Clinical and electrodiagnostic abnormalities of the median nerve in US Army Dental Assistants at the onset of training.

PURPOSE/HYPOTHESIS Dental personnel including dentists, dental hygienists, and dental assistants have been reported as having a high prevalence of upper-extremity musculoskeletal disorders, including carpal tunnel syndrome. Previous research has not involved dental assistant students at the onset of dental training. Therefore, the purpose of this study was to determine the presence of median and ulnar neuropathies in US Army dental assistants at the onset of their training. NUMBER OF SUBJECTS Fifty-five US Army Soldiers (28 female, 27 male) enrolled in the Dental Assistant (68E) course, volunteered to participate in the study. The mean age of the dental assistant students was 24±7.2 years (range 18-41 years). There were 45 right handed dental assistant students, and the mean length of time in the Army prior to dental training was 27 months (range 3-180 months). MATERIALS/METHODS Subjects were evaluated during the first week of their 10-week dental assistant course. Subjects completed a history form, were interviewed, and underwent a physical examination. Electrophysiological status of the median and ulnar nerves of both upper extremities was obtained by performing motor and sensory nerve conduction studies. Descriptive statistics for subject demographics and nerve conduction study variables were calculated. RESULTS Six of the 55 subjects (11%) presented with abnormal electrophysiologic values suggestive of median mononeuropathy at or distal to the wrist. Five of the subjects had abnormal electrophysiologic values in both hands. Five of these 6 subjects had clinical examination findings consistent with the electrophysiological findings. The ulnar nerve electrophysiologic assessment was normal in all subjects sampled. CONCLUSIONS The prevalence of median mononeuropathies in this sample of Army dental assistants at the onset of training is greater than 5% prevalence reported in previous healthy populations and is less than 26% prevalence in previous research examining Army dental assistants with dental work experience. CLINICAL RELEVANCE Median neuropathy at or distal to the wrist has been reported in dental personnel including dentists, dental hygienists, and dental assistants, and is also prevalent in this sample of dental assistants at the onset of training. Further long-term prospective research involving the impact of dental practice and techniques for reducing upper extremity injuries in dental professionals appears to be warranted.