather than self-employed) is a significant predictor of WRMSDs. This represents a risk to the German health system. [1] Alberts DJ. Stakeholders or subject matter experts, who should be consulted? Energy Policy. 2007; 35(4):2336-2346. [2] De Meyrick J. The Delphi method and health research. Macquarie business research papers. 2001; 1-13.