Individual and participatory ergonomics for dental professionals: a systematic review of randomized controlled trials

Objective Work-related musculoskeletal disorders (WR-MSDs) are a major occupational hazard among dental professionals, contributing to disability, absenteeism, and workforce attrition. This systematic review synthesized randomized controlled trial (RCT) evidence on ergonomic interventions for preventing WR-MSDs, emphasizing individual and participatory strategies. Methods Following PRISMA guidelines, comprehensive searches of five databases (PubMed, Cochrane Library, Scopus, Web of Science, and ScienceDirect) and reference lists were conducted through December 2024. Eligibility criteria were restricted to RCTs evaluating ergonomic interventions (e.g., workstation adjustments, devices, training) aimed at reducing WR-MSDs among dental healthcare workers. Methodological quality was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. Data were synthesized narratively, and the certainty of evidence was evaluated using the GRADE approach. Results Nine RCTs met inclusion. Educational programs improved posture awareness and reduced discomfort, though benefits were short-term. Stretching interventions yielded modest reductions in upper-limb pain over 10 weeks. Device-based approaches (loupes, microscopes, prismatic glasses, ergonomic stools) enhanced posture and reduced trapezius activity, but most were laboratory-based with limited follow-up. The strongest evidence came from a cluster-RCT in China (n = 210), where participatory ergonomics significantly increased the odds of recovery from WR-MSD symptoms in the neck and wrists/hands at 12 months. Most studies were judged to have "some concerns" for risk of bias due to an inability to blind participants and reliance on self-reported outcomes. Overall certainty of evidence ranged from low to moderate. Conclusion For dental professionals, individual-level ergonomic interventions (education, stretching, and devices) offer short-term relief from discomfort and improve posture. However, organizational-level participatory ergonomics provides the strongest evidence for driving sustained recovery from WR-MSDs, suggesting that workplace policy should integrate multifaceted ergonomic strategies to ensure workforce sustainability. Systematic review registration PROSPERO CRD42024629341.