Tackling Stress and Burnout in Dentistry by Balraj Sohal

Undergraduate dentistry is a challenging degree in relation to its contact time, teaching and overall commitment. It’s well accepted that dentistry is more demanding and taxing than most other degrees.

With regular exams and deadlines, it is easy to become stressed and potentially experience burnout. After graduation, this can quickly escalate as young dentists attempt to adapt to the realms and strains of the real world. Dentistry is a high-stress occupation; the nature and isolated working conditions of dental surgery are likely to be influencing factors (Table 1).

Because of a combination of interlinking factors, ‘burnout’ has become an increasingly relevant and common phenomenon echoed among dental professionals.¹ It’s not surprising that 8 percent of UK dentists report having experienced burnout, and 18.5 percent of dentists have been identified as being at risk of suffering from burnout.

Burnout is commonly described as having three elements:

• Increased emotional exhaustion; feeling of fatigue by the stress of work.
• Increased depersonalisation; developing negative and cynical attitudes.
• Reduced levels of personal accomplishment; a decline in one’s feelings of competence and self-achievement.²

Stress is a common contributing factor to eventual burnout, so it’s important to educate yourself about some of the most common stress-generating situations reported by dentists. Those who do so should be more wary about such situations developing, and implement effective strategies to tackle the issues before they become significant factors affecting daily practice.

High overall stress in a GDP’s life has been associated with increased job dissatisfaction, a high percentage of NHS work and long hours worked per week.3 Unsurprisingly, it’s also been reported that dentists who spent a greater proportion of their time in NHS practice showed lower work engagement and higher levels of burnout.4 This was contrasted with lower burnout scores and higher work engagement scores among individuals with postgraduate qualifications who worked in larger teams.

One suggestion for this was related to the fact that specialists reported experiencing lower stressors, and that those with postgraduate qualifications are more likely to be involved with a multifaceted career encompassing teaching and research, which offers protective benefits against burnout: The ability to offer a higher level and quality of care after postgraduate or specialist training may also offer greater excitement and reward to the individual.⁴

The impact of stressors and long-term burnout can be significant and shouldn’t be overlooked. In addition to likely adverse effects on quality of care and detrimental psychological and relationship impacts, more disastrous long-term effects such as depression and suicide can also be experienced.⁵

Because dentists have entered an occupation with a strong reputation as a stressful one capable of leading to emotional and physical ill health, it’s paramount that they find and employ sustainable strategies to reduce the risk of adverse outcomes.⁴

Stress-Fighting Strategies

Find the right work/life balance

Taking a well-deserved break from dentistry and achieving an important work/life balance can be useful. Refreshing your thoughts and widening your perspective with activities such as continuing with a regular hobby, playing a sport or involving yourself in something different to your daily routine can be extremely valuable. Holidays and spending time with friends and family outside of dentistry are also great.

Taking time to recharge will help in refocusing and concentrating on whatever lies ahead, so consider exploring something you may have not otherwise.

Include exercise and nutrition

Ten percent of dentists smoke cigarettes, and over one-third of them are overweight or obese.³ Coupled with a likely sedentary lifestyle and alcohol intake to combat high work stress, it’s easy for a dentist’s body to suffer. The benefits of good hydration, eating foods rich in micronutrients and vitamins and regularly undertaking some form of exercise cannot be overemphasised—and can also prevent musculoskeletal problems and pain.⁶ Finding a colleague or friend to engage with is a great way to stay accountable and motivated.

Schedule sleep and recovery

Continued education, case preparation and family commitments can all be demanding. It’s easy to end up on our computer screens until late in the night sending emails, sorting practice management issues or even scrolling through Facebook! While these can be tasks that need to be completed, you can still incorporate small measures such as adjusting screen display settings to colours that reduce eye strain and help increase melatonin secretion to reduce potential sleep disruption. Completely shutting down all visible light sources one to two hours before sleep is ideal.

Value personal development

The workweek routine can become repetitive, draining and mundane. Attending clinical workshops and conferences can be valuable in encouraging learning. It’s great for developing new skills, finding new interests and also helping to reinvigorate inspiration and passion. Personal development courses beyond direct dentistry can also have strong merit here.

Overall, it’s important to pay attention to potential signs of stress and burnout as they creep in, to prevent them from having more substantial effects. It may be impossible to completely change every aspect of your lifestyle, try to pick one or two elements you personally enjoy, and to which you can stay committed. 

Balraj Sohal, BDS5, is a student at King’s College London Dental Institute.