Ergonomics for Clinical Support & Diagnostic Services – Dental

Work-related musculoskeletal disorders (MSDs) are among the most common and debilitating occupational disorders associated with the profession of dentistry (Dong et. al, 2006). Surveys show that shoulders and lower back pain symptoms are the most frequently reported complaints by, followed by neck problems (Hedge, 2008). Dentists report 26–73% period prevalence of neck symptoms over the previous year, and 20–65% with shoulder symptoms. Dental hygienists report even higher rates, from 54–83% for neck and 35–76% for shoulder, and dental assistants in between 38–62% and 27–62% respectively (Morse, T et. al, 2010).

Dentists, dental hygenists and technicians, and dental students often assume awkward and often static physical positions while providing treatment to get a better view of the intraoral cavity; provide a more comfortable position for the patient; and/or operate equipment and reach for instruments and supplies.  Dental work also requires forceful and repetitive hand movements when grasping small tools and holding vibrating handpieces (ADA, 2008).

In addition, as the prevalence of obesity increases in the US population, dental staff are performing more manual transfers of dental patientsbetween wheel chairs and dental exam chairs.

The following resources should provide information about the extent of the MSDs related issues in Dentistry, as well as guidance and resources for solutions.

On this page:

Guidelines & Toolkits

White Papers

ArticlesArticles published since 2000 are listed. Review citations listed in each article to find references prior to 2000.

Other Resources

Also refer to Resources on the Safe Patient Handling Clinics and Acute Care pages

Guidelines and Toolkits

Dental Hygiene Work – case study. The Ergonomics Program at the University of California

Ergonomic Applications to Dental Practice. A Microsoft PowerPoint presentation (1999). David W. Hiipakka, MPH, CIH, Industrial Hygiene Department, U.S. Naval Hospital Rota Spain. DSN 727-2783 & Major Katharyn A. Grant, PhD, CPE, PE, Chief, Ergonomics Function,US Air Force IERA/RSHE. DSN 240-6116.

Ergonomics for very small businesses: dental offices. An educational poster from California OSHA.

Ergonomic requirements for dental equipment. Guidelines and recommendations for designing, constructing and selecting dental equipment IN EUROPE(2006).

Prevention of Work-Related Musculoskeletal Disorders (MSDs) in Dental Clinics (2009). L’Association paritaire pour la santé et la sécurité du travail du secteur affaires sociales (ASSTSAS), Montreal, Canada. This document provides extensive information about MSDs hazards and ergonomics solutions in Dentistry. The document is copyrighted thus permission must be sought from ASSTSAS for reproduction or adaptation.

PowerPoint training materials from the Labor Education and Research Center (LERC) at the University of Oregon.

White Papers

An Introduction to Ergonomics: Risk Factors, MSDs, Approaches and Interventions (2004). The American Dental Association. A Report of the Ergonomics and Disability Support Advisory Committee (EDSAC) to Council on Dental Practice (CDP)

Ergonomics for Dental Students (2008). American Dental Association

Ergonomics Health Promotion for B.C. Dental Offices (2006). Rucker, L. WorkSafe BC.

Dentist Occupational Risk Factors for Musculoskeletal Symptoms (2001). National Institute for Occupational Safety and Health(NIOSH). HETA #99-0106-2838 Indian Health Service.

Survey of Dental Hygienists in the United States: Executive Summary (2007). American Dental Hygienists’ Association.

Articles & Publications

An investigation of ergonomic interventions in dental hygiene work (2002). Smith, C.A.,  Sommerich, C.M., Mirka, G.A., & George, M.C. Applied Ergonomics, 33(2):175-184.

Back Care for Dentists and Surgeons (2000). Updated 2009. Hedge, A.  Spine Universe.

Ergonomics and the Dental Care Worker (1998). Murphy, D. The American Public Health Association, Washington, DC.

Ergonomic Guidelines for Selecting Patient Chairs and Delivery Systems (2009)

Bethany Valachi, B. Dentistry Today. Issue Date: July 2009, Posted On: 8/1/2009.

Mechanisms leading to musculoskeletal disorders in dentistry (2003). Valachi, B & Valchi, K.  J Am Dent Assoc, 134 (10): 1344-1350.

Musculoskeletal disorders of the neck and shoulder in the dental professions (2010). Morse, T., Bruneau,H., & Dussetschleger, J.  Work, 35(4):419-429.

Musculoskeletal disorders (MSDs) and dental practice Part 2.Risk factors for dentistry, magnitude of the problem, prevention, and dental ergonomics (2007). Yamalik N. Int Dent J. 57(1):45-54.

Musculoskeletal disorders of the neck and shoulder in dental hygienists and dental hygiene students (2007).Morse T, Bruneau H, et al.  J Dent Hyg. 81(1):10.

Perceived musculoskeletal symptoms among dental students in the clinic work environment (2008). Thornton, L.J., et. al. Ergonomics, 51(4):573–586

Practice Dentistry Pain-Free: Evidence-based Ergonomic Strategies to Prevent Pain and Extend Your Career (2008). Valachi, B. Posturedontics Press.

Prevalence of carpal tunnel syndrome and upper extremity tendinitis among dental hygienists (2002). Werner, R.A., Hamann, C., Franzblau, A., & Rodgers, P. A. Journal of Dental Hygiene,76(2):126-32.

Prevalence and correlates of musculoskeletal disorders among Australian dental hygiene students (2009). Hayes. M.J., Smith D.R., & Cockrell D. Int J Dent Hyg.7(3):176-8.

Preventing musculoskeletal disorders in clinical dentistry (2003). Valachi, B & Valchi, K.  J Am Dent Assoc, 134 (12): 1604-1612.

Preventing Shoulder Injuries. Dimensions of Dental Hygiene (2007). McNitt-Gray J. L., &  Mathiyakom, W.  Dimensions of Dental Hygiene, 5(1): 16-18. Retrieved from

Reducing the Mechanical Demand: How to Maintain musculoskeletal health while generating sufficient force for effective periodontal instrumentation (2006). McNitt-Gray, J.L., & Mathiyakom, W. Dimensions of Dental Hygiene, 4(3): 18-21.

The Effects of Finger Rest Positions on Hand Muscle Load and Pinch Force in Simulated Dental Hygiene Work (2005). Dong,H., Barr, A., Loomer,P., & Rempel, D.  Journal of Dental Education 69(4):453-460.

The effects of periodontal instrument handle design on hand muscle load and pinch force (2006). Dong,H., Barr, A., Loomer,P., LaRoche, C., Ed Young, E., & Rempel, D.,  J Am Dent Assoc 137(8):1123-1130.

Understanding and Preventing Musculoskeletal Disorders in Dentistry (2006).  Cuny, E &  Wood, J. Inside Dentistry

Working In A Dental Practice Shouldn’t Be A Pain In the Neck! Guignon, A. The Preventative Angle,  V (II).  The Richmond Institute for Dental Education. Algonquin, IL.

Working postures of dentists and dental hygienists (2005). Marklin, R.W., & Cherney, K. J. Calif Dent Assoc.,33(2):133-6.

Young female patient takes a dental attendance in the dentist's office.

Other Resources

NIOSH Safety and Health Topic: Dentistry  and

The OSHA Safety and Health Topics for Dentistry.

These sites contains links to resources related to common safety and health hazards that might be found in Dentistry.

Search the following professional association sites for 'Ergonomics' to view various articles and resources

America Dental Association(ADA)

American Dental Hygiene Association(ADHA)

American Dental Assistants Association (ADAA)

California Dental Association(CDA)

OSAP, the Organization for Safety, Asepsis and Prevention in Global Dental Safety.

University of British Columbia Dentistry Search for 'Ergonomics'  to view multiple publications related to ergonomics and dentistry authored by UBC faculty

USAF Dental Evaluation & Consultation Service

Information about dental equipment including chairs

RDH Magazine for Dental Hygiene Professionals.Search for 'Ergonomics' to view various articles