Saturday, September 27, 2008

Prevalence of carpal tunnel syndrome and median mononeuropathy among dentists -- HAMANN et al. 132 (2): 163 -- The Journal of the American Dental Association

My interest for Carpal Tunnel Syndrome among dentists was motivated by an email I received a September 1, 2008 from Marita Kritzinger, Editorial Director, Dental Learning HUB.

We're now looking into this field while the
"cross-sectional study, quoted below, demonstrates that a relatively high number of dentists have a prolonged median-ulnar latency, yet two-thirds of the dentists affected are asymptomatic."

Mediracer could, in my view, be used as a device to do the occupational health testing for dentists. A mobile clinic focusing on crafts people might be a solution for many other occupations as well.

There also is a higher rate of hand and finger pain symptoms among dentists than among the general population. This higher rate of pain is associated with dentists who reportedly work longer hours, says the report.

However, there appears to be no significant difference between the prevalence of clinically and electrodiagnostically definite CTS among dentists and the rate among the general population.

I have to talk with Veijo Lesonen how such a service could be arranged and how the service could be distributed to reach those who should be diagnosed.

As in the general population, there are many dentists with slowing of the median nerve who are asymptomatic but may be at an increased risk of experiencing CTS in the future.

Prevalence of carpal tunnel syndrome and median mononeuropathy among dentists -- HAMANN et al. 132 (2): 163 -- The Journal of the American Dental Association: "Background. The authors undertook a study to determine the prevalence in dentists of abnormal sensory nerve conduction and/or symptoms of carpal tunnel syndrome, or CTS, the most common nerve entrapment syndrome.

Methods. In a cross-sectional study, dentists (n = 1,079) were screened during the American Dental Association’s Annual Health Screening Program in 1997 and 1998 by means of standard electrodiagnostic measures in the dominant hand and a self-reported symptom questionnaire. The authors diagnosed a median mononeuropathy from a 0.5- or 0.8-millisecond, or ms, prolongation of the median sensory-evoked peak latency compared to the ulnar latency. They diagnosed CTS if the subject also had accompanying symptoms of numbness, tingling or pain.

Results. Thirteen percent of screened dentists were diagnosed with a median mononeuropathy (using a 0.5-ms prolongation as the criterion), but only 32 percent of these had symptoms consistent with CTS (4.8 percent overall). When the 0.8-ms prolongation was used as the electrodiagnostic criterion, only 2.9 percent (overall) were diagnosed with CTS. People with diabetes, rheumatoid arthritis and obesity were more likely to have a median mononeuropathy.

Conclusions. The prevalence of symptoms consistent with CTS in the dominant hand among dentists was higher than the prevalence in the general population. However, when electrodiagnostic confirmation is added, the prevalence of CTS was nearly the same as that among the general population.

Clinical Implications. Early recognition of CTS can lead to more effective management. Education regarding ergonomic risk factors can be an effective preventive measure."

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