by Kishan Sheth
Modern dentistry demands that high levels of quality work be done in a short amount of time. Your patients, staff and finances must also be managed effectively. All of these factors can add to your stress load.
Some stress-causing factors
- Feeling inadequate for the task
- Boredom, since dentistry involves lots of repetitive movements
- Too much work; not enough time
- Working long hours—this leads to poor personal relationships, nutritional habits and exercise habits
- Extreme attention to detail and the continuous striving for absolutely perfect restorations
- Treating patients who are anxious
- Frustration from constantly having to adapt and keep up with new materials and products
- Lack of patient satisfaction for the work you are providing
- Loneliness as a result of working in a confined and isolated environment
- Poor professional relationships between team members
- Financial/business pressures
- Eyestrain, back and neck problems
However, stress is not always a bad thing. Small amounts of stress are great efficiency boosters, which increase performance. However, surplus amounts can have dangerous effects on health.
Stress has always been a well-known problem in our profession. Throughout history, our colleagues have often resorted to drugs and alcohol to relieve their stress. And it was noted recently that "the suicide rate of dentists is more than twice the rate of the general population and almost three times higher than that of other white-collar workers".1 Obviously we need to find effective ways to cope with stress.
What is stress?
Stress is a very complicated concept, which facilitates physiological and emotional responses to the environment when a threatening stimulus occurs. The physiological response is known as "fight or flight," during which our bodies prime us for action by increasing the release of adrenaline into the bloodstream and vasodilating vessels running to skeletal muscle. This has an effect on our thinking, making it seem as though everybody or everything is out to get us—thus increasing our chances of survival.
For example, if a threatening stimulus—such as a tiger—is running toward you, your body will get primed in order to either run from the tiger or fight the tiger. In the modern dental setting it is unlikely that you will ever have a tiger running around your clinic, but seemingly harmless stimuli will occur that will activate the fight or flight response (see Fig. 1).
What happens to you when you are stressed?
- Increased neck and back pain, and headaches
- Increased perspiration
- Quick mood swings, which can erode your relationships
- Reduced ability to concentrate
- Less precision with your work, leading to a reduction in quality
- This may ultimately result in poor sleep patterns, increased alcohol consumption and poor dietary patterns (see Fig. 2).
Fig. 2: Yerkes-Dodson law, indicating that the optimal performance level is at a medium level of stress. Poor performance is caused by stress levels that are either too low or too high, indicating that some level of stress has positive attributes.3
So how can I reduce stress?
It is important to understand that we are all different. Factors that increase my stress levels may or may not increase yours by the same amount. But any potentially harmful or threatening stimulus in the dental setting is likely to increase stress levels to some degree.
On a personal level, we need to prioritize our stress-relieving activities and hobbies. I ensure that I always have slots in my schedule when I can go to the gym and dance classes. If you don't have a hobby, find something you are passionate about and balance these activities with your work life. Also, give yourself a break by taking holidays when the pressures of dentistry start to crowd in, as a break will re-energize you. Make time to spend with family and friends and maintain these personal, intimate relationships. Talking with loved ones or close friends and colleagues can help minimize anxiety and stress.
In the professional setting, you should ensure you are sitting comfortably and with the correct positioning. Many dentists suffer from back, neck and eye problems because of poor posture. Place your feet flat on the floor with your legs wide apart, sit right back into the chair, keep your back straight, ensure forearms are parallel to the floor, and make sure the patient's head is at your abdominal region. If checking the maxillary teeth, tilt the head up, and for mandibular teeth, tilt the head down. Understanding good posture may seem like a basic task, but is absolutely imperative as it maintains good health and professional fulfillment, and improves your efficiency and quality of work. In the real world, correct positioning is often overlooked. Get into good habits straight away!
Also, try to avoid conflicts and arguments by quickly resolving any issues. Delegate effectively so that each team member knows his or her role, and carefully schedule your workload to prevent overload. The last point is crucial for achieving stress reduction.
As dentistry operates like all other businesses do, you will at times try to do lots of work in unrealistic time limits which will either lead to more financial gain if performed well, or—more than likely—lead to poor-quality procedures and feelings of professional inadequacy. These procedures will need to be corrected later, and the patient will be unimpressed. So keep realistic targets and plan well in advance.
Finally, a good way to relieve stress is by properly managing your work environment. Many practitioners have poor management systems that force their patients to wait. Invest in a good system and you will find your schedule will be better planned, appointments will be more effectively allocated and patient recalls will be automatic, leaving you able to focus on what you do best—clinical dentistry. Also optimize lighting, equipment and heating for your own comfort. Wear comfortable clothing. Feeling confident will translate into better work.
I hope that implementing these methods in your daily routine will enable you to feel more confident and excel in your clinical endeavors. Remember: a less-stressed dentist is a more successful practitioner!
References
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http://www.oralhealthgroup.com/news/stress-in-dentistry--it-could-kill-you/1000214585/?&er=NA
- http://psychorevision.blogspot.co.uk/2013/01/how-does-body-respond-to-stress.html
- http://theclearparent.com/tag/yerkes-dodson-law/
Kishan Sheth is a third-year dental student studying at Kings College London. He is working on a systematic review with one of his professors, entitled, "Periodontitis and Cancer: Is There a Link?" He has also secured funding from his college to take dental students into care homes to conduct oral-hygiene workshops to help improve the oral-health levels in elderly populations. In addition, Sheth is a passionate dancer and is choreographing the annual dental charity show this year, after playing the lead role last year.
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