Risk for cervical herniated intervertebral disc in dentists: a nationwide population-based study

Abstract

Background Prolonged static postures (PSPs) may predispose dentists to develop cervical herniated intervertebral disc (C-HIVD); however, there is limited evidence supporting this in the literature thus far. We conducted this study to fit the data gap. Methods We conducted a retrospective nationwide population-based study using the Taiwan National Health Insurance Research Database to identify 10,930 dentists, an identical number of age- and sex-matched participants from the general population, and 73,718 other health care providers (HCPs, non-dentists). Comparisons for the risk of developing C-HIVD between dentists and the general population, and between dentists and other HCPs were performed by tracing their medical histories between 2007 and 2011. Results Dentists had a cumulative incidence rate of 1.1% for C-HIVD during the 5-year follow-up period. Overall, there was no difference of the risk for C-HIVD between dentists and the general population after adjusting for hypertension, hyperlipidemia, liver disease, mental disorders, diabetes mellitus, coronary artery disease, chronic obstructive pulmonary disease, malignancy, stroke, and renal disease (adjusted odds ratio [AOR]: 1.2, 95% confidence interval [CI]: 0.9–1.6). However, stratified analysis showed that younger dentists (≤ 34 years) had a trend of higher risk for C-HIVD than members of the younger general population (AOR: 1.9, 95% CI: 0.9–4.1). There was no difference found between dentists and other HCPs (AOR: 0.9, 95% CI: 0.8–1.1). Conclusion Younger dentists had a trend of higher risk of developing C-HIVD than members of the general population.

Flexion Dysfunction of Atlanto-occipital Joint as a Risk Factor for Cervical Spondylosis

“…Therefore, stiff atlanto-occipital joint, represented by low FOC, makes increased mechanical stress downward. This may aggravate degeneration or herniation of the spinal discs [17,21]. The presented case (Fig.…”

“…Previous studies indicated that pathophysiological changes, such as disc degeneration and disc protrusion, were surprisingly common ndings in young adults with neck pain [16,17]. The course and outcome of CS are highly varied, especially in young patients [16].…”

“…A minority of them have to accept surgical treatments due to severe pain and neurologic symptoms, while others do not. Several studies investigated that the risk factors about anatomical variables of the cervical vertebrae, such as anteroposterior vertebral body diameter, mid-sagittal vertebral canal diameter, and canal-body ratio [17,18]. However, these anatomical variations just statically reveal their effects.…”

“…CS gradually occurs over time accompanied by dynamic activities that are complex anatomically and biomechanically. Cheng Huang reported that in a population of 10,930 dentists and 73,718 controls, younger dentists had a higher risk of developing cervical herniated intervertebral dis [17]. Sustained contraction of the cervical muscles to keep forward-head postures that involve holding the neck and head in an unbalanced and unnatural forward position to gain better visibility is universally unavoidable in daily dental operations [19].…”

“…Sustained contraction of the cervical muscles to keep forward-head postures that involve holding the neck and head in an unbalanced and unnatural forward position to gain better visibility is universally unavoidable in daily dental operations [19]. The painless, insidious nature of repetitive minor trauma caused by such a prolonged static posture (PSP) may lead to the degeneration of spinal discs [17,19,20]. These suggested that there existed a signi cant role of the head's movement in a pathophysiologic change of the cervical spine.…”