Work-related musculoskeletal symptoms across the dental training-practice continuum: a cross-sectional survey

To estimate the prevalence, frequency, and severity of musculoskeletal symptoms (MSS), and associations with preclinical history, loupe practices, and ergonomic exposures across a dental workforce and training pipeline over a 12-month period.

A cross-sectional online survey was administered to dental students and clinicians. The survey assessed 12-month MSS prevalence by body region, symptom frequency and severity, care-seeking behaviours, loupe use and fitting practices, and exposure to posture or ergonomic training. Descriptive statistics were reported by cohort. Musculoskeletal symptom prevalence was assessed using a 12-month retrospective recall window administered at a single time point, consistent with standardised Nordic Questionnaire methodology. Associations between categorical variables were assessed using χ² tests, and differences in pain severity were examined using non-parametric Mann-Whitney U tests.

A total of 308 respondents completed the survey. Musculoskeletal symptoms were highly prevalent, with practising clinicians reporting greater symptom frequency and severity than students. The neck, upper back, and lower back were the most commonly affected regions. A subset of participants reported musculoskeletal disorder (MSD) conditions prior to commencing dental training. Loupe uptake varied across cohorts, and post-purchase fitting or magnification review was undertaken infrequently among loupe users. When stratified by professional status, neck pain prevalence among practising clinicians was virtually identical regardless of loupe use (75.7% vs 76.0%). An adjusted logistic regression identified an association between loupe use and neck pain in the overall sample (adjusted OR = 2.06, 95% CI 1.25-3.41, p = 0.005). This most plausibly reflects confounding by clinical exposure in the student subgroup rather than a direct effect of loupe use.

Musculoskeletal symptom burden was evident across all career stages surveyed. Practising clinicians reported greater symptom frequency and severity than students at the time of survey; however, the cross-sectional design precludes temporal or causal inference. These findings support a prevention-oriented approach across the dental training-practice continuum that prioritises early risk identification, appropriate visual ergonomics practices with verification of use, and sustained, skills-based ergonomic training with ongoing reinforcement.

This study highlights the critical role of ergonomics in preventing MSD among dental professionals. MSD are common among dental professionals and are evident from early in dental training. Early ergonomic education, proper loupe fitting, and reinforcement of correct posture are essential to reduce risk. Preventive strategies can improve practitioner health, career longevity, and quality of patient care.