Relationships between the postures of dentists and chairside dental assistants

J Dent Educ. 2020 Sep;84(9):1025-1031. doi: 10.1002/jdd.12178. Epub 2020 May 18.


Introduction: Dental professionals have been encouraged to maintain their neutral postures throughout their workday in order to maintain a healthy musculoskeletal system. However, with 4-handed dentistry, maintaining neutral postures becomes more challenging when the dentist and dental assistant work concurrently alongside the patient to complete dental procedures.

Purpose: The purpose of this study was to determine whether relationships exist between the postures of dentists and dental assistants.

Methods: Upon institutional review board approval, this study used a cross-sectional research design of a convenience sample of 31 unique pairings of dentists and dental assistants. The Modified-Dental Operator Posture Assessment Instrument (M-DOPAI) and Rapid Upper Limb Assessment (RULA) were used to assess ergonomic scores and ergonomic risks of captured photographs of dentists and dental assistants performing 4-handed dentistry. The data were analyzed using descriptive statistics and correlational analysis.

Results: The dentists and dental assistants demonstrated higher ergonomic scores for the trunk, head, and arm positions and higher ergonomic risk scores for the neck/trunk/leg positions. The head position of dental assistants was positive correlated with hip position of dentists. The shoulder position of dental assistants was negatively correlated with the head position of dentists.

Conclusion: Ergonomic risks scores indicated further investigations and potential changes in postures to reduce ergonomic risks. Multiple postural components of the dentists and dental assistants were related. Ergonomic training should include consideration of dentists and dental assisting working concurrently in 4-handed dentistry. More ergonomic training is needed with 4-handed dentistry among dental and dental assisting students and faculty members.

Keywords: dental assistants; dentists; ergonomics; musculoskeletal disorders.

MeSH terms

  • Cross-Sectional Studies
  • Dental Assistants*
  • Dentists
  • Ergonomics
  • Humans
  • Occupational Diseases*
  • Posture