Stress and Burnout in Dentistry

Dentistry is generally considered both within the profession and outside of the profession as a very stressful occupation.

What is stress and why do we consider it nowadays?

There are various definitions of what stress is and here is one accepted definition. Stress can be defined as an imbalance between an actual or perceived stimulus and the actual ability or the perceived ability of a person to cope with these demands. Stress can be manifested both physically and emotionally.

We can consider stress nowadays as a way of life due to several reasons.

Our predecessors even as little as 100 years ago, had a much more physical existence.  For instance, most men would have a largely physical nature of work such as employment in factories or farming or intense labouring outside.  Most women would stay at home and would eventually look after children. Once again this was physically arduous as has there were little or no machines to do the work for them.  Clothes would need to be washed by hand and then they would need to be physically rinsed out before drying them. This was tough and exhausting work.  All meals would need to be cooked from scratch and all the cleaning would need to be done physically by kneeling down on all fours and brushing or scrubbing the floors.  For men, studies show that typical labourer would need to consume in excess of 3000 calories per day 100 years ago. 

Nowadays, the need for calories has been drastically reduced but we have continued to consume the same number of calories with less usage.  In addition, most employed workers will be sitting down in an office and most households will have the usual conveniences such as washing machines, dishwashers, vacuum cleaners and kitchen utilities.

Of course, the physical nature is all but one part of the equation as our emotional needs and demands have dramatically altered.

Compared to 100 years ago, we want everything done now and then and have become much less patient. Our diet has also been detrimentally affected and we eat much less natural food and much more processed food. Finally, our knowledge of stress has greatly increased and we are now much more aware of stress and it has become considered as a general way of life.

What is burnout?

Excessive and severe stress over a continued time results in a phenomenon called burnout.

As a result of this, the body almost gives up and shuts down. Some researchers think that this is a protective response.

The person with burnout will feel physically exhausted, being not able to sleep or switch off, have a reduced immune system and will stop enjoying life.  This can lead to long-term depression and even suicidal thoughts.

The first stage of burnout is emotional exhaustion which is when one will overextend themselves and no longer be able to handle the emotional demands of others. This leads onto the act of depersonalisation when the person will detach themselves from everyone so for a dentist this includes their patients, colleagues and others they work with on a day-to-day basis. The final stage of burnout is reduced personal accomplishment where the person will lose confidence in the ability to perform the job expected. 

Dentistry is generally considered both within the profession and outside of the profession as a very stressful occupation.

It certainly has a higher stress factor compared to nearly every other profession and even amongst healthcare workers, it is high on the list.

There are many reasons for this and we shall discuss these below.

1. Firstly, dental teaching at undergraduate level generally does not deal with the issues of stress once a student has qualified and gained their degree.  

2.  Dentists will typically be dealing with many nervous patients on a day-to-day basis.  If a dentist is poor at treating nervous or anxious patients, they will become stressed and this will also affect their clinical work.  It is well known that only 50% of the general population attend the dentist regularly and the most common reason for a regular attendance is dental anxiety or phobia.  When these patients attend your clinic, they are more difficult and take longer to treat.

3. Being a dentist also involves being knowledgeable in business skills especially if you have your own practice.If you cannot make your practice financially viable, it does not matter if you are good at your clinical skills because your practice will not be able to continue.You will also be not able to reinvest improving your practice such as getting better equipment. Many dentists question the compromise between doing the dentistry and getting the right turnover.

4. Dental treatment involves working within a small proximity space and needs a high level of concentration for every patient.

There are various ways in which you can manage stress as a dentist.

1. Firstly you need to look after yourself physically and emotionally. It is important that you have outside hobbies to be able to switch off. It does not matter what you do as long as you do have some other interests or hobbies to lean on.

One also needs a good family and friends supporting network.

2. Secondly, you must be good at your clinical skills. As an example, the distance of only 1 mm make a difference between a good root canal treatment and a failed root treatment resulting in extraction. To be good at your clinical skills, you must keep on practicing your skills and also attend good courses.

3. You must be skilled at managing your patients. Patients will like you and will be less anxious if you get along with them positively.

4. A dentist must also have good business and marketing skills in order to ensure that the practice runs successfully.

5. Finally and most importantly,you should not forget the reasons why you became a dentist in the first place. The primary role of a dentist is to make patients’ lives better.