Depression, anxiety and stress in dental students

Oral health-related quality of life and psychological states of dental students with temporomandibular disorders

PURPOSE/OBJECTIVES

This study investigates the frequency of temporomandibular disorders (TMD) in dental students, and evaluates the association between TMDs, psychological states, and oral health-related quality of life (OHRQoL). The presence of bruxism was also determined.

METHODS

Two hundred ninety-three dental students completed the Symptom Checklist 90-Revised (SCL-90-R) and Oral Health Impact Profile 14 (OHIP-14) questionnaires and underwent a clinical examination according to Diagnostic Criteria for TMDs.

RESULTS

TMDs were detected in 46.4% of the dental students. OHIP-14 scores of students with TMDs were significantly higher than scores for students without TMDs (p < 0.05). Significant differences were observed in all SCL-90-R scores among students with and without TMDs, except for phobic anxiety and additional SCL-90-R subscale scores (p < 0.05). The prevalence of myalgia was significantly higher in clinical students (26.6%) than in preclinical students (15.6%). OHIP-14 scores of clinical students were significantly higher than preclinical students (p < 0.05).

CONCLUSIONS

In dental students, there was a high frequency of TMDs and bruxism. OHRQoL was poorer in clinical students. Levels of anxiety, depression, and somatization were not different in clinical and preclinical students. SCL-90-R scores are higher in students with TMDs except for phobic anxiety and additional SCL-90-R subscale scores.

The relationship of educational environment and preparedness to practice - perceptions of Malaysian dental graduates

Gauging dental graduates' perceptions of their university training and of how it prepares them for professional practice is useful in measuring the quality and adequacy of the curriculum to which they were exposed.

OBJECTIVES

This study aimed to evaluate the perceptions of dental graduates' educational environment as well as preparedness to practice, and how these two components are correlated.

METHODS

A self-administered, validated questionnaire, developed from previous studies, was distributed to dental graduates of a public Malaysian university (n = 178, response rate = 60%) via online and postal surveys. Bivariate analyses were carried out using Spearman's rank-order correlation (Spearman's Rho, significance level p < .01) to determine the correlation between (1) Global Preparedness Score and Global DREEM Score, (2) domains of DREEM Inventory and perceived preparedness, and (3) domains of perceived preparedness and DREEM Score.

RESULTS

The Global Preparedness Score was 191.52, with more than 90% of respondents feeling well prepared in the "General Patient Management," "Drug and Emergency Management" and "Practice Management" domains. The Global DREEM Score was 148.99/200, interpreted as "more positive than negative." The DREEM Inventory domains with the highest and lowest scores were "Students' Academic Self-Perception" (78.03%) and "Students' Social Self-Perception" (71.86%), respectively. A moderate positive correlation was found between Global Preparedness Score and Global DREEM Score (p < .01). In addition, moderate to large positive correlations were noted between perceived preparedness and "Student Perception of Learning," "Student Perception of Atmosphere" and "Student Academic Self-Perception" (p < .01). Moderate positive correlations were also found between the DREEM Score and most domains of perceived preparedness (p < .01).

CONCLUSIONS

The majority of graduates were well prepared to perform in most areas of clinical practice and perceived their overall educational environment as positive. In particular, those who viewed the educational environment in a positive light were also found to possess a good level of preparedness.

Temporomandibular joints disorders (TMDs) prevalence and their relation to anxiety in dental students

Background: Temporomandibular joint disorders (TMDs) are very common disorders affecting the population and causing pain. Researchers have reported a high prevalence of TMDs among university students due to increased distress. The aims of this study were to determine the frequency of TMDs in Umm al-Qura University (UQU) dental students using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), and to examine the relationship between anxiety, bruxism, and TMDs among those students. Methods: The DC/TMD pain screener questionnaire was completed by dental students. Students who reported TMD pain or had at least one positive TMD symptom were invited to the dental clinic for a full TMJ evaluation. History of bruxism was documented and an ultra-brief tool for detecting anxiety and depression (Patient Health Questionnaire-4 PHQ) was completed by all students. Results: A total of 240 students responded to the TMD pain screener in which 119 reported at least one TMJ symptom. Only 93 dental students presented to clinical examination in which 64.5% (n=60) of them had temporomandibular joint disorders. Disc displacement with reduction and local myalgia (38.7% & 32.25%, respectively) were the most frequent diagnosis. A total of 29% (n=27) of students had more than one diagnosis. Overall, 41 participants (44.09%) reported a positive response to the anxiety scale and (n=38) 40% of participants reported parafunctional habits. Both the history of bruxism and anxiety were significantly related to TMDs (P=0.0002) and also significantly higher in women of higher academic years (P≤0.01). Conclusions: This study found a high prevalence of TMDs among UQU dental students. Disc displacement with reduction was the most prevalent disorder. Bruxism and anxiety were associated with painful TMDs.

Gender Differences in Job Burnout, Career Choice Regret, and Depressive Symptoms Among Chinese Dental Postgraduates: A Cross-Sectional Study

Background

Job burnout, career choice regret, and depressive symptoms among medical students have received widespread attention. However, little is known about the role of gender in these areas for dental postgraduates. This study aimed to explore gender differences in job burnout, career choice regret, and depressive symptoms among Chinese dental postgraduates.

Methods

The data were collected from an epidemiological survey conducted by our group from February 2021 to March 2021. We used a self-administered questionnaire covering demographic characteristics, the Maslach Burnout Inventory, the Primary Care Evaluation of Mental Disorders scale, and the Career Choice Regret scale. Univariate and multivariable analyses were performed to explore influencing factors.

Results

A total of 558 valid dental postgraduate questionnaires were included in this study. The prevalence of job burnout, career choice regret, and depressive symptoms exceeded 30% in males and females. The prevalence of job burnout was 4.7% higher in females than in males; career choice regret was 12.2% higher in females than in males (P < 0.05), and depressive symptoms were 4.9% higher in females than in males. The multivariable analysis showed that factors associated with job burnout for males were sleep time and career choice regret for females. The influencing factors on career choice regret for females were postgraduate entrance examination score, sleep time, and job burnout. Depressive symptoms were a common influencing factor for job burnout and career choice regret in male and female dental postgraduates. Also, job burnout and depressive symptoms had the highest odds ratio for influencing factors on each other.

Conclusion

Over 30% of dental postgraduates suffered from job burnout, career choice regret, and depressive symptoms, and incidences were higher in females. A discrepancy of influencing factors existed between male and female dental postgraduates. Targeted measures should be taken to change this situation.

Effect of distance learning on the quality of life, anxiety and stress levels of dental students during the COVID-19 pandemic

BACKGROUND

The long-term psychological effects of COVID-19 on dental students are unclear. The aim of this cross-sectional online study was to investigate the psychological effects of the COVID-19 pandemic on dental students.

METHOD

The Quality of Life Scale (WHOQOL-BREF) was sent to all dental students through Google Forms to evaluate their quality of life (QoL), and the DASS-21 scale was used to evaluate their psychosocial status due to distance learning during the COVID-19 pandemic. The answers were analyzed both on the basis of year of education and type of education (online versus classroom learning). One-way ANOVA was used for comparison of students in the different years of education; post hoc LSD test was used for pairwise comparisons. Sample t-test was used to compare the two groups separated as classroom/face-to-face learning and distance/online learning.

RESULT

The questionnaire was completed by 580 students with a response rate of 87.74%. According to the QoL scale results, there was no significant difference between the groups regarding general health, physical health, and psychology, both between different years and learning methods (p > 0.05). According to the results of the DASS-21 scale, anxiety and depression in the 3rd year students were significantly higher than the other years. The stress level of the 2nd year students was statistically significantly different from the other years (p < 0.05). Evaluation of anxiety, stress and the QoL showed an overall detrimental effect of distance learning on the dental students, although the evaluation did not reach statistical significance.

CONCLUSION

Anxiety, stress and factors affecting the quality of life negatively affected dental students who received online/distance learning, although the difference did not reach statistical significance when compared to students who received in-classroom learning.

Burnout and Its Association With Competence Among Dental Interns in China

Intern physicians are generally more burdened by stress than the general population. This cross-sectional study aimed to evaluate the current situation regarding burnout and explore its association with the self-evaluation of competence among Chinese dental interns. A self-administered anonymous survey was conducted on 91 dental interns in the Peking University School of Stomatology, from August 2019 to June 2020. It consisted of a psychological stress questionnaire, including burnout and self-evaluation of clinical competence. The Wilcoxon signed rank test was used to determine the differences between self-evaluation scores of clinical competence. Results showed average scores for emotional exhaustion, depersonalization, and personal accomplishment of 22.22 ± 9.04, 8.16 ± 5.21, and 36.08 ± 7.76, respectively. Dental clinical technology was considered more useful than other clinical competencies, and there was a correlation between its importance and the stress caused by its deficiency (r = −0.201, p = 0.056). Significant associations were found between stress due to a lack of dental clinical technology and high emotional exhaustion (r = 0.273, p < 0.05). Burnout was common among the dental interns, which may be a valuable finding. Among the six different aspects of clinical competence, “dental clinical technology” represented the most stressful item. Strengthening pre-clinical training and promptly conducting targeted training in the early clinical process may be considered as decompression measures.

Dental Students’ Experiences during the COVID-19 Pandemic—A Cross-Sectional Study from Norway

The purpose of this cross-sectional study was to map dental students’ experience of the study situation throughout the pandemic. All clinical dental students (year 3 to 5) at the Faculty of Medicine, Department of Clinical Dentistry (IKO), University of Bergen (UiB), Norway, were invited. Participation was anonymous and voluntary, and the response rate was 63%. Questions regarding stress-related factors were divided into three categories. In the category «Stressors/learning», a statistically significant difference was observed between both the genders (p = 0.001) and years of study (p = 0.028). Statistically significant differences between the genders were also observed in the category «Stressors/infection» (p = 0.008). Women were significantly more stressed due to lack of clinical skills (p = 0.048), not receiving as good theoretical teaching as before the pandemic (p = 0.016), and uncertain issues around the exams (p = 0.000). Fourth year students were significantly more stressed due to lack of clinical skills (p = 0.012), for not passing the clinic/skills courses due to lack of study progression (p = 0.005), and worries about not being a good enough dentist after graduation (p = 0.002). In conclusion, the pandemic had a major impact on dental students. The most prominent stressors in relation to the study situation were experienced by students from the fourth year and female students. Clinical and theoretical learning outcomes among students were regarded as worse than before the pandemic. The students preferred in presence lectures, but experienced digital asynchronous video lectures as a good alternative. The pandemic negatively affected the students’ social life. Dental schools should be aware that students have been exposed to increased distress and burden through the pandemic and should provide support for those in need.

Investigating the Relationship between Personality Traits and Distress Tolerance with Mental Health and Academic Performance of Dental Students of Kashan University of Medical Sciences

Background:Mental health and academic performance of students in the quality of dental education is very important to the learners in this field. Study aim:This study was designed to investigate the relationship between personality traits and distress tolerance with mental health and academic performance of dental students attending Kashan University of Medical Sciences, Iran. Methods:Seventy three dental students from Kashan University of Medical Sciences, Iran, participated in the present study. The sampling method was the census method. In this descriptive cross-sectional study, the Mental Health Questionnaire (GHQ), Distress Tolerance Questionnaire (DTS) and Five-Factor Personality Questionnaire (NEO) were used to assess the desired indicators and the total grade point average of students as a measure of their academic performance. Data was analyzed using Poisson regression estimators and descriptive statistics. Results:Study participants had a mean age of 22.42 years and 84.9% of them were single. In this study, the mean score was 23.84 (±11.90) for GHQ and 45.01 (±8.93) for DTS. There was no significant relationship between different variables and their dimensions and students' academic performance. Conclusion:Improving the mental health of dental students is very important and should be on the agenda of educational policy makers.

Influence of knowledge on Brazilian student's perception of life and clinical classes during COVID-19

BACKGROUND

The current pandemic associated with SARS-CoV-2 has negatively influenced several activities, including teaching in Operative Dentistry. The aim of this study was to evaluate the influence of knowledge in Operative Dentistry on undergraduate students' perception related to personal life and return to clinical practices classes during pandemic.

MATERIALS AND METHODS

The present research was a cross-sectional, observational, and qualitative survey. The 16-item based questionnaire was sent to undergraduate students in 2020, which were divided into two groups, according to the Operative Dentistry knowledge: G1-not started clinical practice; G2-already started or completed clinical practice. Questions were focused on the impact of the pandemic in relation to their personal lives and return to clinical practice classes. Chi-square association test was performed using the SigmaPlot 12.0 software (P ≤ 0.05).

RESULTS

The response rate was 55.5% for G1 and 44.4% for G2. Regarding the questions related to personal life, G1 demonstrated higher percentages of fear of contracting the virus during theoretical classes. Same observations were found when students answered about their fear of contracting coronavirus during the clinical practice classes. However, G2 presented the highest agreement responses for the preparedness feeling to return to theoretical classroom, clinical practice classes, and the possibility of applying online learning.

CONCLUSIONS

In general, students' knowledge had little influence on perception of personal life. However, students who have more knowledge in operative dentistry presented more security about returning to clinical classes.

Estonian Dental Students' Oral Health-Related Knowledge, Attitudes and Behaviours (KAB): National Survey-Based Study

The strategic plan for dentistry and oral health in Estonia of 2030 focuses on oral health promotion and disease prevention through undergraduate dental curricula and fostering public health-oriented research among students. The present study was designed as a descriptive cross-sectional study to evaluate oral health-related knowledge, attitudes, and behaviours (KAB) of dental students in Estonia. The study was carried out in the spring semester of 2020, and it used a modified version of the Hiroshima University Dental Behavioural Inventory (HU-DBI). A total of 129 students responded to the survey, constituting a response rate of 93.5% due to the total population sampling (census) technique used in this study and the small target population size. Out of the 124 students included in the final analysis, 79% were females, 62.1% were clinical students, 11.3% reported smoking tobacco at least once a week, and 86.3% reported problematic internet use. The present study found that mean HU-DBI score of Estonian dental students was 8.09 ± 1.22 which is so far the highest recorded HU-DBI score in Europe. There was no significant difference between female vs. male or preclinical vs. clinical students in terms of HU-DBI score. While clinical students reported less faulty oral hygiene practices, such as hard toothbrush use and aggressive toothbrushing, preclinical students reported a slightly higher mean HU-DBI score. Smoking behaviour was more common among male and clinical students, and it was also associated with alcohol drinking and worry about teeth colour and halitosis.

Burnout and Its Relation to Emotion Dysregulation and Social Cognition among Female Interns and Undergraduate Dental Students at King Khalid University

Background: Burnout is a state of vital exhaustion that has a high global prevalence among dental professionals. Yet the early diagnosis of this syndrome is challenging due to its multidimensional nature. Aim: To assess burnout and its relation to emotional dysregulation and social cognition among undergraduate dental students. Methods: We mailed 148 self-administered questionnaires to all interns and undergraduate dental students belonging to the College of Dentistry’s female campus at King Khalid University, Saudi Arabia. A questionnaire was designed comprising three measuring instruments of psychological inventories to assess work-related stress, namely, burnout (Copenhagen burnout inventory questionnaire (CBI)), emotional dysregulation (emotion regulation questionnaire (ERQ)), and social cognition (interpersonal reactivity index (IRI)). We examined the difference in burnout between two cohorts (interns and undergraduates) using Student’s ‘t’ test and the association between emotional regulation/social cognition domains using Pearson’s correlation. Results: Among the participants, around 70% obtained higher scores than the cut-off points for personal and work-related domains in both groups. There was no statistically significant difference in burnout domain between the two cohorts (p > 0.05; Cohen d < 0.3). A negative correlation existed between burnout and emotion regulation, i.e., higher burnout score is associated with lesser cognitive reappraisal and more expressive suppression (CBI—personal burnout r = −0.251; r = −0.220 respectively). Social cognitive scores had various associations among interns and undergraduates, with personal distress being significantly associated with greater burnout levels among both groups (p < 0.05). Conclusions: The present study revealed significantly elevated burnout levels among both interns and undergraduate students. Emotional dysfunction and social cognition assessment can be a valuable adjunct in identifying this erosive syndrome. Early recognition and primordial prevention targeting burnout are strongly recommended.

A microanalysis of expert-student dialogue videos: Supporting preparation and learning for clinical competence assessment

INTRODUCTION

The aim of this qualitative study was to analyse students' perceptions and impact of using a novel video genre designed to support their learning and preparation for a clinical competence assessment. The videos demonstrate expert-student dialogue (ESD) of authentic, one-on-one discourse between the teacher and student, relating to the case presentation and self-evaluation of the assessment.

METHODS

Students who were about to perform a competence assessment were invited to participate in the study. Students were asked to watch a relevant ESD video they had not previously had access to, which showed the examiner-examinee dialogue relating to a peer's tooth preparation for the competence assessment. Immediately after watching the video, a video simulated recall approach was performed to analyse students' perceptions. Thematic analysis was performed to induce relevant themes.

RESULTS

Five themes were identified: analysis and judgement, observational learning from expert dialogue, observational learning from student dialogue, self-efficacy and empathy. Positive responses from interviews suggested high cognitive engagement with this video genre with an affective component that was also valued as an informative learning resource. Students reported the video could stimulate them to think, make it easier to remember knowledge, avoid errors observed, and gain insights into assessment process and examiner's expectations. Empathy was also reported towards the examinee in the video.

CONCLUSIONS

The ESD videos facilitated students' active and analytical thinking as well as improved their assessment preparedness. This video genre has shown how observing ESD can support students' learning and preparation for a clinical competence assessment.

Psychological Distress During COVID-19 Curfews and Social Distancing in Saudi Arabia: A Cross-Sectional Study

Background: Coronavirus disease 2019 (COVID-19) has spread to over 150 countries worldwide. Since the first case of COVID-19 was confirmed in Saudi Arabia, cases have continued to escalate exponentially. The COVID-19 outbreak has had a negative effect on mental health and well-being. The study aimed to investigate the effects of the strict national regulations associated with the COVID-19 pandemic on mental health. Methods: This was a cross-sectional study of a convenience sample of Saudi residents. Saudi residents aged 18 years or older were invited to complete an online questionnaire after one month of a nationwide 24-h curfew between May 6, 2020 and May 13, 2020. We measured psychological distress using the Depression, Anxiety, and Stress Scale-21 (DASS-21). We ran binary logistic regression analyses to detect variables that significantly predicted DASS-21 scores. Results: A sample of 2252 participants was recruited from the general population of Saudi Arabia. The DASS-21 score means and standard deviations for depression and anxiety for the whole sample (10.73 ± 10.29 and 6.98 ± 8.30, respectively) were in the range of mild depression and anxiety. In contrast, the mean DASS-21 stress score was within the normal range (11.97 ± 10.80). The mean stress score for healthcare workers was within the normal range (13.70 ± 10.68) but was significantly higher than the mean score for the public (11.56 ± 10.89; P = 0.0006). Several variables (e.g., age, gender, and history of contact with confirmed COVID-19 cases) were significantly associated with higher DASS-21 scores. Conclusions: The COVID-19 pandemic has created a psychological burden. Therefore, there is an urgent need to implement emergency public health interventions that ameliorate the risk perception of COVID-19 through the dissemination of adequate and targeted health information that could be a successful measure to mitigate the psychological impact of the Covid-19 pandemic.

Short Sleep Duration as a Risk Factor for Depression, Anxiety and Fatigue in Patients with Leukemia

OBJECTIVE

Our study aimed to investigate the level of depression, anxiety, and fatigue in patients with leukemias, and analyze the influence of sleep duration on the mental symptoms of patients with leukemias.

METHODS

A total of 127 patients were enrolled in our study and completed the questionnaire survey. Self-Assessment Depression Scale (SDS), Self-Assessment Anxiety Scale (SAS), and the Fatigue Scale-14 (FS-14) were adopted. The patient's lifestyle information, including exercise, alcohol abuse, and smoking, was obtained from the patient's self-report.

RESULTS

Depression score of patients with sleep duration >8 hours (long duration group) was 56.21±11.63, which was significantly lower than that of patients sleep duration between 6 and 8 hours (medium duration group) with 59.61±8.77 and patients sleep <6 hours (short duration group) with 64.82±6.42 (P = 0.007). Similarly, the anxiety score of long duration group, medium duration group and short duration group was 45.36±11.41, 48.26±6.96 and 53.53±5.87, respectively (P = 0.005). The fatigue score of short duration group is 8.47±2.45, which is higher than others (P = 0.046). To further identify the relationship, we evaluated physical fatigue and mental fatigue levels in patients with or without symptoms of depression. We found that patients with symptoms of depression have a higher score both in physical fatigue and mental fatigue (all p < 0.001). Similar trend was observed in patients with or without symptoms of anxiety (all p < 0.001). However, alzhough patients with leukemia in long duration group have the highest score of physical fatigue (p = 0.016), no significant difference in mental fatigue was found in different sleeping duration group (p = 0.587). Furthermore, multivariate analyses were conducted and revealed that sleep duration was the independent factor associated with depression (OR = 0.270, P = 0.003) and anxiety (OR = 0.473, P = 0.010).

CONCLUSION

For leukemia patients with short sleep duration, a prompt evaluation of their level of depression, anxiety, and fatigue and the initiation of timely interventions is essential.

Psychological consequences of lockdown on dental professionals during the early phase of the COVID-19 pandemic

BACKGROUND

Severe acute respiratory syndrome coronavirus 2, the virus that causes COVID-19, mainly spreads through respiratory droplets. The dental profession is particularly at risk. Routine dental care was suspended after the announcement of the first lockdown in India. This makes the group vulnerable to psychosocial consequences. The present study aims to evaluate the psychosocial issues among dental professionals during COVID-19 pandemic.

MATERIALS AND METHODS

A cross-sectional study was conducted among 627 dental professionals of India, using online Google Forms from April 23, 2020, through April 30, 2020. Participants were evaluated using self-constructed and self-administered personal and professional hardship and fear checklist specifically developed for this study. The 9-item Patient Health Questionnaire (PHQ-9) Depression Scale and 7-item Generalized Anxiety Disorder Scale and PHQ-15 were used to assess the depression, anxiety, and somatic symptoms.

RESULTS

Fear had a remarkable impact on 80.7% of responders. Among the participants, 40.5%, 24.5%, and 30.6% reported symptoms of depression, anxiety, and somatic symptoms, respectively. Somatic symptoms were significantly associated with gender (P = 0.000). Work setting was significantly associated with depression (P = 0.011) and anxiety symptoms (P = 0.001). Concern, worry, and fear due to COVID-19 were significantly associated with depression (P = 0.000), anxiety (P = 0.033), and somatic symptoms (P = 0.009). There was a positive correlation between depression and anxiety symptoms (P = 0.01) and between age and somatic symptoms (P = 0.5).

CONCLUSIONS

This group reported a high level of depression, anxiety, and somatic symptoms. Female dental professionals and private practitioners had more depression, anxiety, and somatic symptoms. Immediate and special intervention is needed for this group. Further exploration into the nature and its effects of the psychological symptoms may be required.

Effect of Dental Environment Stressors and Coping Mechanisms on Perceived Stress in Postgraduate Dental Students

Aim and objective

To investigate the effect of dental environment stressors and coping mechanisms on perceived stress in postgraduate dental students.

Materials and methods

This cross-sectional study enrolled 250 postgraduate students from four dental colleges. Modified dental environment stress (DES) questionnaire was used to study the dental environment-related stressors, perceived stress score (PSS) to measure the extent of stress perception, and brief COPE (BC) scale to measure the use of various coping strategies deployed to combat stress. An independent T-test was used to determine the associations of these measures with gender and marital status and one-way ANOVA for associations with year of study. Hierarchical regression was used to determine the effect of demographic factors, career-related psychological background, health-related habits, DES, and BC score on PSS.

Results

“Synopsis, thesis, library dissertation” and “lack of adequate infrastructure” were reported as the highest stressors by the postgraduate students. Only 4.8% of respondents perceived low stress, while 65.2% perceived high stress. A high correlation between the DES score and PSS was observed. Active coping, acceptance, and positive reframing were the most commonly utilized coping strategies. Planning and use of emotional support were the only coping strategies that were significant negative predictors of PSS. Problem-focused coping strategies had a positive, but non-significant correlation with PSS, while emotion-focused coping strategies had a significant negative correlation with PSS.

Conclusion

Postgraduate dental environment causes a high-stress perception in students and reactive coping strategies have only a limited role in reducing stress perception.

How to cite this article

Sikka N, Juneja R, Kumar V, et al. Effect of Dental Environment Stressors and Coping Mechanisms on Perceived Stress in Postgraduate Dental Students. Int J Clin Pediatr Dent 2021;14(5):681–688.

The Association between Emotional Stress, Sleep, and Awake Bruxism among Dental Students: A Sex Comparison

Psychosocial factors may play an important role in the etiology of sleep and awake bruxism. The purpose of this study was to assess the relationship between emotional stress and bruxism in male and female dental students at various stages of their education. Dental education in Israel is based on a six-year curriculum, divided into three stages: pre-medical studies (yr. 1-2), manual skills (yr. 3-4), and clinical experience (yr. 5-6). Each stage requires different capabilities and skills. Questionnaires regarding psychological state (SCL-90) measuring depression, anxiety, and somatization as well as stress evaluation questioners (Perceived Stress Scale questionnaire 14) were completed by 387 dental students in the 1st to 6th years. Sleep and awake bruxism were evaluated based on the respondent's awareness. During the manual stage of studies, a significant increase was identified, albeit with weak correlations, between stress scales, depression, anxiety, somatization, and the prevalence of awake bruxism, particularly among males. Only in females was sleep bruxism correlated with emotional parameters, whereas no significant difference in sleep bruxism was observed in males throughout the stages of the study. The manual years of dental education were found to be linked to higher levels of emotional distress and awake bruxism, particularly in men. Sleep bruxism, on the other hand, was not directly linked to emotional factors, implying a distinct etiology.

Risk analysis of factors in clinical anxiety among undergraduate and postgraduate students in dentistry

BACKGROUND

When anxiety is persistent among dental students, the consequence could be poor academic performance, ill health, lack of empathy, and exhaustion.

OBJECTIVE

This study aimed to determine the level of anxiety along with anxiety-provoking factors among clinical dental students.

METHODS

This study included dental undergraduate and postgraduate clinical students from a public university. A modified version of the self-administered Moss and McManus questionnaire, which consisted of 50 items, was utilized to evaluate the levels of anxiety. The results were analyzed using SPSS ® version 24. The significance level was set at p <  0.05.

RESULTS

Within 180 participants, 140 (77.77%) were undergraduate students, while 40 (22.22%) were postgraduate dental students. Overall, the top clinical anxiety-provoking factor included failure to pass the final examination, whereas the least clinical anxiety-provoking element was communicating with the opposite gender. Significant differences existed among male and female participants in the seven anxiety-provoking factors among the participants namely dealing with elderly patients, fail to pass finals, arresting post-extraction bleeding, patients asking difficult questions, fear of accidental pulp exposure, dealing with a child or non-cooperative patient, and fear of taking an incorrect impression. Postgraduate students showed lower anxiety scores in various clinical tasks as compared to undergraduate students.

CONCLUSIONS

Postgraduate dental students share largely the same perspectives with undergraduate dental students on the clinical anxiety-provoking situations with slight variations. Being the future healthcare providers, dental students must learn techniques to help them manage their dental anxiety and fear as well as deal with anxiety related to treating patients.

Prevalence, awareness, and management of bruxism in Thai dental students: A cross-sectional study

OBJECTIVE

To determine the prevalence of self-reported bruxism, awareness of bruxism's adverse effects, and bruxism management among Thai undergraduate dental students.

METHODS

An online self-reported questionnaire was designed and tested for validity and reliability and then distributed to dental students at 12 universities in Thailand from September 2020 to January 2021.

RESULTS

There were 464 respondents (338 females and 126 males) with an average age of 21.42 ± 2.06 years. The prevalence of self-reported awake and sleep bruxism was 35.78% and 37.28%, respectively, and 19.40% had both awake and sleep bruxism. Awareness scores were higher for dentists than for patients (p< 0.001). Only 12.14% of sleep bruxers still wear an occlusal splint for bruxism management.

CONCLUSION

The prevalence of self-reported awake and sleep bruxism was high among Thai dental students. They are well aware of the adverse effects of bruxism with inappropriate management of the condition.

Mental burden and perception of the study situation among undergraduate students during the COVID-19 pandemic: a cross-sectional study and comparison of dental and medical students

OBJECTIVES

To investigate levels of distress, depression, anxiety, stress and perception of their current study situation during the COVID-19 pandemic among undergraduate dental and medical students.

DESIGN

Observational, cross-sectional study including two consecutive surveys (May and July 2020).

SETTING

A large medical school in Germany.

PARTICIPANTS

All first year dental and medical students were invited. 132 participating first year students (44 dental, 88 medical) from the first survey and 150 students (50 dental, 100 medical) from the second were included in our analyses.

PRIMARY AND SECONDARY OUTCOME MEASURES

Mental burden (distress thermometer, Patient Health Questionnaire-4, Perceived Stress Scale-4) and self-reported changes in mental health and perception of study situation during the COVID-19 pandemic (self-developed items) were compared. Open-ended questions were analysed by conventional content analyses.

RESULTS

A considerable proportion of students (t1: May 2020: 84.1%; t2: July 2020: 77.3%) reported distress levels above cut-off. In July 2020, dental students reported significantly higher distress scores than medical students (dental: M=7.0, SD=2.3; medical: M=5.7; SD=2.1; p<0.001). More dental than medical students reported mild, moderate and severe levels of anxiety and depression symptoms. The majority stated that their mental health and study motivation had not changed during the pandemic. Logistic regression showed that being a dental student was significantly associated with a higher likelihood for serious worries regarding the study situation during COVID-19 at t1 (OR 4.0; 95% CI 1.1 to 14.2). At t2 higher distress was significantly associated with a higher likelihood for experiencing serious worries (OR 1.8; 95% CI 1.3 to 2.5). Regarding current concerns related to the pandemic, students most frequently reported difficulties with self-regulated learning (15.2%), study-related worries and uncertainty (14.4%), missing feedback of students and lecturers (11.4%) and lack of practical training (9.8%).

CONCLUSION

The results suggest that high mental burden and the lack of practical training among medical and dental students is an increasing problem, with a possibly even higher urgency in dental students. Tailored psychological and educational support offers during and after the COVID-19 pandemic might help them as they progress through (medical and) dental school.

Meta-Analysis of Prevalence of Depression in Dental Students during COVID-19 Pandemic

Background and Objectives: The COVID-19 pandemic has a negative impact on the mental health of the population in general, and in college students in particular. Dental students have seen their teaching altered and their clinical practice reduced. This study was aimed at conducting a systematic review and meta-analysis of studies reporting levels of depression among dental students during the COVID-19 and estimating the pooled prevalence of depression. Materials and Methods: Medline via PubMed and other databases were searched for studies on the prevalence of depression in dental undergraduates, published from 1 December 2019 to 1 September 2021. The pooled proportions of depression were calculated with random effects models. Results: We identified 13 studies from 9 countries. The pooled prevalence of depression in dental students was 37% (95% CI: 26-49%) with no variation due to gender, response rate or methodological quality. We only found a significantly higher prevalence of depression in studies from Asia compared to Europe and America. Conclusions: Our results suggest that dental students are suffering from higher levels of depression compared with the general population or other college students during the COVID-19 pandemic, with differences across regions. Measures to improve mental health and wellbeing of dental students during the pandemic are needed.

Extreme Situation Experienced by Dental Students of the Medical University of Silesia Due to the SARS-CoV-2 Epidemic during the First Lockdown

The pandemic declared in many countries in 2020 due to COVID-19 led to the freezing of economies and the introduction of distance learning in both schools and universities. This unusual situation has affected the mental state of citizens, which has the potential to lead to the development of post-traumatic stress and depression. This study aimed to assess the level of stress in dental students in the context of the outbreak of the SARS-CoV-2 virus pandemic. A survey on the PSS-10 scale was prepared to measure the level of perceived stress. The study included 164 dental students at the Faculty of Medical Sciences of the Medical University of Silesia in Katowice, Poland. The results showed the impact of COVID-19 on the stress of students, with 67.7% reporting high levels of stress. The study also revealed that stress was higher among older female students. This paper recommends that the university provide more intensive psychological care as psychological first aid strategies in epidemics or natural disasters and to consider telemedicine in order to deliver services due to the limitations of the pandemic.

The Relationship between Stress Levels Measured by a Questionnaire and the Data Obtained by Smart Glasses and Finger Pulse Oximeters among Polish Dental Students

Stress is a physical, mental, or emotional response to a change and is a significant problem in modern society. In addition to questionnaires, levels of stress may be assessed by monitoring physiological signals, such as via photoplethysmogram (PPG), electroencephalogram (EEG), electrocardiogram (ECG), electrodermal activity (EDA), facial expressions, and head and body movements. In our study, we attempted to find the relationship between the perceived stress level and physiological signals, such as heart rate (HR), head movements, and electrooculographic (EOG) signals. The perceived stress level was acquired by self-assessment questionnaires in which the participants marked their stress level before, during, and after performing a task. The heart rate was acquired with a finger pulse oximeter and the head movements (linear acceleration and angular velocity) and electrooculographic signals were recorded with JINS MEME ES_R smart glasses (JINS Holdings, Inc., Tokyo, Japan). We observed significant differences between the perceived stress level, heart rate, the power of linear acceleration, angular velocity, and EOG signals before performing the task and during the task. However, except for HR, these signals were poorly correlated with the perceived stress level acquired during the task.

New psychometric evidences on the Dental Environment Stress questionnaire among Romanian students

BACKGROUND

The academic environment is a challenge for dental students due to the multiple sources of stress they face. For this reason, the present study analyzes the psychometric properties of the Dental Environment Stress (DES) questionnaire. The secondary objective was to identify the specific sources of stress perceived by dental students related to gender and years of study.

MATERIALS AND METHODS

A cross-sectional study was conducted among dental students (n = 340; M_age= 22.45) from the Romanian University of Medicine and Pharmacy in October- December 2019. The factorial structure of the questionnaire was performed by means of the confirmatory factor analysis (CFA) and the multi group-CFA. The convergent and divergent validities were measured by associating DES with scales that measure depression, anxiety, and tension/stress (Depression Anxiety Stress Scale-21-R), perceived stress (Perceived Stress Scale-14), and life satisfaction (Satisfaction with Life Scale).

RESULTS

New measure obtained supported a five-factor and thirty-item structure, which is gender invariant. All the factors within DES have a significant positive correlation with depression, anxiety, tension/stress, and perceived stress and a negative correlation with life satisfaction. The Cronbach's α coefficients are acceptable (range: 0.67-0.89). The female students perceive aspects related to performance, the relations with the faculty, clinical responsibilities, and personal life to be more stressful than males. Senior students perceive more stressed aspects related to personal life, while freshmen have higher scores on stress associated with clinical responsibilities.

CONCLUSIONS

The present results show that DES has psychometric properties which are adequate for the assessment of dental stress in the case of Romanian students; nevertheless, it is necessary to extend the use of DES to students attending other universities and to dental practitioners.

Depression and suicidal ideation among dental students of Southern Saudi Arabia: A cross sectional study

PURPOSE

To assess depression and suicidal ideation among dental students at King Khalid University College of Dentistry, Abha, Saudi Arabia.

METHODS

A cross-sectional questionnaire-based study was carried out among dental students between January and March 2020. The Arabic version of the Patient Health Questionnaire (PHQ-9) was used to assess depression, while suicidal ideation was assessed using three questions related to suicidal behaviors drawn from the literature.

RESULTS

A total of 218 participants completed the questionnaires. More than 40% of the participants experienced depression while the prevalence of suicidal ideation was 48.2%; around a third of the sample had suicidal ideation, and half of which made a suicidal attempt in the preceding year (p < 0.05). There was a lack of association between depression severity and suicidal ideation.

CONCLUSION

A large proportion of dental students experienced depression and suicidal ideation. These findings invite in depth analysis of the causative and contributing factors for such high rates as well as ways for addressing them.

Effects of COVID-19 lockdown on the mental health of dental students: A longitudinal study

OBJECTIVES

Many countries have enforced lockdowns on their populations due to the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to assess the effects of the lockdown on dental students.

METHODS

A longitudinal, repeated cross-sectional study was conducted to evaluate psychological problems experienced by dental students during the COVID-19 lockdown in Saudi Arabia. The dental students were selected from different universities using 2-stage cluster sampling. The validated Arabic version of the 21-item depression, anxiety, and stress scale questionnaire was distributed at the beginning and end of the lockdown. Mann-Whitney U and Kruskal-Wallis tests were used as appropriate. Chi-square test was used to compare the proportions between the sociodemographic data, and logistic regression analysis was used to identify variables associated with the students' responses.

RESULTS

A total of 1287 respondents participated in this study (695 first-survey respondents, 592 second-survey respondents). There were longitudinally significant differences in the students' mental health outcomes based on gender, university, class year, and survey time during the COVID-19 lockdown. The lockdown increased the likelihood of female, single, and junior students experiencing stress. The students who lived alone recorded a high chance of elevated levels of depression, anxiety, and stress, which showed a significant longitudinal reduction during the lockdown. Moreover, the lockdown increased the likelihood of mental health problems among the students staying in households of two persons or two-five persons.

CONCLUSIONS

This study indicates the importance of considering the detrimental mental health consequences on dental students in the event of future pandemics.

The Application of a Case-Based Social Media-Assisted Teaching Method in Cariology Education：Comparative Study

Background

Current cariology education based on the traditional teaching method faces a lot of challenges. Meanwhile, the COVID-19 pandemic caused an unprecedented disruption in medical education and health care systems worldwide. Innovation in the teaching mode of cariology education is required to change the situation.

Objective

The goal of the research was to evaluate the application effects of a case-based social media–assisted teaching method in cariology education.

Methods

Dental students of class 2019 were enrolled into the experimental group, while students of class 2018 served as control. A case-based social media–assisted teaching method was used in the experimental group, which included preclass activity via social media, additional discussion and practice process record in class, and questions and answers on the platform after class. The traditional teaching method, which consisted of conventional preparation before class, traditional lectures and demonstrations followed by students practice in class, and questions and answers step after class, was used in the control group. The teaching materials were the same in both groups. At the end of the program, students from both groups took cavity preparation skill evaluation tests. Questionnaires were tested on the case-based social media–assisted teaching group students anonymously. All data were analyzed using SPSS statistical software (version 22.0, IBM Corp).

Results

The mean student cavity preparation skill evaluation scores was 82.51 (SD 6.82) in the experimental group and 77.19 (SD 5.98) in the control group (P<.05). The questionnaire response rate was 100%. Of those, 94.3% (100/106) of the students recommended the case-based social media–assisted teaching method in cariology education. The majority of the participants agreed that it helped them memorize the theoretical knowledge of cariology, facilitated in-depth discussion, improved their enthusiasm and initiative in learning, and enhanced the relationship between teachers and students (104/106, 98.1%). They also recognized that the classroom atmosphere was active (94/106, 88.7%).

Conclusions

The case-based social media–assisted teaching method was beneficial in terms of learning, as demonstrated by the statistically significant improvement of the cavity preparation skill evaluation scores and satisfaction from attending students. This method could be used to supplement the teaching of cariology.

Risk Factors for Depression and Anxiety Disorders Among Bangladeshi Dental Students: A Cross-Sectional Survey Study

Dental students are highly prone to mental health suffering due to the stressors related to their educational, academic, and clinical environment. However, there are no previous studies that evaluated the mental health problems among dental students in Bangladesh. Therefore, the present study assessed the prevalence of depression and anxiety and its covariates. A cross-sectional survey was carried out among the students of five (out of a total of nine) Bangladeshi public dental institutes. The survey included the Patient Health Questionnaire, the Generalized Anxiety Disorder scale, and questions relating to sociodemographic factors, personal suffering, and family mental health history. Results indicated that the prevalence rates for moderate to severe depression and anxiety were 27.4% and 18.2%, respectively. The risk factors for depression and anxiety were being female, coming from city areas, having past-year psychological and physical suffering, having past-year traumatic events, and having a family history of mental illness, as well as a range of suicide-related behaviors. The prevalence rates of depression and anxiety in the present study were relatively lower than other dental student cohorts residing outside Bangladesh. Further investigations are suggested based on the limitations and strengths of the present study.

Exploring the term "resilience" as understood and experienced by dental educators

INTRODUCTION

Working as a dentist is a demanding and stressful occupation. Resilience is therefore widely thought to be a desirable quality in dentists, and these attitudes are likely to be initially formed during undergraduate training. The attitudes and experiences of dental educators are important as they are likely to influence dental undergraduates. This study describes how dentists working within an academic setting understand and experience resilience.

METHODS

A series of qualitative interviews were conducted with a purposive sample of 12 dentists working within an academic setting in the UK. All interviews were digitally recorded and transcribed verbatim. A structured process of thematic analysis was followed in order to describe key themes that arose in the interviews.

RESULTS

There was a common acknowledgement that resilience is the result of a dynamic process involving multiple factors. Six factors were described as relating to resilience: background and personal characteristics, environment, life challenges, mood, attitudes and expectations and actions and strategies. Each of these factors was also described as affecting the others in a reciprocal manner.

CONCLUSION

The academics in this study described resilience in terms of both personal and environmental factors and their interactions. This understanding could inform the development of programmes designed to enhance resilience for both dental educators and students, which might usefully focus on a range of individual and systemic factors.

Factors affecting the prevalence of stress, anxiety, and depression in undergraduate Indian dental students

BACKGROUND

The objective was to assess the prevalence and the associated demographic factors of stress, anxiety, and depression among undergraduate (UG) Indian dental students and determine whether the pattern is different in government-run institutions and those managed by private authorities.

MATERIALS AND METHODS

A cross-sectional study was conducted among dental UG students from five dental colleges. Snowball sampling was used to approach 776 potential participants, resulting in a complete response from 507 students. The questionnaire consisted of demographic data; year of study; type of college; accommodation; and Depression, Anxiety, and Stress Scale (DASS)-42. Descriptive data and inferential statistics were obtained. Chi-square test was applied for categorical data to test for significance, and higher analysis was done using multiple linear regression.

RESULTS

Females and males comprised 71.8% (n = 364) and 28.2% (n = 143) of the study population, respectively. The prevalence of anxiety was highest (66.86%, n = 339), followed by depression (57.39%, n = 291) and stress (43.99%, n = 223). In terms of severity also, anxiety was the most prevalent condition as more than one-fourth of the students presented with severe and very severe scores in this aspect (25.43%, n = 129) compared to depression (14.39%, n = 73) and stress (10.09%, n = 51). Regression analysis revealed age as a strong positive predictor for all the three conditions, while staying in the hostel was a positive predictor for anxiety and stress. Being female was also an independent predictor for the high prevalence of stress.

CONCLUSION

Stress, anxiety, and depression are highly prevalent among Indian dental students. Clinical students and interns have a higher prevalence of stress than preclinical students. Age, being female, and staying in the hostel are positive predictors for the severity of stress. There is no significant difference between government and private colleges, regarding the prevalence of any psychological condition.

Association between depression, anxiety, stress and perceived quality of life in a Malaysian B40 urban community during the COVID-19 lockdown: A cross-sectional study

Background: In Malaysia, B40 communities are those with a median monthly household earning of under RM 3166. With the prolonged COVID-19 pandemic and the resulting lockdown, the livelihoods of those in these areas has been severely impacted. This has increased their vulnerability to psychological afflictions and has led to a poorer perception of their quality of life (QoL) in comparison to the rest of the population. We investigated the association between perceived levels of depression, anxiety and stress and their impact on quality of life (QoL) among B40 residents in a low-cost urban housing area in Kuala Lumpur, Malaysia. Methods: A cross-sectional study was conducted between July 2020 and February 2021 in the Seri Pantai housing settlement. The validated Malay versions of the depression, anxiety, and stress scale-21 (DASS-21) and the World Health Organization Quality of Life, brief (WHOQOL-BREF) were distributed to the participants using Google forms. The statistical significance of the association between subscales of depression, anxiety, stress and QoL domains were assessed using the Pearson's correlation test. Results: Of the 180 participants, the majority were Malays (87.2%) and females (82.2%). The average scores were the highest for stress (5.66 ± 4.59) and the score in the environment domain of QoL (59.27 ± 17.23) was the lowest. A statistically significant negative correlation was found between the subscales of DASS-21 and the four domains of the QoL, with the social relationships and psychological domains showing a highly significant association (p < 0.001). The strongest correlation was observed between the psychological domain and depression (r= -.520) followed by psychological domain and stress (r= -.496). Conclusion: The strongest correlation was observed between psychological domain and depression. This suggests a need to address potential devastating mental health consequences of the COVID-19 pandemic and its effect on the QoL of residents in B40 communities.

Level of anxiety in clinical settings and coping mechanisms used by dental undergraduate students to overcome it

INTRODUCTION

Dental undergraduate students encounter anxiety in their professional years of study, the impact of which is reflected on their overall performance. Various coping techniques are advocated that help individuals to deal effectively with the adverse effects of anxiety.

OBJECTIVE/AIMS

The objectives of this study were to determine the level of anxiety encountered by dental undergraduate students during clinical rotations, the clinical procedures precipitating it and the number of different coping strategies (problem solving, social seeking support, and avoidance) used by students for anxiety management.

METHODS

A descriptive, questionnaire-based, cross-sectional study was conducted on the third and fourth-year undergraduate dental students from six colleges of Islamabad and Rawalpindi. A total of 353 students were included in the study, and their participation in the study was anonymous and voluntary. The administered questionnaire consisted of three parts: Part 1: Moss and McManus Scale (MMM) for anxiety-provoking situations; part 2: Hamilton Anxiety Rating Scale (HAM-A) for the level of anxiety, and Part 3: Coping Strategy Indicator Scale (CSI scale) to determine the frequency of coping strategies used by students. The data were collected and analyzed using SPSS version 22.0.

RESULTS

A majority of participants (96.3%) felt mild to moderate levels of anxiety in the clinical settings. Students felt more anxious about getting infected by the patient (62%), extracting the wrong tooth (46.5%), and getting a wrong diagnosis (43.1%). A significant number of participants (47%) used problem-solving mechanisms to overcome their anxiety.

CONCLUSION

Mild to moderate levels of clinical anxiety prevailed in most dental undergraduate students. The top clinical situations precipitating anxiety were getting infected by patients and extracting the wrong tooth. Measures should be taken to encourage a vigorous, confidence-enhancing environment for students. This will reduce their levels of clinical anxiety along with training and foster healthy coping strategies to deal with unavoidable anxiety.

The status of climate studies in the United States and Canadian dental schools: Deans' perspectives

OBJECTIVES

Institutions with a positive cultural climate make community members from all backgrounds valued and included, and treated equitably. Such an environment is optimally suited to prepare future dentists well for leading a diverse team of staff members and addressing the oral health care needs of increasingly more diverse patient populations. The objectives were to assess how many United States and Canadian dental schools had participated in a climate study at their parent institution and/or had conducted their own climate study, which topics these studies had addressed, how they collected their data, from whom they collected data, and how the findings affected these academic units.

METHODS

In January 2020, 54 of the 78 dental school deans in the United States and Canada responded to a web-based survey (response rate: 69%).

RESULTS

Forty-six parent institutions (85%) and 27 dental schools (50%) had conducted climate studies. Eighty-seven percent of parent institutions assessed the climate overall and the climate for specific groups (70%), such as for persons from underrepresented minority backgrounds (67%) or different religious backgrounds (59%). Most parent institution and dental school studies utilized surveys to collect data from faculty (parent institutions: 76%/dental schools: 96%), staff (74%/93%), administrators (72%/93%), and students (72%/89%). Overall, climate study results positively affected parent institutions' and dental schools' humanistic environment (61%/63%) and the recruitment of faculty (46%/50%), students (46%/46%), and staff (41%/43%).

CONCLUSIONS

Climate studies are a widely accepted practice at dental schools and their parent institutions. Their results can play a vital role in shaping the climate of these academic units by fostering efforts to increase diversity, equity, and inclusion.

Depression among the Non-Native International Undergraduate Students Studying Dentistry in Bangladesh

BACKGROUND

Bangladesh has been attracting international students with interests in various subjects recently. Every year students from different parts of the world come to study undergraduate and postgraduate courses, mostly at private universities in Bangladesh. This study evaluates the depression status among international students who are studying dentistry in Bangladesh.

METHODS

This cross-sectional survey was conducted among International undergraduate dental students who enrolled in the Bachelor of Dental Surgery program in nine public and private dental colleges in Bangladesh. Participants were selected using a convenience sampling method. A total of 206 students completed the survey where 78.5% of them were female students and 21.5% students were male, and a CES-D 10-item Likert scale questionnaire was used for data collection. The Cronbach alpha for the 10-item CES-D scale for this population is 0.812.

RESULTS

The majority of the students (79.5%) are below 24 years of age with a mean age of 23.22 years and standard deviation of 2.3, and are students who cannot communicate well in Bengali (Bangla), about 60% of them have experienced depression. About 77.3% (p < 0.00) of the international students having financial difficulties exhibited depression. The international students who went through financial problems were two times more likely to suffer from depression (OR = 2.38; p-value < 0.01).

CONCLUSION

This study tried to highlight the struggles faced by international students in Bangladesh studying dentistry. It is evident from the findings that several factors influence students' mental well-being during demanding dental education years.

Relationship between physical activity, academic achievement, gender, and learning styles in students of a Latin American Dental School: A cross-sectional study

BACKGROUND

Little is known about the inference that physical activity (PA) may have on academic performance and learning styles of Latin American dental students.

MATERIALS AND METHODS

In this cross-sectional study, an administrative dataset and a voluntary university characterization provided information about PA and academic performance. Moreover, 218 dental students of the University of Antioquia in Colombia completed a structured questionnaire to identify their learning styles. To analyze the information obtained a Pearson correlation, and logistic and linear regression models were implemented.

RESULTS

A total of 131 (60%) students informed being physically active (PA group), and 87 (40%) did not report PA (non-PA group). The results showed a high-grade point average (GPA) in the PA group (P = 0.01). The PA group showed a preference for the theorist and pragmatist learning styles with statistically significant differences between the groups (P = 0.004 and P < 0.0001, respectively). It was also observed a statistically significant Pearson positive correlation between the theorist style and higher GPA (r = 0.15; P = 0.04). The multivariate regression model showed that PA protects against lower means of GPA (odds ratio = 0.3; 95% confidence interval [CI]: 0.09-0.7, P = 0.01). Furthermore, the adjusted linear regression models also showed that PA protects against lower means of the theorist (β= -0.15; 95% CI: -0.02 to - 0.002, P = 0.002) and pragmatist styles (β= -0.18; 95% CI: -0.03 to - 0.006, P = 0.0006). Interestingly, men were statistically significant in all multivariable models.

DISCUSSION

This study suggests that PA is associated with higher academic performance and the theorist and pragmatist styles. Male students were also more physically active; therefore, it is relevant to establish strategies to stimulate physical activities in dental students, especially in women, including extracurricular activities.

Self-Perceived Impact of COVID-19 Pandemic by Dental Students in Bucharest

All social and economic systems worldwide, including the educational one have been disrupted by escalating the global COVID-19 pandemic. One of the most impacted areas were the medical and dental education fields, due to the forced break from clinical practice during the lockdown, which affected both the educational part, as well as the patients. Thus, the main goal of our research was to investigate the impact of the COVID-19 pandemic on the dental students' education as related to their perceptions and evaluations, in Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. A cross-sectional study was conducted on 878 dental students who reported their perception of the psychological and educational impact of this period by completing a Google Forms questionnaire. Collected data were statistically analyzed using Stata/IC 16. There was a severe psychological impact among the respondents, the levels of stress being perceived as high and very high (33.83%, n = 297; 28.59%, n = 251), similar to high and very high anxiety feelings (26.54%, n = 233; 24.26%, n = 213). Very high educational impact from the point of view of the acquisition of practical skills (48.52%, n = 426) and future professional perspectives (38.95%, n = 342) were recorded. While online theoretical learning ability was principally low (37.93%, n = 333) despite consistently modified time allocated to the individual study (44.35%, n = 389), most of the students evaluated the efficiency of lecturers in online courses as neutral (41.12%, n = 361). New dentistry teaching programs will have to be adopted taking into account the dynamics of the pandemic and its strong impact on our students, in order to improve both their wellbeing and the sustainability of dental education.

Evaluation of temporomandibular disorders among dental students of Saudi Arabia using Diagnostic Criteria for Temporomandibular Disorders (DC/TMD): a cross-sectional study

BACKGROUND

Temporomandibular disorders (TMD) are a broad category of conditions arising from the various components of the temporomandibular joint complex. Bio-psychosocial model is the most accepted theory describing the etiopathogenesis of TMD. Dental students are vulnerable to psychological disorders, including anxiety, depression, and stress. Hence, the aim of the current study was to evaluate the prevalence and possible risk factors of TMD among dental students of various academic levels and explore the association of TMDs with demographic, academic, and psychosocial parameters.

METHODS

A total of 246 students of a Saudi Arabia dental school were chosen for the study. After getting consent, all students were examined according to the Diagnostic Criteria for Temporomandibular Disorders, including Axis I and II components.

RESULTS

The overall cross-sectional prevalence of TMD was found to be 36.99%. Pain arising from the jaw, temple, and the peri-auricular area were the most commonly reported symptoms and elicited signs during examination. Among the pain-related TMD, myalgia was the commonest diagnosed condition, whereas disc displacement with reduction was found prevalent in the intra-articular disorder category. Female (OR = 1.94; P = 0.004), married (OR = 1.74; P = 0.04), and students in clinical academic levels (OR = 1.65; P = 0.03) were found to have significantly increased risk of TMD. Among the psychosocial parameters, anxiety (OR = 1.55; P = 0.04) and parafunctional behaviours (OR = 2.10; P < 0.001) were shown to increase the risk of developing TMD. Students with any TMD reported to have significantly higher pain intensity levels (OR = 1.68; P = 0.01) and jaw functional limitations (OR = 1.45; P = 0.008).

CONCLUSION

Dental students, especially in clinical levels were shown to pose a higher risk of developing TMD, hence strategies such as academic counselling and objective evaluation via rubrics should be planned to modify the administration of the curriculum, training methods and evaluation process.

Evaluation of the Most Stressful Dental Treatment Procedures of Conservative Dentistry among Polish Dental Students

BACKGROUND

Dental schools are considered to be a very stressful environment; the stress levels of dental students are higher than those of the general population. The aim of this study was to assess the level of stress among dental students while performing specific dental procedures.

METHODS

A survey was conducted among 257 participants. We used an original questionnaire, which consisted of 14 questions assigned to three categories: I-Diagnosis, II-Caries Treatment, and III-Endodontic Treatment. Each participant marked their perceived level of stress during the performed dental treatment procedures. The scale included values of 0-6, where 0 indicates no stress, while 6 indicates high stress.

RESULTS

Third- (p=0.006) and fourth-year (p=0.009) women were characterized by a higher level of perceived stress during dental procedures related to caries treatment. Caries treatment procedures were the most stressful for 18.3% of third-year students, 4.3% of fourth-year students, and 3.2% of fifth-year students. Furthermore, 63.4% of third-year students, 47.3% of fourth-year students, and 17.2% of fifth-year students indicated that they felt a high level of stress when performing endodontic procedures.

CONCLUSION

Third- and fourth-year female students are characterized by a higher level of stress during caries and endodontic treatment procedures. The most stressful treatments for participants were endodontic treatment procedures.

Depression, anxiety and stress among medical and non-medical students in Saudi Arabia: An epidemiological comparative cross-sectional study

Objectives:

To quantify the extent and variation of depression, anxiety and stress among medical and non-medical Saudi Arabian students.

Methods:

In this cross-sectional study, students from Umm Al-Qura University, Makkah, Saudi Arabia, were recruited. The Faculty of Education was randomly selected to represent the non-medical colleges. The depression, anxiety and stress scale-21 items (DASS-21) was used to estimate the study outcomes.

Results:

Of the 465 undergraduates recruited in this study, 49.68% (n=231) were medical students and 50.32% (n=234) were non-medical students. Approximately 54%, 53%, and 38% of the participants were found to be suffering from depression, anxiety, and stress, respectively. The analyses showed that the two groups did not differ significantly with respect to stress and depression (p=0.934 and 0.423, respectively). However, the non-medical students exhibited a significantly higher anxiety score compared to the medical students (p=0.002). Family conflicts was a common risk factor for the studied psychological disturbances. Female gender and travel time from home to university were significant predictors of depression and anxiety, whereas a positive history of a psychological condition increased the likelihood of depression and stress.

Conclusion:

There was a high prevalence of anxiety, stress, and depression among the students, with a significantly higher anxiety levels among the non-medical students.

Prevalence and factors associated with depression, anxiety and stress among healthcare workers of Trinidad and Tobago during COVID-19 pandemic: a cross-sectional study

OBJECTIVES

To determine the prevalence and factors associated with depression, anxiety and stress among healthcare workers (HCWs) during COVID-19 pandemic.

DESIGN

Cross-sectional online survey.

SETTING

HCWs from four major hospitals within the Regional Health Authorities of Trinidad and Tobago.

PARTICIPANTS

395 HCWs aged ≥18 years.

MAIN OUTCOME MEASURES

Depression, anxiety and stress scores.

RESULTS

Among the 395 HCWs, 42.28%, 56.2% and 17.97% were found to have depression, anxiety and stress, respectively. In the final stepwise regression model, contact with patients with confirmed COVID-19, p<0.001 (95% CI 3.072 to 6.781) was reported as significant predictors of depression. Further, gender, p<0.001 (95% CI 2.152 to 5.427) and marital status, p<0.001 (95% CI 1.322 to 4.270) of the HCWs were considered to be correlated with anxiety. HCWs who had contact with patients with suspected COVID-19 had lower depression, p<0.001 (95% CI -5.233 to -1.692) and stress, p<0.001 (95% CI -5.364 to -1.591).

CONCLUSIONS

This study has depicted the prevalence and evidence of depression, anxiety and stress among HCWs during the COVID-19 pandemic. The findings of the study will serve as supportive evidence for the timely implementation of further planning of preventative mental health services by the Ministry of Health, for frontline workers within the public and private health sectors.

The impact of resilience on anxiety and depression among grass-roots civil servants in China

Background

The grass-roots civil servants are the final implementers and executors of a series of government policies and the fundamental force for social stability and harmonious development. However, the mental health problems of grass-roots civil servants have not got full attention. This study aimed to assess the impact of resilience on anxiety and depression among grass-roots civil servants in China.

Method

From Oct to Dec 2019, 302 civil servants completed a series of questionnaires. The Civil Servants Stress Scale (CSSS) was used to assess the stress of civil servants. The Self-rating Depression Scale (SDS) and the Self-rating Anxiety Scale (SAS) were used to evaluate the depression and anxiety of participants, respectively. The resilience of civil servants evaluates by the Connor-Davidson Resilience Scale (CD-RSCI). We conducted the moderating and mediating analysis on the impact of resilience on depression and anxiety in grass-roots civil servants.

Results

There were significant differences in gender, education, position, relationship with coworkers, physical exercise, and monthly income for stress in grass-roots civil servants (P < 0.05). Resilience can negatively regulate the stress of grass-roots civil servants, and an effective mediator and moderator in the relationship between stress and anxiety and depression and the mediating effect ratios of 7.77 and 22.79%.

Conclusion

Resilience has moderating and mediating effects on the relationship between stress and depression, and anxiety. The negative effects of stress on depression and anxiety of grass-roots civil servants can be buffered by resilience as a dynamic moderator directly and indirectly. These findings contribute to society and government better understand the mental health status of grass-roots civil servants and provide references and guidance for the formulation of corresponding management and prevention measures.

Psychological Distress among Undergraduate Dental Students in Saudi Arabia and Its Coping Strategies-A Systematic Review

The objective of this paper was to evaluate the studies that have reported on psychological issues among dental students in Saudi Arabia and to develop coping strategies to overcome these mental health-related issues. The present systematic review is in accordance with the guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search for the articles was carried out in the electronic databases by four independent researchers. The data search was performed in the electronic search engines like PubMed, Google Scholar, Web of Science, Scopus, Medline, Embase, Cochrane and Saudi Digital Library for scientific research articles published from January 2000 until December 2020. STROBE guidelines were adopted for qualitative analysis of six articles which met the eligibility criteria. The analysis of the literature revealed that most of the studies included were conducted in the past 8 years in different regions of Saudi Arabia. Findings of this systematic review clearly state that dental students in Saudi Arabia experience higher levels of depression, stress and anxiety and stress during their education period, with a higher stress for female students compared to male students. There is an urgent need to introduce interventional programs and preventive strategies to overcome the long-term effects.

COVID-19 pandemic and its impact on dental students: A multi-institutional survey

Purpose/objectives

To investigate dental students’ perceptions and concerns regarding the COVID‐19 pandemic, their coping strategies and support resources, and their perceived stress levels.

Methods

A customized 19‐item survey and the perceived stress scale (PSS) were applied to undergraduate dental students from the US, Spain, Ireland, Chile, India, and Brazil between April 10 and July 5, 2020. Linear modeling and mediation analysis were used to explore the relationships among demographics, stressors, coping mechanisms, social support, and stress

Results

A total of 4475 students responded to the survey. The majority (72.4%) were women, and 52.3% had no COVID‐19 training at the time of the survey. The students reported that they had to accommodate to changes in patient care (96.6%) and didactic learning (95.2%) activities, while 88.5% of the respondents indicated at least one of their courses moved online. Transition to online courses went “smoothly with some troubles” for 51.8% of the respondents, and 48.3% perceived the faculty as prepared for the online transition; however, 45.9% reported feeling extremely concerned about the impact of COVID‐19 on their education. The average PSS score was 21.9 of 40 (moderate stress). Multivariate models were built for participants with full data (n = 3899). Being male, having completed more dental coursework, and perceiving a smoother transition were associated with lower PSS scores; more concern about academic progress was associated with higher PSS. Faculty support mediated the relationship between a smoothness of transition and concern about academic progress and PSS scores

Conclusion

Stress caused by the pandemic may be alleviated by smoother transition and good faculty support.

Stress and work-life balance in undergraduate dental students in Birmingham, United Kingdom and Hong Kong, China

PURPOSE/OBJECTIVES

Dentistry is a challenging profession, subjecting students to various stressors which can affect well-being. This study in 2019 investigates the relationship between stress and work-life balance in dental students at University of Birmingham and The University of Hong Kong, from two different countries.

METHODS

Online anonymous questionnaires were completed by 54 students from Birmingham and 48 students from Hong Kong. Ethical approval was gained by both centres. Quantitative and qualitative data were captured with Likert scales and open questions. Using simple descriptive statistics in SPSS, Pearson chi-square tests determined statistical significance between categorical and quantitative variables (p < 0.05).

RESULTS

The majority of students from University of Birmingham (38.9%) felt "extremely stressed," whereas the majority of students from The University of Hong Kong (45.8%) only felt "slightly stressed" (p < 0.001). Exercise and emotional support appeared to be positive approaches for stress relief. Hong Kong dental students (68.8%) reported a good work-life balance compared to significantly fewer students (24.1%) in University of Birmingham (p < 0.001).

CONCLUSION

Major stressors in this study included examinations and fear of failure. Students found that hobbies and extracurricular activities contributed to a healthier lifestyle. A better work-life balance reduced reported stress levels.

Dental trainees' mental health and intention to leave their programs during the COVID-19 pandemic

Background

Dental trainees (dental students, graduate students, and postdoctoral residents) are at increased risk of experiencing poor mental health, which can lead to intentions to leave their program, especially during the COVID-19 pandemic.

Methods

The authors invited 355 dental trainees at the University of Washington School of Dentistry to complete an 83-item questionnaire in August and September 2020. The outcome analyzed was intention to leave their programs. There were 4 self-reported predictors: anxiety, burnout, depression, and COVID-19 impact on overall mental health. The authors ran multiple variable logistic regression models to evaluate relationships between each predictor and outcome (α = .05) and reported odds ratios (ORs) and 95% CIs.

Results

The survey response rate was 35.5%. Overall, 12.7% of participants reported any intention to leave. In total, 22.2% and 16.7% of participants endorsed clinically significant anxiety or depression symptomatology, respectively; 28.6% reported 1 or more burnout symptoms; and 69.0% reported that COVID-19 affected their overall mental health. Participants reporting anxiety (OR, 8.87; 95% CI, 1.80 to 43.57; P = .007), depression (OR, 11.18; 95% CI, 1.84 to 67.74; P = .009), or burnout (OR, 8.14; 95% CI, 1.73 to 38.23; P = .008) were significantly more likely to report intention to leave than those not reporting mental health problems. All participants reporting that the COVID-19 pandemic impacted their mental health expressed intention to leave.

Conclusions

Poor mental health is common among dental trainees and is associated with intention to leave their program.

Practical Implications

COVID-19 has exacerbated the prevalence and consequences of poor mental health among dental students, highlighting the importance of providing wellness resources.

Socio-demographic and educational factors associated with Depression, Anxiety and Stress among Health Professions students

Depression, anxiety and stress are the most prevalent mental health problems among health professions' students. The study was aimed to explore the socio-demographic and educational factors associated with depression, anxiety and stress among health professions' students. Using non-random purposeful sampling, 366 health professions' students studied in 2018/19 were surveyed via a self-reported questionnaire that included Depression, Anxiety and Stress Scale (DASS-21) and questions on sociodemographic and educational characteristics. The majority of respondents were from the School of Medicine (59.8%), with 116 males and 250 females. Sleep duration, communication problems with teaching staff, feelings of inferiority to friends and family problems were determined to be independent predictors of depression in the current study. Communication problems with teaching staff, feelings of inferiority to friends and family problems were important predictors of anxiety. Further, we found that feelings of inferiority to friends and family problems were found to be important risk factors for stress. Our results suggest that the overall prevalence of depression, anxiety and stress among health professions' students were considerably high. All students having a severe mental health issues should be supported by the student counselling centre and expert clinicians in order to confirm the diagnosis and implement subsequent treatment strategies.

Anxiety Symptoms Are Associated With Higher Psychological Stress, Poor Sleep, and Inadequate Sleep Hygiene in Collegiate Young Adults-A Cross-Sectional Study

Background: Anxiety symptoms, stress, poor sleep, and inadequate sleep hygiene are common in university students and these affect their learning and increase attrition. However, limited knowledge exists about the inter-relationship between these factors among university students in low-middle income countries. Therefore, this study aimed to investigate the prevalence of anxiety symptoms and their relationship with sleep quality, sleep hygiene practices, and psychological stress. Materials and Methods: A cross-sectional study was conducted with a randomly selected sample of students in Mizan-Aman, Ethiopia. Participants completed a self-administered questionnaire, which included questions about socio-demographics, socio-economic factors, the Leeds Sleep Evaluation Questionnaire-Mizan, Sleep hygiene index, Perceived stress scale-10 (PSS-10), and Generalized anxiety disorder-7 scale (GAD-7). Results: The prevalence of anxiety symptoms was about 22%. Multivariate regression analysis showed that both anxiety status χ²[(13, N = 480) = 82.68, p < 0.001], and increasing levels of anxiety (model adjusted R2 = 0.204, p < 0.001) were associated with greater psychological stress, inadequate sleep hygiene practices, and poor sleep quality scores after adjusting for age, gender, attendance, substance use, years of university education, time spent in athletic activity every day, and frequency of tea/coffee consumption. Conclusion: There was a high prevalence of anxiety symptoms in this study population, and this condition was associated with psychological stress, poor sleep, and inadequate sleep hygiene parameters. These results suggest a need to address the various aspects of mental health and its diverse sleep correlates in university students.