Teaching methodologies for improving dental students' implementation of ergonomic operator and patient positioning.

OBJECTIVES: Musculoskeletal disorders (MSDs) related to operator and patient positioning are prevalent among dentists. Knowledge of correct operator and patient positioning promotes safe working postures that can prevent the development of MSDs. The aim of this study was to assess the impact of inter-professional teaching on the application of those skills associated with correct operator and patient positioning in dental settings. METHODS: A randomized case-control study was conducted with 83 first-year dental students at the UNC-Chapel Hill Adams School of Dentistry in 2019. Forty-one (n = 41) of the students solicited for the project participated. All 83 students in the cohort participated in a didactic lecture on ergonomics and correct operator and patient positioning, along with a pre-clinical practice session with peer patients. During the clinical practice session, students in the case group received an additional 10 minutes of 1-on-1 instruction by a trained physical therapy student or dental faculty member. Two weeks later, the final cohort (n = 41) was assessed by 2 faculty members using a scored rubric on operator and patient positioning for restorative work on an anterior tooth, posterior mandibular tooth, and posterior maxillary tooth. RESULTS: There was a statistically significant difference between the 2 groups with respect to the composite ergonomic positioning score (P = 0.006), operator shoulder abduction position (P = 0.03), and lateral flexion of the spinal column (P = 0.02). CONCLUSIONS: Hands on instruction with physical therapists and trained dental faculty positively affects ergonomic compliance and provides students with tailored feedback that can be applied to clinical practice.

Effects of foot orthoses on quality of life for individuals with patellofemoral pain syndrome.

STUDY DESIGN: Repeated-measures analysis of intervention. OBJECTIVES: To determine the effects of foot orthoses on quality of life for individuals with patellofemoral pain who demonstrate excessive foot pronation. BACKGROUND: Foot orthoses are a common intervention for patients with patellofemoral pain. Limited information is available, however, regarding the effects of foot orthoses on quality of life for these patients. METHODS AND MEASURES: Sixteen subjects with patellofemoral pain who also exhibited signs of excessive foot pronation were studied. Subjects underwent a 2-week period of baseline study followed by custom foot orthotic intervention. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was administered to subjects at the time of screening, just prior to foot orthotic intervention, and at 2 weeks and 3 months following foot orthotic intervention. RESULTS: Wilcoxon matched-pairs signed-rank test results indicated statistically significant improvements in the pain and stiffness subscales 2 weeks following the start of foot orthotic intervention. All WOMAC subscale scores were significantly improved at 3 months compared with preintervention measurements. CONCLUSIONS: Custom-fitted foot orthoses may improve patellofemoral pain symptoms for patients who demonstrate excessive foot pronation.