Musculoskeletal disorders and the Australian dental hygiene profession: investigating prevalence, correlates and interventions

It is well established that dental hygienists are commonly affected by musculoskeletal disorders. However, due to the complexity of this occupational health issue, an understanding of the progression of musculoskeletal disorders and strategies for prevention are far from being understood. The aim of this thesis is to establish the prevalence and correlates of musculoskeletal disorders among the previously understudied demographic of dental hygienists and dental hygiene students, and to also investigate the effect of loupes as an intervention for this problem. To meet this aim, three research projects were undertaken. A systematic review of the evidence confirmed that musculoskeletal disorders are reported by dental hygienists at consistently high rates; however, a lack of longitudinal studies and standardised research techniques limited any conclusions about the progression of disease or successful interventions. A longitudinal cohort study followed dental hygiene students across the three years of their education and training, to determine whether musculoskeletal disorders begin even before their careers begin. Dental hygiene students reported musculoskeletal disorders at rates similar to practising hygienists. A cross sectional study of Australian dental hygienists identified that both work-related tasks and psychosocial factors influence the reporting of musculoskeletal disorders, and that equipment such as loupes may have a protective effect. An intervention study investigated the effect of loupes on musculoskeletal disorders among a sample of dental hygienists; both positive and negative outcomes for physical measures were noted. Overall, the findings in this thesis provide evidence that musculoskeletal disorders begin during dental hygiene training, are prevalent in a relatively young and recently established group of practicing dental hygienists, and are influenced by a multitude of factors. Furthermore, it appears that loupes might not be a panacea for optimal musculoskeletal health, at least in dental hygienists. Recommendations for future studies in this field are provided.