University of Southern California
University of Southern California
USC Chan Division of Occupational Science and Occupational Therapy
USC Chan Division of Occupational Science and Occupational Therapy

Musculoskeletal Sonography and Occupational Performance Laboratory

Active Research

Musculoskeletal Disorder Risk Assessment in Dental Hygienists

Nearly 70% of dental hygienists report experiencing discomfort in their forearms/wrists/hands, primarily due to the use of dental scaling instruments. Dental scaling requires sustained pinching and repetitive movements that place high load on the forearm and hand muscles. This high muscle load, combined with pinching and non-neutral wrist positions, approximately doubles the risk of developing hand and median nerve pathology due to strain on the tendons and compression of the median nerve.  Scaling of more than four hours per day has been directly associated with pathology.

Dental hygiene students have an elevated risk of musculoskeletal injury due to intensive exposure to scaling during their educational training. We have documented a significant increase in subjective reports of discomfort in the hand, wrist, and fingers of these students, with the prevalence of students with discomfort doubling to tripling across their two-year training program. Up to 60% of individuals report having discomfort at the end of their training. To enhance education, develop preventive training, and address work-related musculoskeletal disorders in dental hygienists, it is necessary to better understand the link between exposure and pathology development.

Overall, the problem of musculoskeletal injury within the practice of Dental Hygiene is a multifaceted issue. In addition to adopting awkward trunk and neck postures for long hours due to patient positioning, dental hygienists are also required to apply significant hand forces during removal of plaque and calculus from patient’s teeth. In an effort to mitigate these issues, we are utilizing a synchronized three-view video capture system to monitor dental hygienists during clinical practice.

These videos are being used in the following assessment projects:

Funding

Sonographic tissue morphology in early stage work-related pathology
National Institute for Occupational Safety and Health / Centers for Disease Control
R01-OH010665 (PI: Roll)
Total Funding: $2,324,186
Funding Period: 9/30/15 – 9/29/19

Validity and reliability of ergonomic assessment tools used in dental hygiene practice
USC Office of Provost
Undergraduate Provost’s Fellow: Samanatha Randolph
Total Funding: $1,000
Funding Period: 10/1/18 – 11/30/18

Identifying Risk of Musculoskeletal Injury in Dental Hygiene Practice
USC Office of Undergraduate Programs – Undergraduate Research Associates Program
Total Funding: $4,500
Funding Period: 8/15/17 – 5/15/18

Publications

Roll, S. C., Tung, K. D., Chang, H., Sehremelis, T. A., Fukumura, Y. E., Randolph, S., & Forrest, J. L. (2019). Prevention and rehabilitation of musculoskeletal disorders in oral health care professionals: A systematic review. The Journal of the American Dental Association, 150(6), 489-502. https://doi.org/10.1016/j.adaj.2019.01.031 Show abstract

Tung, K. D., Fukumura, Y. E., Baker, N. A., Forrest, J. L., & Roll, S. C. (2019). Identifying an optimal sampling method to estimate postural risk in a dynamic work task. Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 63(1), 1028-1033. https://doi.org/10.1177/1071181319631180 Show abstract

Presentations

Tung K, Baker NA, Fukumura Y, Forrest JL, Roll SC. Identifying an optimal sampling method to estimate postural risk. Paper presentation at: Human Factors and Ergonomics Society Annual Meeting, 2019; Seattle, WA

Tung K, Baker NA, Fukumura Y, Forrest JL, Roll SC. Identifying an optimal sampling method to estimate postural risk. Poster presentation at: USC Ostrow School of Dentistry Research Day, 2019; Los Angeles, CA.

Forrest JL, Mack WJ, Roll SC. Factors associated with the development of hand discomfort in dental hygiene students. Poster presentation at: International Symposium on Dental Hygiene, 2019; Brisbane, Australia

Roll SC, Forrest JL. Implementation of ergonomic, observational techniques that empower dental hygiene educators, practitioners, and students to reduce the risk of work-related injuries. Workshop presentation at: International Symposium on Dental Hygiene, 2019;  Brisbane, Australia

Roll SC, Forrest JL, Mack WJ.  Differential effects of work-related task training on upper extremity health in occupational therapy and dental hygiene students. Poster presentation at:  97th Annual Conference of the American Occupational Therapy Association, 2019; New Orleans, LA

Colclazier, N. L., Sumi, J. Y., Forrest, J. L., & Roll, S. C. (2017). Developing an observational method for assessing dental hygienists’ injury risk. Poster presentation at USC Ostrow School of Dentistry Research Day, Los Angeles, CA.

Melrose, D., Wilkins, M. A., Forrest, J. L., & Roll, S. C. (2017). Identifying risk of upper extremity injuries in dental hygiene professionals. Poster presentation at USC Ostrow School of Dentistry Research Day, Los Angeles, CA.

Colclazier, N. L., Sumi, J. Y., Forrest, J. L., & Roll, S. C. (2017). An observational method for injury risk assessment of dental hygienists. Poster presentation at 94th Annual Conference of the American Dental Hygienists’ Association, Jacksonville, FL.

Hardison, M. E., Colclazier, N., & Roll, S. C. (2017). Risk for musculoskeletal strain among dental hygiene students: Video analysis protocol and pilot testing. Poster presentation at 6th Annual Occupational Therapy Summit of Scholars, Boston, MA.

Melrose, M. D., Wilkins, K., Forrest, J. L., & Roll, S. C. (2017). Identifying risk of hand injuries in dental hygienists: A longitudinal cohort study. Poster presentation at American Dental Educators Association Allied Program Directors’ Conference, Baltimore, MD.