Levin 1

Caylin Levin
ENC 1102-0M12
April 23, 2015
Rhetorical Analysis
Dentists and orthodontists have a high risk for musculoskeletal
disorders due to the nature of their profession, and to prevent this they
should start early with practicing good ergonomics. Musculoskeletal disorders
are injuries or disorders that affect full body movements. In professions such
as doctors, nurses, and athletes MSDs have always been evident, but over
the years the amount of musculoskeletal disorders in dentists and
orthodontists has been a great issue. Dentists and orthodontists are exposed
to several occupational hazards. Because of the improper posture when
sitting in a dentists chair the neck, shoulders, lower back, hand, and wrist
pain is unfortunately very common. The nature of this type of work and
posture entails abnormal use of the lower spine and causes tension in the
ligaments. The earlier you can get ahold of the problem the easier it is to
fix and depending how quickly you can do this the treatment may range
from pain relief medications or end up having to get surgery. Something
needs to be done to prevent such high percentages of dentists and
orthodontists with pain. The increasing number of work injury related
dentists and orthodontists prompts me to examine the issues that are related
to how this happens, and how to try and prevent it in the dental field, and to
understand the best options as an orthodontist. Recognize that there are

Levin 2
several perspectives on having good ergonomics and how to help with the
pain dentists/ orthodontics face in their daily lives, but the three that are
going to be talked about in my argumentative research paper are acquiring
ergonomic furniture, taking more frequent breaks, and physical exercising
like yoga.
6

A Study on Job Postures and Musculoskeletal Illnesses in Dentists by Ehsan

Rafeemanesh, Zahra Jafari, Farzad Omidi Kashani, and Farzaneh Rahimpour
published in the International Journal of Occupational Medicine and
Environmental Health in 2013 was a study among dentists working in the
Health Centers of Mashhad. The authors themselves have conducted a study
where the survey and observe 65 dentists and every author has had their fair
share of education within the medical / dental fields and are highly qualified
to partake in such a survey and get reliable results, we as readers can trust.
Their main argument is to relay back the information the researchers found
about Work-related Musculoskeletal Disorders (WMSDs) and how in
dentistry, due to the repetitive activities, long term working in static
postures, inappropriate working conditions as well as usage of inappropriate
tools musculoskeletal disorders are likely to occur (Rafeemanesh, et al.).
This study did a survey of dentists (58/65 participated) in Iran to see which
body part receives the most pain and this is what they found:

Levin 3

As you can see the majority of dentists feel pain predominantly in their neck
and then their shoulders and back and we have to try and decrease that
percentage.
The visuals and content I have chosen are from an article called A
Study on Job Postures and Musculoskeletal Illnesses in Dentists by Ehsan
Rafeemanesh, Zahra Jafari, Farzad Omidi Kashani, and Farzaneh Rahimpour
published in the International Journal of Occupational Medicine and
Environmental Health. The main argument of the text is to relay back the
information the researchers found about Work-related Musculoskeletal
Disorders (WMSDs) and how in dentistry, due to the repetitive activities,
long term working in static postures, inappropriate working conditions as well
as usage of inappropriate tools musculoskeletal disorders are likely to
occur(Rafeemanesh et al.). The possible underlying claims would be since

Levin 4
these authors on did a study on dentists working in the Health Centers of
Mashhad which is in Iran that it wont correlate to people here in the United
States. The claims and evidence go hand and hand because basing on the
national study on burden of the diseases in Iran in 2004, back pain, knee
arthritis, and other WMSDs were identified as the most important diseases of
the country right after cardiovascular disorders (Rafeemanesh, et al.) and
when you look at the bar graph (which is on page 7) then you can see how
these cardiovascular disorders are the same. Where the claims and evidence
dont agree with each other is told in the discussion saying,
Although in this study the most prevalent musculoskeletal complaints
were related to neck and shoulder and these comprised the major
cause of job restriction in dentists, the major reason for job
absenteeism was back pain. According to the method of our study and
its data collection, which was by means of a questionnaire, there might
be a recall bias (Rafeemanesh, et al.).
This article explains what Musculoskeletal Disorders are to prove that
the most common musculoskeletal complaints among dentists are related to
the neck, shoulders, upper back, lower back, and wrists. The pathos would
be the appeal to better our nature because its to help the common man
(dentist). As a reader find these authors extremely trustworthy just because
of their background and what research they do where were they do it, and
their education as well.
The text strictly follows the IMRAD formula, which is useful to see and

Levin 5
be familiar with it. This first visual is in the methods/materials section where
they talk about how in order to score job postures the Rapid Entire Body
Analysis or the REBA was used which is where the limbs are divided into 2
groups:
A) Neck, upper and lower back, and legs
B) Shoulders, elbows, and wrists
And with this information a chart was prosed to us as the readers by
observing each posture the neck, body, upper and lower limbs are scored on
the base of their posture. Depending on the individual scores, a total score is
found and the need for level of action is shown like in this Table1:

Using this chart to compare how everything is directly related to one other
like the action level you take to the REBA score to the risk level and to the
action of needing further assessment in your injury is helpful to understand
how important it is to stay on top of you injuries. The higher the REBA score
the closer you are to surgery or severe damage to your body.
The next form of information given to the reader in a visual sense is a
Demographic chart with 58 studied dentists studied. 49 were males (84.5%)

Levin 6
and 9 were females (15.5%).

The research being conducted is why dentists are caused so much pain in
their work field and how to ultimately prevent it. Whether that is by having
ergonomic furniture, or taking breaks through out the day because the
numbers of patients are only increasing, which means the number of breaks
dentists and orthodontists get are diminishing, and that results in requiring
longer times periods in uncomfortable positions. This chart could be used to
talk about how each characteristic can affect the pain someone sees. For
instance if someone is obese or has a large BMI that is bound to effect the
percentage if the majority of dentists surveyed are overweight. And to go off
of exercising you can find another perspective: doing yoga. Yoga isnt only a
way to stay fit, but its also a healthy lifestyle that you can only benefit from.
It is built to emphasize the your strength in the core area and when worked
out properly your posture is improved, which then leads the alleviating back,
shoulder, and neck pain. Dentists and orthodontists should partake in this
exercise to try and reduce their injuries or at least try to relive them. Yoga
does many things for your body. It increases flexibility, increases your muscle

Levin 7
strength, tones your muscles, improves your breathing as well as your
energy and vitality, maintains a balanced metabolism, reduces weight gain,
improves ones athletic performance, and protects you from injury. As a
matter of fact it is also a great stress reliever.
The next piece of information given is the most valuable to my
research. I want to know what pain how many people are feeling the same
pain and this bar graph shown is just that.

Despite the data being collected outside the US, it is still useful for extending
my knowledge and to compare statistics from Iran to those found in the US.
It helps with visually understanding that most dentists feel pain primarily in
their neck and shoulder and backs and because of this dentists and
orthodontists should look into ergonomic furniture because of the fact that
dentists and orthodontists sit in such awkward positions for such long periods
of time they need some type of chair that supports their uncomfortable
setting. These specific chairs reduce the risk of back pain because research

Levin 8
shows that with the support maintaining the low back curve when sitting can
reduce or prevent low back pain. It will also cut back on the amount of neck
problems because of the head rests, so having these items in a profession
that has a record of back and neck pain would be ideal. Normal chairs tend
to have a hard surface, so when sat upon there is an excess amount of
pressure on your hips, but with ergonomic chairs theres a seat depth that
reduces the pressure on your hips, and thats just another added indulgence.
Even though this study was done in Iran it still exhibits valuable
context for my research paper. Im looking for the statistical facts about how
many dentists and orthodontists feel pain and require to cancel
appointments because of it, and where the majority feel this pain whether
itd be in their backs, necks, shoulders, wrists, ect. I also like the use of the
visuals so I tend on including them within my paper for a visual appeal and
just for a better understanding on my argument, and all my perspectives.

After Writing my Actual Research Paper:

I realized that I barley used this article as much as I thought I was
going to. I figured that because I was first just looking for pictures to include
in my paper I would use it a lot, but that didnt happen. I only talked about
the bar graph and how this article talks about what this study was so I could
use the graph and how in dentistry, due to the repetitive activities, long term working in
static postures, inappropriate working conditions as well as usage of inappropriate tools
musculoskeletal disorders are likely to occur (Rafeemanesh, Jafari, Kashani, Rahimpour). Other

Levin 9
than that I should have paid more attention to the content rather than the images even though that
bar graph was a good touch in my opinion.

Work Cited

Rafeemanesh, Ehsan, Zahra Jafari, Farzad Omidi Kashani, and Farzaneh

Rahimpour. "A Study on Job Postures and Musculoskeletal Illnesses in
Dentists." International Journal of Occupational Medicine and
Environmental Health 26.4 (2013): 615-20. Versita. Web. 2 Mar. 2015.