ORIG INAL ART ICLE

Health of dentists in United Arab Emirates

Raghad Hashim* and Khalid Al-Ali

Ajman University of Science and Technology, Ajman, UAE.

Objectives: The aims of this study were to investigate the prevalence and nature of some health and lifestyle problemsamong dentists in United Arab Emirates (UAE). Method: A cross-sectional study with a one-stage complex samplingtechnique using a self-reported questionnaire distributed to all 844 dentists, working in three cities (Abu Dhabi, Dubaiand Sharjah) in UAE. Results: Seven hundred and thirty-three (87%) dentists, aged 22–70 years, responded. More thanhalf (n = 442, 61%) of dentists do not exercise regularly. Around one-seventh of the dentists are smokers. One hundredand eighteen dentists (16%) reported having some known systemic problem. The most common systemic health prob-lems were cardiovascular diseases (n = 56, 8%). Conclusion: The present study indicates that the prevalence of exerciseamong dentists in UAE is relatively low and some systemic health problems, especially cardiovascular diseases, are pres-ent among dentists practicing in UAE. Cigarette consumption is relatively high in this population of dentist. Furthercontinuing education and investigation of the appropriate intervention to improve rates of exercise and reduce the levelof smoking among dentists in UAE is needed, and this may help reduce the level of systemic disease.

Key words: Health, exercise, smoking, dentists, UAE

Dentistry can be a stimulating and rewarding occupa-tion but is also physically and mentally demanding1.It has been suggested that dentists lack awareness andknowledge about managing their stress2–4. The mostcommon stressors reported include time-related pres-sure, heavy workloads, financial concerns, anxiouspatients, staff problems, poor working conditions,medical emergencies in the surgery and the routinenature of the job2,5. Failure to adapt to or contendwith the working environment can predispose to ill-ness6. The most frequent causes of premature retire-ment among dentists are musculoskeletal disorders(29.5%), cardiovascular disease (21.1%) and neuroticsymptoms (16.5%), as reported by Burke et al.7;therefore, practicing dentists should be aware of theseillnesses and take steps to avoid them, especially mus-culoskeletal problems and cardiovascular disease7.Despite anecdotal evidence of these conditions, littlehas been published on systemic problems specificallyin relation to dentists.Self-awareness and the benefits of regular exercise

are important needs. Various studies have recordedself-perceived health and health-related behaviours ofdentists in various countries but little is known aboutthe health of dentists in United Arab Emirates (UAE).

This study was designed to investigate the prevalenceand nature of some health and lifestyle problems ofdentists in UAE, including occupational issues thatrelate to exercise, cigarette smoking and systemic dis-eases.

METHODS

The present study was approved by the ethics commit-tee of Ajman University of Science and Technology(AUST), the General Authority for Health Services forthe Emirate of Abu Dhabi, Department of Health andMedical Services of government of Dubai, and Minis-try of Health in UAE. This research was conducted infull accordance with the World Medical AssociationDeclaration of Helsinki and written consents wereobtained from all participants in this study.The questionnaire used in this study consists of 21

closed-ended questions that provided information onindividual characteristics such as age, gender, maritalstatus, number of years since graduation and numberof hours worked per week. Furthermore, informationon a range of health issues of dentists was sought,including exercise, cigarette smoking and systemicdiseases. A total of 844 dentists (general dental

26 © 2013 FDI World Dental Federation

International Dental Journal 2013; 63: 26–29

doi: 10.1111/idj.12000

practitioners and specialists) working in three cities(Abu Dhabi, Dubai and Sharjah) in both private andpublic sectors in UAE were selected for inclusion inthis study. Participants had to have at least 1 year ofwork experience in the current position to be includedin the study.The clinics were selected from the membership reg-

ister of Ministry of Health for emirates of Abu Dhabi,Dubai and Sharjah. This includes dental clinics, medi-cal centres, polyclinics and hospitals. The purpose ofthe questionnaire and how the questions should beanswered was explained and, whenever necessary, fur-ther information was provided to the participant. Thequestionnaires were distributed by the researchersbetween July 2005 and February 2006. All the dataentered into a Microsoft Excel spreadsheet. Data werethen transferred into SPSS windows version 11.0 (SPSSInc., Chicago, IL, USA) for analysis. The chi-squaretest was used were appropriate and the level of statis-tical significance was set at P < 0.05. Univariate andbivariate analysis were used when appropriate.

RESULTS

This cross-sectional study examined the prevalence of,and some factors associated with, health problemsamong dentists in UAR. Questionnaires were com-pleted by 733 dentists from Abu Dhabi, Dubai andSharjah from both public and private sectors with atotal response rate of 87%. Missing data wereexcluded from the analysis. Of the 733 dentists, 445(61%) were male and 288 (39%) were female, withan age range of 22–70 years (mean � SD38.1 � 10.3). Background data on age, number ofyears since graduation (or in clinical practice) andworking hours per week are summarized in Table 1.Male dentist were found to work for longer hoursthan female dentists.More than one-third of the dentists (39%) reported

exercising on a regular basis (Table 2). Male dentistswere significantly more likely to report exercising ona regular basis (P < 0.05). A variety of reasons fornot excising regularly were given (Table 2), with themost common reason being lack of time (43%). Notexercising on regular basis was more common among

dentists in the public sector than in the private sector(P < 0.05; data not presented).As shown in Table 3 more than one-fifth of the

male dentists are smokers, and there were significantdifferences between regular smoking and gender(P < 0.05). There was a clear association betweenhaving systemic disease and regular smoking(P < 0.01; data not presented).The prevalence of reported systemic problems have

been summarized in Table 4. One hundred and eigh-teen dentists (16%) reported having some known sys-temic problem at some time since graduation. Themost commonly reported systemic illnesses includedcardiovascular diseases (n = 56, 8%), gastrointestinalconditions (n = 38, 5%), neurological symptoms(n = 14, 2%) and respiratory problems (n = 9, 1%),with the remainder reporting a variety of differentconditions. There were significant difference in the

Table 1 Age, number of years since graduation andworking hours by sex

Male (n = 445)(Mean � SD)

Female (n = 288)(Mean � SD)

Age (years) 40.8 � 9.2 36.4 � 7.5Number of yearssince graduation

16.7 � 9.2 13.5 � 8.1

Working hoursper week (hours)

30.5 � 15.5 26.6 � 14.5

Table 2 Number (percentage) of dentists reported tobe exercising regularly and reported reasons for notexercising classified by sex

Malen (%)

Femalen (%)

Totaln (%)

Exercise regularlyYes* 205 (46) 80 (28) 285 (39)No 236 (54) 206 (72) 442 (61)Total 441 (100) 286 (100) 727 (100)

Reasons for not exercisingNot a sports person** 24 (5) 30 (10) 54 (7)No time** 167 (38) 147 (51) 314 (43)Too tired** 61 (14) 78 (27) 139 (19)Others 26 (6) 24 (8) 50 (7)

*P < 0.05.**P < 0.01.

Table 3 Number (percentage) of dentists reportingsmoking on a weekly basis by sex

Smoking on a weekly basis Malen (%)

Femalen (%)

Totaln (%)

Non-smoker 351 (79) 277 (98) 628 (86)Smoker* 92 (21) 7 (3) 99 (14)

*P < 0.05.

Table 4 Prevalence of reported systemic problems bysex

Malen (%)

Femalen (%)

Totaln (%)

With systemic problem 74 (17) 44 (15) 118 (16)Type of systemic problemsCardiovascular* 42 (9) 14 (5) 56 (8)Gastrointestinal 22 (5) 16 (6) 38 (5)Symptoms of neurosis 8 (2) 6 (2) 14 (2)Respiratory problems 4 (1) 5 (2) 9 (1)Others 22 (5) 15 (5) 37 (5)

*P < 0.05.

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prevalence of cardiovascular disease and sex(P < 0.05).

DISCUSSION

This cross-sectional study examined the prevalence of,and some factors associated with health problems indentists in UAE by means of a self-administered ques-tionnaire. To our knowledge, this is the first study toreport on health problems among dentists working inUAE. Although the response rate for this study wasgood, one of the major limitations of this type ofresearch is that people may not accurately report whatthey actually do.In most studies the dentists are reported to be rel-

atively inactive and very few took any form ofphysical exercise although they acknowledged thebenefits of physical exercise4. The prevalence ofexercise in this population of dentists was relativelylow, particularly given the relatively high rates ofmusculoskeletal problems seen in this population8.The present investigation showed that only 39% ofdentists reported exercising on a regular basis. Simi-lar findings were reported in Thailand9. It has beennoted that poor general physical fitness has beenassociated with musculoskeletal symptoms. Thisfinding is in line with the study of Leggat et al.9.Conversely, a study conducted in Poland10 reportedno significant relationship between the practice ofphysical activity and the number of musculoskeletaldisorders.A significant association was found between lack of

regular exercise and the gender of the participant:being a female dentist was significantly associatedwith not exercising regularly. The main reasonreported for this was lack of time, which could beattributed to home and family responsibilities. How-ever, those who reported not exercising regularlybecause of time limitation were working more than35 hours per week. This indicates that those dentistscould adjust their working time in order to exerciseregularly and improve their physical fitness.In addition, it was noted that dentists working in

the public sector exercised much less regularly thandentists in the private sector. This might be attributedto the working times for the dentists. Dentists work-ing in the public sector in UAE have a fixed workingtime for 8 hours continuously, while dentists in theprivate sector work on average two 4-hours shifts(4 hours in the morning and 4 hours in the evening);therefore, they have more a flexible working timehealthy lifestyle habits such as exercise.It is surprising that almost 14% of dentists smoke

in UAE, as this rate of smoking appears to be muchhigher than that reported in other populations of den-tists1,11, specifically male dentists. This high

prevalence of dentists who reported smoking is of par-ticular concern; therefore, continuing education in theavoidance of smoking would be beneficial. Furtherstudies are needed to identify the causes of this highrate of smoking and to identify the appropriate inter-ventions that would reduce its prevalence among den-tists in UAE.In general, it would be expected that the prevalence

of disease among dentists would be lower comparedwith averages from other groups within the popula-tion because dentists belong to a higher socioeco-nomic grouping12,13, and higher socioeconomic statusaffords better dietary habits, better living conditionsand the ability to transform health information intoaction14. In this respect, the prevalence of illnessessuch as cardiovascular disease, tumours and respira-tory disease is higher within the general populationthan in the dental profession15. The present studyshows that around one-sixth of the dentists (16.1%)have systemic diseases, and these were mainly cardio-vascular problems. This percentage is lower than thatreported in a study conducted by Leggat et al.9 inThailand where they found that 27.8% of dentistshad a systemic diseases.It was noted that the prevalence of systemic prob-

lems among dentists in the public sector were higherthan among dentists in the private sector. This iscould be caused by the different position of publicsector dentists in the in the workplace hierarchy, withpossibly more stress over work activities comparedwith private practitioners, or it might be attributed tothe fact that dentists in the private sector exercisemore regularly. Although a cross-sectional study can-not show causality, the results imply that physicalexercise is a buffer against systemic problems. Thisfinding is supported by a study conducted in Fin-land16. Lehto et al.16 suggested that poor generalphysical fitness may be partly responsible for theseproblems and there is certainly scope for furtherdecreasing the prevalence and severity of these prob-lems by performing regular specific exercises17,18.Therefore, measures should be investigated to improveparticipation rates in exercise amongst this group ofdentists. In addition, male dentists reported havingmore systemic problems compared to their female col-leagues. Notably, the prevalence of systemic diseaseswas higher among smokers and smoking is a well-known hazard to health.Consideration of occupational and individual risk

factors, prevalence, symptoms and consequences ofthese disorders, and implementing the recommendedhealth and safety measures can enable a long andhealthy career. It is therefore essential to providebackground information for dentists regarding themagnitude of the problem, particular risk factors andrecommendations for prevention 19.

28 © 2013 FDI World Dental Federation

Hashim and Al-Ali

CONCLUSION

The present study indicates that some systemic healthproblems, especially cardiovascular diseases, are pres-ent among dentists practicing in UAE. Lack of timewas cited as the most common reason for dentists notexercising, especially among female dentists. Cigaretteconsumption was relatively high in this population ofdentists. Further continuing educational and investiga-tion of appropriate interventions to improve rates ofexercise and reduce the level of smoking among den-tists in UAE is needed, and this may help reduce thelevel of systemic diseases.

Acknowledgement

The authors acknowledge all the dentists who partici-pated in this study. This study was not supported orfunded by any research grants.

Conflict of interest

None declared.

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Correspondence to:Dr Raghad Hashim,

Head of Growth and Development Department,Ajman University, PO Box 346 Ajman, UAE.

Email: raghad69@yahoo.co.nz

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