Effects of Instrument Handle Design on Dental Hygienists' Forearm Muscle Activity During Scaling

Purpose: The purpose of this study was to determine the effects of 4 different commercially available instrument handle designs (A. 16 grams and 12.7 mm diameter, B. 23 grams and 11.1 mm diameter, C. 21 grams and 7.9 mm diameter and D. 18 grams and 6.35 mm diameter) on the muscle activity of four forearm muscles during a simulated scaling experience.Methods: A convenience sample of 27 (n=27) dental hygienists used a Columbia 13/14 curet with four different instrument handles to scale artificial calculus from typodont teeth. Each participant's muscle activity was measured using surface electromyography (sEMG).Results: Similar muscle activity was generated when scaling with instruments at 16, 18, and 21 grams with varying diameter handles. Instrument B generated significantly more muscle activity when compared to each of the other instrument handle designs (p=0.001, p=0.002, p=0.039). The lower left quadrant displayed significantly less muscle activity during scaling than the upper and lower right quadrants (p=0.026, p=0.000), although no significant interaction effect was found with instruments within quadrants. Most participants (62.96%) preferred instrument A, which was rated more comfortable based on weight when compared to the other instruments tested.Conclusions: Instrument handle design has an effect on forearm muscle activity when scaling in a simulated environment. The heaviest instrument with a relatively large diameter (B 11.1 mm and 23 g) generated significantly more overall mean muscle activity compared to the other three instruments. Similar amounts of muscle activity were produced by instruments weighing between 16 and 21 g. Participants' instrument preferences were more affected by handle diameter than weight. Results support the need for further research to determine the impact of these findings on muscle load related to risk of musculoskeletal disorders in a real-world setting.