The Role of Ergonomic Saddle Seats and Magnification Loupes in the Prevention of Musculoskeletal Disorders: A Systematic Review – Science Sunday

The Role of Ergonomic Saddle Seats and Magnification Loupes in the Prevention of Musculoskeletal Disorders: A Systematic Review

Dentistry is a visually dependent occupation which often causes clinicians to find themselves in awkward postures for extended periods of time. Multiple studies have shown that awkward static posture is directly associated with a higher prevalence of musculoskeletal disorders (MSD). MSDs have been the primary cause for dental professionals’ early retirement, reducing work hours or quitting the profession. MSDs are also a common reason dental hygienist seek medical care and miss work. 

 In a recent systematic review published in November 2018 in the International Journal of Dental Hygiene the authors tried to answer the following questions: 

1. Do ergonomic dental saddle seats alleviate musculoskeletal pain or correct the posture of the dental professional?
2. Do magnification loupes alleviate musculoskeletal pain or correct the posture of the dental professional?1

Nine studies met the inclusion criteria and were evaluated for the systematic review. Of the included studies seven studied posture while two evaluated pain as an endpoint. Four evaluated the efficacy of loupes, while four evaluated saddle seats and two evaluated the combined effect of both loupes and saddle seats.

The results showed the use of an ergonomic saddle seat is beneficial in correcting posture. Though improved posture is considered to help reduce musculoskeletal health and reduce or prevent pain, none of the studies included in the review evaluated the benefits as it applies to the relief of musculoskeletal pain.

The use of loupes was shown to improve posture and reduce shoulder pain. Improved quality of dental care was an additional benefit noted with the use of loupes. Loupes were shown to improve the accuracy of caries diagnosis and detection, decreased number of errors, and improved quality of cavity preparations.

Moreover, the combination of the use of a saddle seat and loupes is even more effective in improving posture and reducing musculoskeletal pain. The limitations cited in this systematic review were small sample sizes and weak methodologies for 4 of the studies. In some of the studies, the participants were aware they were being observed which may have increased the likelihood that they adopted better posture during the study.

More randomized clinical studies are warranted to better assess the efficacy of loupes and saddle seats on posture as well as musculoskeletal pain. Due to the nature of the study blinding and fully accounting for confounders is not possible. 

The authors conclude by stating, “Saddle seats significantly improve the operator’s posture. However, evidence of their effect on reducing musculoskeletal pain is scarce. Similarly, magnification loupes appear to improve the operator’s posture and provide relief of shoulder pain. An additive effect may exist when the two ergonomic measures are used conjunctively.”

Do you currently suffer from musculoskeletal pain or poor posture when treating patients? Do you currently use loupes and/or a saddle seat? Do you feel it has improved your posture and/or musculoskeletal pain? If you are not currently using one or both, are you considering incorporating one or both in your armamentarium soon? 

Plessas A, Bernardes Delgado M. The role of ergonomic saddle seats and magnification loupes in the prevention of musculoskeletal disorders. A systematic review. Int J Dent Hyg. 2018;16(4):430-440. doi:10.1111/idh.12327