Depression, anxiety and stress in dental students

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.

Oral Health Attitudes among Preclinical and Clinical Dental Students: A Pilot Study and Self-Assessment in an Egyptian State-Funded University

Dentists should present to patients as good role models in their oral health behaviour. Previous studies have demonstrated how education can improve dental students’ oral health. This pilot investigation aimed to compare and evaluate the features of the oral health behaviour and attitudes of preclinical and clinical dental students at Ain Shams University, a public Egyptian university. The Hiroshima University-Dental Behaviour Inventory (HU-DBI) survey was provided to 149 (78 female/71 male) dental students. Dichotomised (agree/disagree) answers to 20 HU-DBI items were possible, with a maximum conceivable score of 19. An estimation of oral health behaviour and attitudes was calculated by the sum of correct oral health answers to every item by the study groups and evaluated statistically. The score of oral health-favouring answers was higher in clinical (11.50) than preclinical students (10.63) and was statistically significant (p < 0.05). Single-item evaluations showed no statistical significance, except in one survey item. This survey exhibited weak differences in the improvement of oral hygiene behaviour and attitudes between participating preclinical and clinical students, as well as overall poor oral health behaviour in both groups. This inadequacy of Egyptian public dental education in terms of sufficient student oral health progress emphasises the necessity for supplementary courses and curricular reviews that accentuate the need for future dentists to display the correct oral health behaviour.

The Psychological Impact Analysis of Novel COVID-19 Pandemic in Health Sciences Students: A Global Survey

OBJECTIVE

 To evaluate the anxiety and depression amid novel coronavirus disease-19 (COVID-19) pandemic in health sciences students around the globe.

MATERIALS AND METHODS

 This cross-sectional observational study comprised 523 health science students. A well-structured online questionnaire consisting of closed-ended questions based on student's general information, Patient Heath Questionnaire (PHQ)-9 and Generalized Anxiety Disorder (GAD)-7 scales were used to assess the psychological impact of COVID-19.

STATISTICAL ANALYSIS

 SPSS-25 was used to analyze the outcome of this study. Multiple linear regression analysis test was used to assess variables which had impact on PHQ-9 and GAD-7 scores among the participants. A p-value of ≤ 0.05 was considered as statistically significant.

RESULTS

 Among the 523 participants, 365 (69.55%) students were from developing countries and 158 (30.21%) from developed countries; 424 (81.1%) students were tested negative for COVID-19 and 99 (18.9%) had suffered from severe acute respiratory syndrome coronavirus 2 infection during pandemic. The mean GAD-7 and PHQ-9 scores were 7.16 ± 5.755 and 7.30 ± 6.166, respectively. Significant impact on anxiety levels was associated with age, gender, education status, and COVID-19 positive patient, while depression was not significantly associated with gender, COVID-19, and its reported symptoms in participants.

CONCLUSION

 As the world is trying to contain the health effects of COVID-19, the psychological effects might take a longer time to be addressed. Our study highlights the dire need to identify mental well-being of health science students as this may have a direct impact on their professional commitments and future responsibilities.

A Systematic Review of Mental Health-Improving Interventions in Veterinary Students

Literature over the past 5 years has demonstrated that veterinary students globally are experiencing poor mental health. This has detrimental consequences for their emotional well-being and physical health, as well as implications for their future careers. Considering this issue, a systematic review was devised to investigate what interventions were being used, and what effect they had, in veterinary students. The review process involved a search of five databases, from which 161 records were retrieved. Following this, the screening process revealed seven articles eligible for appraisal. These studies investigated seven different interventions, six being cohort-level workshops/courses and one being a collation of several individual strategies. All seven studies reported that the interventions were effective to some degree in improving the mental health of their participants. However, the lack of repeat interventions and control groups limited the external validity of each intervention. A comparison to the research in medical students is briefly discussed. Three of the appraised articles were recommended for further investigation.

The Protective Role of Resilience in Emotional Exhaustion Among Dental Students at Clinical Levels

Purpose

The epidemic of burnout among dental students has been repeatedly documented. This study aimed to assess burnout, specifically emotional exhaustion (EE), and examined the impact of protective and risk psychological factors for EE among clinical-level dental students in Saudi Arabia (SA).

Methods

A cross-sectional study was conducted, using a convenience sample of undergraduate dental students who were recruited from five separate dental schools. A self-administered questionnaire was distributed to 500 students to obtain socio-demographic data and to assess the students’ psychological characteristics (Maslach Burnout Inventory EE subscale, Dental Environment Stress Scale [DES] and Brief Resilience Scale [BRS]). Descriptive, bivariate and multivariable logistic regression analyses were performed.

Results

Of 272 respondents, 53% reported high EE. Adjusted multivariable logistic regression modelling demonstrated that students who reported higher BRS scores were significantly less likely to report high EE (adjusted odds ratio [AOR]=0.79, 95% CI=0.70–0.89, p<0.001). However, females were more than twice as likely as males to report high EE (AOR=2.27, 95% CI=1.14–4.61, p=0.024). In addition, students who reported higher DES scores also reported high EE (AOR=1.10, 95% CI=1.07–1.12, p<0.001).

Conclusion

The findings suggest that resilience is a protective factor against high EE, after adjusting for key characteristics. There is a need for a preventive programme that addresses EE, taking into consideration other unexplored underlying factors.

Psychological impact of the coronavirus disease 2019 (COVID-19) pandemic on dental students: A nationwide study

OBJECTIVES

Public mental health concerns have been raised during the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to assess the psychological impact of the pandemic on dental students in Saudi Arabia.

METHODS

A cross-sectional analytical study was conducted among dental students from different universities in Saudi Arabia selected using 2-stage cluster sampling. The psychological impact was assessed using the validated Arabic version of the Depression, Anxiety and Stress Scale-21 Item questionnaire. The data were analyzed using SPSS software. The Mann-Whitney U and Kruskal-Wallis tests were used as appropriate. A chi-squared test was used to compare the proportions between the sociodemographic data and logistic regression analysis to identify variables associated with the student's responses.

RESULTS

The internal consistency of the scale was excellent (0.954). A total of 697 dental students participated voluntarily in the study; their mean age was 21.76 ± 1.859 years, and 54.7% were female. The majority (96.1%) were single, and 69.4% lived in a household of > 5 persons. Significant differences in mental health outcomes were evident for gender, university, and survey time. Elevated levels of depression, anxiety, and stress were recorded among 60.64%, 37.02%, and 34.92%, respectively, of the students. Females, students who lived alone, and junior students were more likely to experience psychological problems during the COVID-19 pandemic.

CONCLUSIONS

The presence of elevated levels of depression, anxiety and stress among dental students highlights the need for psychological empowerment strategies involving institutional counseling services.

The Influence of Gender and Year of Study on Stress Levels and Coping Strategies among Polish Dental

Background and objectives: Stress is a common term used to describe various adverse psychological conditions. Students in the dentistry field face many negative psychological outcomes. The core factors for stress among dental students are related to their training course and social contacts with peers. This research aimed to assess the stress of dental students depending on their gender and study year. Materials and methods: We used the Perceived Stress Scale (PSS-10) and Mini-COPE questionnaire. The surveys were conducted among 446 dental students (320 women and 126 men) at the Faculty of Medical Sciences of the Medical University of Silesia in Katowice. Results: For the second-year and fifth-year students, the differences in scores were statistically significant, while in both cases, men had significantly lower values on the analysed scale. The results of the Kruskal-Wallis test indicated significantly lower values on the PSS-10 scale for the third-year and fourth-year students than in first-year students. The performed statistical analysis of the data obtained from the Mini-COPE questionnaire showed significant differences between men and women in individual years of study. In the first year, women chose more often the strategies related to turning to religion (p = 0.007), seeking emotional support (p = 0.046), seeking instrumental support (p = 0.045) and dealing with something else (p = 0.029) in coping with stress than men. Conclusions: The highest level of stress was found among first-year dental students. Moreover, women were characterised with higher stress levels than men. Men more often use psychoactive substances and resort to a sense of humour to cope with stress. On the other hand, women turn to religion, seek instrumental and emotional support.

Assessment of Anxiety and Stress among Dental Students to Return to Training in Dental College in COVID-19 Era

Objectives  The aim of this study is to evaluate the sources of anxiety and stress among dental students when returning back to training in dental colleges in the era of COVID-19, with the evaluation of a secure condition for training and practicing without the risk of contamination.

Materials and Methods  A questionnaire was edited in English and distributed to the dental students through the official site of Al-Farabi Private College/Jeddah/KSA. The questionnaire was assessed with different parameters: general information of respondents, anxiety and stress during dental training, importance criteria to be applied by dental college, and exploring the uses and benefits of e-learning.

Results  There were 315 respondents who participated in the study. About 85% participants feel anxiety and stress to return to the dental college. Theses-fearing expressed as high level for 63% compared with 2% before COVID-19. Almost 75% had supported the procedures to be implemented to ensure the safety of the students. About 43% of respondents agreed to continue e-learning in theoretical part only, 1% for clinical part only, and 47% in both. Finally, 67% of respondents preferred the use of alternative methods of learning (Phantom Laboratory) or any simulated teaching aids.

Conclusions  A revision of infection control management, improving the working environment, and learning how to deal with patients in purpose to protect everyone are mandatory to alleviate student anxiety to return to training in dental colleges.

Use of Virtual Reality for the Management of Anxiety and Pain in Dental Treatments: Systematic Review and Meta-Analysis

(1) Background: Dental treatments often cause pain and anxiety in patients. Virtual reality (VR) is a novel procedure that can provide distraction during dental procedures or prepare patients to receive such type of treatments. This meta-analysis is the first to gather evidence on the effectiveness of VR on the reduction of pain (P) and dental anxiety (DA) in patients undergoing dental treatment, regardless of age. (2) Methods: MEDLINE, CENTRAL, PubMed, EMBASE, Wiley Library and Web of Science were searched for scientific articles in November 2019. The keywords used were: “virtual reality”, “distraction systems”, “dental anxiety” and “pain”. Studies where VR was used for children and adults as a measure against anxiety and pain during dental treatments were included. VR was defined as a three-dimensional environment that provides patients with a sense of immersion, transporting them to appealing and interactive settings. Anxiety and pain results were assessed during dental treatments where VR was used and in standard care situations. (3) Results: 32 studies were identified, of which 8 met the inclusion criteria. The effect of VR in children was significant, both for anxiety (standardized mean difference (SMD) = −1.75) and pain (SMD = −1.46). (4) Conclusions: The findings of the meta-analysis show that VR is an effective distraction method to reduce pain and anxiety in patients undergoing a variety of dental treatments; however, further research on VR as a tool to prepare patients for dental treatment is required because of the scarcity of studies in this area.

Self-reported depressive symptoms in dental students: Systematic review with meta-analysis

OBJECTIVE

This study aimed to systematically review the literature about the prevalence of self-reported depressive symptoms in dental students.

METHODS

PUBMED, SCOPUS, and EMBASE databases were search up to January 2020 with the following focused questions: "What is the prevalence of self-reported depression symptom in dental students?" and "Are sex and years of educational training associated with self-reported depressive symptom in dental students?". Observational studies that applied a questionnaire assessing depression were eligible. Standard mean differences (SMD) and pooled odds ratios (OR) were calculated for the questionnaires' scores and self-reported depressive symptom, respectively.

RESULTS

Fifty-eight studies were included, and 15 different questionnaires were used. The prevalence of self-reported depressive symptoms/at least mild depression ranged from 2.75% to 89.84%, and the pooled overall prevalence was 29% (95% confidence interval [CI]: 26-34). Meta-analysis showed significantly lower scores in the questionnaires for self-reported depressive symptoms of male students (SMD: -0.22; 95% CI: -0.42 - -0.03). Conversely, no significant difference was detected for the OR of self-reported depressive symptom in the comparison between sex (OR: 1.11 - 95% CI: 0.77-1.62). Similarly, no significant difference was observed for the different school years regardless of the analytical strategy used.

CONCLUSION

It was concluded that female dental students presented more self-reported depressive symptoms, but no difference is demonstrated during the years of dental education.

Self-reported dental student stressors and experiences during the COVID-19 pandemic

OBJECTIVE

To compare the influence of coronavirus disease 2019 (COVID-19) pandemic on the student reported outcomes among dental students reading/studying different courses offered in the only dental school in Malta.

MATERIALS AND METHODS

An anonymous questionnaire consisting of 13 closed-ended and open-ended questions was sent to all students (n = 97) at the Faculty of Dental Surgery at the University of Malta. Emergent themes from open-ended questions were identified and tallied. Since data were classified as categorical ranks, nonparametric tests were used to compare variables among the different courses, years of study, preclinical/clinical students, and gender categories.

RESULTS

Dental technology students were significantly less stressed about contracting COVID-19 (P = 0.005) and regarding lack of preparation due to inability to physically go to the library (P = 0.019). Female students reported significantly more anxiety for the following factors: "feeling anxious all the time" (P = 0.033), "worried about contracting COVID-19'" (P = 0.012), "worried that a family member may contract COVID-19'" (P = 0.048), "more anxious about exams this year because of the challenges we are facing" (P = 0.029), and "concern about losing manual dexterity skills" (P = 0.038). Qualitative data gathered show considerable stress reported by students regarding changes in examination processes and formats and lack of timely communication.

CONCLUSION

Students were greatly affected by the COVID-19 pandemic and this caused fear of losing their manual dexterity skills, anxiety related to its consequences on their long-term plans, and anxiety related to the examinations. Dental schools in turn should adapt rapidly and customize changes that are specific to the individual student cohort and their stage of training.

The magnitude of COVID-19 related stress, anxiety and depression associated with intense mass media coverage in Saudi Arabia

The Coronavirus Disease 2019 (COVID-19) has resulted in catastrophic consequences in many aspects of life; including negative psychological effects. We aimed to assess the mental health status of a group of Saudi population during this pandemic. Also, we aimed to assess the effect of the intensive media coverage of the pandemic news on mental health status. A questionnaire was distributed online to test depression, anxiety, and stress (using the DASS-21 scale) and their relationship to certain variables. A total of 215 respondents were included. Higher mental health prevalence rates were reported in non-Saudi participants compared to Saudi ones (i.e., 50.74% vs. 30.40%; 34.23% vs. 13.51% and 59.70% vs. 27.70%; for depression, anxiety and stress, respectively). About 55.8% of the participants felt the extensive coverage in the media of COVID-19 news, which caused higher mental sufferings. Higher mental health prevalence rates were reported in females compared to males participants (i.e., 56.97% vs. 23.25%; 30.23% vs. 13.17% and 54.65% vs. 26.35%; for depression, anxiety and stress, respectively). Reasonable following of the COVID-19 news; and less exposure to the pandemic information could help in reducing the mental health issues related to the ongoing pandemic. Special care and attention should be paid to females and younger people who seem to be particularly affected during the era of COVID-19.

Mixed-methods analysis of videoed expert-student dialogue supporting clinical competence assessments

INTRODUCTION

This mixed methods study evaluates the use and perceptions of a novel video genre of authentic, in-the-moment expert-student dialogue to support student preparation for a summative clinical competence assessment.

METHODS

Expert-student dialogue videos were available on the university learning management system (Moodle) for self-directed access for a fixed prosthodontics course. These comprised 3 categories of video relating to dialogic episodes of previous student's performance relating to a clinical competence assessment. These were as follows: case suitability, case discussion and self-evaluation. Fourteen students who were taking the competence test and had watched the supporting videos were invited for focus group interviews. Twelve students participated in three focus groups within 24 hours of the assessment and the audio recordings were analysed. A thematic analysis was performed using an inductive approach. Video access data were also retrieved and analysed based on when the videos were watched.

RESULTS

Three key themes were identified: assessment preparation, enhanced learning and affordance phenomena. By accessing the videos, students gained insights into the case suitability, assessment process and criteria, and the examiners' expectations. They reported reduced uncertainty and stress, improved confidence and better preparedness for the assessment. Students also reported this video genre stimulated higher-order thinking and provided a broader clinical experience. A diverse array of viewing patterns was observed immediately before the assessment and across the year. For the focus group of students, they watched 65% of all their videos for the prosthodontics course one week before their competency testing periods.

CONCLUSION

The expert-student dialogue videos that captured peers clinical competence tests improved students' assessment literacy, increased their assessment preparedness, reduced stress and enriched their learning.

Evaluating the stress-response of dental students to the dental school environment

Introduction and Objective

Dentists experience high amounts of professional stress beginning with their student years in dental school. This stress, given its early onset, may negatively impact the personal and professional lives of these individuals, as well as the quality of their clinical work. We sought to create an objective scale to evaluate the levels of stress in students at different stages of their education, as well as in practicing physicians.

Materials and Methods

Thirty dental students participated in this study, with 10 students each selected from junior, mid-senior, and senior classes. They were randomly divided into two groups in which one group was subjected to stressors while the other group was not. JINS MEME ES_R (JINS) smart glasses and Garmin Vivoactive 3 smartwatches were used to obtain data, including electrooculography (EOG), heart rate (HR), and accelerometer (ACC) and gyroscope (GYRO) feedback, while the subjects performed a dental exercise on a phantom tooth.

Results

The heart rates of more experienced students were lower than those of the junior students. The EOG, ACC, and GYRO signals showed multiple differences in the measurement of amplitudes and frequency of episodes.

Conclusion

Our pilot results show that electronic tools, like smart glasses with software and sensors, are useful for monitoring the stress levels of dental students in preclinical operating conditions. We would like to further assess the stress levels in students performing dental procedures on phantom teeth and in later clinical interactions with patients.

Self-reported psychological problems amongst undergraduate dental students: A pilot study in seven European countries

AIM

To map psychological problems amongst undergraduate dental students with a focus on different time points in clinical work in seven Eastern European and Scandinavian countries.

MATERIALS AND METHODS

A total of 1063 3rd- and 5th-year dental students (response rate 70%) participated in this pilot study and completed a pre-tested, structured questionnaire, which collected information on sociodemographic characteristics and self-reported psychological problems. Data were analysed by bivariate and multivariate methods.

RESULTS

The majority of participants were female and were younger than male participants. Most participants, though more females than males, agreed that the clinical work of dentistry was psychologically difficult. Almost half of participants felt nervous before working with patients (N = 506, 48%) and experienced a lot of stress whilst working with patients (N = 488, 46%); almost one-third (N = 287, 27%) felt anxious/worried after working with patients. Being a 3rd- and 4th-year student (vs 5th-year) reduced the odds for anxiety after working with patients; being a 3rd-year student (vs 5th-year) increased the odds for stress whilst working with patients. Studying in countries other than Norway reduced the odds for stress whilst working with patients. Less than good self-perceived health, presence of psychological health complaints before starting dental education, female gender and lack of physical activity increased the odds for psychological problems.

CONCLUSION

A high number of undergraduate dental students reported psychological problems in connection with clinical work. It is unlikely that "one size fits all"; therefore, further qualitative investigations on stressors in clinical learning environments should be done in order to design tailor-made supportive strategies.

Evaluating the stress and its association with stressors among the dental undergraduate students of Kanpur city, India: A cross-sectional study

BACKGROUND

Dental education can be a critical wellspring of stress among dental students, and studies have observed higher levels of stress among dental students than in the all-inclusive community. The present study aims to evaluate the perceived stress among dental undergraduate students, the sources of stress, and an association of perceived stress with sociodemographic characteristics and various stressors.

MATERIALS AND METHODS

A cross-sectional study was conducted among 380 undergraduate dental students (from 1^st year to final year) in a private dental college, Kanpur. A self-administered questionnaire was used to collect data regarding sociodemographic profile, perceived stress using Perceived Stress Scale-14, and academic, psychosocial, and environmental stressors. Data were analyzed using IBM SPSS Statistics-Version 21 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0, Armonk, NY, USA: IBM Corp.).

RESULTS

The mean perceived stress score was 30.25 ± 1.914. The median perceived stress score was 30. Statistically significant (P < 0.001) values were found for higher age group and year of studying Bachelor of Dental Surgery (BDS) were important sociodemographic determinant of stress. Vastness of academic curricula, frequency of examination (P < 0.05), and fear of failure/poor performance in examinations were important academic determinants of stress. High parental expectations and family problems were important psychosocial stressors. Accommodation away from home was an important predictor of stress (P < 0.001).

CONCLUSION

This study revealed that there are various sociodemographic (age and year of study in BDS), academic (curricula, frequency of examination, and performance level) determinants and predictors of stress (type of accommodation), along with psychosocial stressors (parental expectation and family problems). Dental colleges should develop stress management programs to promote gender and social equity and strategies to improve psychological support services. The stress management programs reported either helped to reduce the number of stressors or enhance stress coping skills, using relaxation techniques such as deep breathing, yoga, and stress management programs.

Psychological Stress and Stressors Among Clinical Dental Students at Shiraz School of Dentistry, Iran

OBJECTIVE

The purpose of this study was to assess the level of psychological stress and the perceived stressors among the undergraduate clinical dental students of Shiraz School of Dentistry.

MATERIALS AND METHODS

This study was conducted during the second semester of the academic year 2018-2019 at Shiraz School of Dentistry, Shiraz University of Medical Sciences, Iran. The study group consisted of 150 dental clinical students. The participants were surveyed via the validated Depression, Anxiety, and Stress Scale (DASS-21) and the Dental Environment Stress (DES) questionnaires. One-way ANOVA, post hoc Tukey's test, repeated measure ANOVA, Holm-Sidak's test, and t-test were performed to analyze the data after the normality of the data was checked by Kolmogorov-Smirnov test. The P values of less than 0.05 were considered as statistically significant.

RESULTS

No significant differences were observed among the dental students with different academic levels in terms of depression and anxiety scores (P=0.057 and 0.154, respectively). The lowest and highest stress scores were observed among the sixth- and fifth-year students, respectively (P values <0.05). The scores of the stressors associated with the academic factors were significantly higher than those of the other domains (P<0.05) except for that of the clinical education domain (P=0.070). The females showed significantly higher DES scores (P values <0.05).

CONCLUSION

The highest and lowest stress levels were observed among the fifth- and sixth-year students, respectively. The primary sources of stress were academic factors and clinical education. The females expressed higher levels of stress in certain areas of dental training.

Psychological Impact of the COVID-19 Pandemic on Dental Interns in Riyadh, Saudi Arabia: A Cross-sectional Survey

Background

Dental profession is labeled as a high-risk profession, due to which dental care professionals are under tremendous pressure during the outbreak of COVID-19 pandemic. The aim of this study was to assess the psychological impact of the COVID-19 pandemic on dental interns in Riyadh, Saudi Arabia.

Materials and methods

A cross-sectional study was conducted among dental interns from different universities in Riyadh, Saudi Arabia. The data were collected using a validated Depression, Anxiety and Stress Scale-21 Items (DASS-21) questionnaire. Descriptive statistics were presented using frequencies (n) and percentages (%). Chi-square and Fisher exact tests were used to assess the association between sociodemographic data (age, gender, nationality, marital status, and history of physical and mental illness) and levels of depression, anxiety, and stress. A p < 0.05 was considered as statistically significant.

Results

A total of 160 dental interns were invited to participate in this survey; out of which 110 participants responded yielding a response rate of 78%. The mean age of the study participants was 25.1 years. About 65% of the participants were female. Only 14.5% of the subjects reported having a past history of physical or mental illness. Depression, anxiety, and stress were identified in 11.9%, 7.3%, and 0.9% of the dental interns, respectively. Demographic characteristics did not appear to influence depression, anxiety, or stress levels (p > 0.05).

Conclusion

The outbreak of COVID-19 pandemic has affected the mental health of dental interns. The presence of depression, anxiety, and stress among dental interns highlights the need for special intervention and support programs to promote mental health and well-being among dental interns.

How to cite this article

Khanagar SB, Alfadley A. Psychological Impact of the COVID-19 Pandemic on Dental Interns in Riyadh, Saudi Arabia: A Cross-sectional Survey. Int J Clin Pediatr Dent 2020;13(5):508-512.

Self-Evaluation of Anxiety in Dental Students

Aim

The aim of the study was to analyze anxiety in female and male dental students related to their first procedure performed on a pediatric patient as part of their study curriculum.

Materials and Methods

The study was carried out in eighty-four 3rd year dental students (75.00% females and 25.00% males), aged 22-28 years. The participation in the research was anonymous and voluntary. The study was performed during clinical classes in pediatric dentistry where the students were supposed to perform simple prophylactic or therapeutic procedures on pediatric patients. To assess anxiety, a State-Trait Anxiety Inventory was used prepared by Spielberger et al. based on the American STAI questionnaire of 1970 that is composed of two-parts scales: the X-1 scale to assess anxiety as a state and the X-2 scale to assess anxiety as a trait. For statistical analysis, the Wilcoxon signed-rank test, Pearson's chi-squared test, and Mann-Whitney test as well as Statistica 10 programme were used.

Results

The results obtained from the first and second part of the questionnaire concerning anxiety as a state and as a trait showed high level of anxiety as a state in 51.19% of the students and as a trait in 32.14% and low level in 19.05% and 41.67%, respectively. The obtained results showed minimal and maximal values to be 24 and 71, respectively, for the STAI-1 scale (mean = 40.55), and 24 and 57, respectively, for the STAI-2 scale (mean = 41.75).

Conclusions

The results show that the anxiety level during clinical classes is relatively high in the studied population of students. Preparing the students to cope with stress resulting from treating the patients seems to be of importance. Such programmes should be implemented before the start of practical clinical classes. The acquired knowledge will be useful in further professional career.

The precedence and viability of yoga in the lives of D3-dental students, dental practitioners, and dental patients

Dentistry as a profession is quite demanding and challenging and is also associated with occupational hazards like musculoskeletal disorders and stress-related problems. The practice of yoga has been proven to be efficacious in management of quite a lot of stress and lifestyle disorders. It strengthens one physically, mentally, and emotionally. Moreover, yoga can also be used in the management of dental patients for stress-related oral conditions like lichen planus, burning mouth syndrome, aphthous ulcers, etc., Yoga has also been found to have antiinflammatory, antianxiety effect, and also a lot of other beneficial effects. This review emphasizes on the relevance of yoga in the dental profession, from the practitioners, students, and patients viewpoint. Data pertaining to the subject was obtained after a thorough search of the PubMed literature and Google search engine.

Self-reported confidence and anxiety over endodontic procedures in undergraduate students-Quantitative and qualitative study

PURPOSE

The current literature shows a growing interest to assess the feelings and perceptions of students associated with the performance of elective endodontic procedures. This study aimed to evaluate the students' anxiety and self-perceptions related to performing such treatments.

METHODS

Forty-five students participated in the research (G1 = 22 beginners students; G2 = 23 senior students). Demographic data, STAI-State and Numerical Rating Scale (NRS) for pre-operative anxiety were completed before the appointment with patient. The STAI-Trait; NRS for post-operative anxiety; previous experiences in endodontics; and level of confidence in each stage of endodontic treatments were collected after appointment. Focal groups for qualitative data collection were performed on separate occasion.

RESULTS

Both groups showed higher scores in STAI-State than for STAI-Trait scale. G1 showed higher levels of anxiety in the pre-operative, compared with post-operative moment in the NRS scale. G2 reported feeling more confidence to insert intracanal medication and to restore teeth between appointments than G1. In both focus groups, participants reported insecurity in performing endodontic procedures due to difficulty in visualisation and to anatomic complexities. G1 reported that all the confidence they had was based in pre-clinical experience, and G2 mentioned concern about the end of graduation.

CONCLUSION

The participants' anxiety diminishes as they gain more experience in performing endodontic procedures. However, as they approach the end of the course anxiety levels increase. Greater availability of elective courses in endodontics could be a valuable alternative to provide students with more exposure to and experience with these procedures.

The comparison of dexmedetomidine and midazolam premedication on postoperative anxiety in children for hernia repair surgery: A randomized controlled trial

BACKGROUND

Perioperative anxiety is common in pediatric patients undergoing surgery.

AIMS

The aim of this study was to determine whether an infusion of dexmedetomidine prior to hernia repair in children provides better postoperative anxiety outcomes that a preoperative infusion of midazolam.

METHODS

Ninety 6-11-year-old children, who were scheduled to undergo elective hernia repair, were enrolled for this double-blind, randomized controlled trial. Group D (n = 45) received an intravenous infusion of dexmedetomidine (0.5 μg/kg) and Group M (n = 45) received an intravenous infusion of midazolam (0.08 mg/kg) in 20 mL of normal saline for 10 minutes before the induction of anesthesia. Pre- and postoperative scores on the modified Yale Preoperative Anxiety Scale were the main outcomes. Secondary outcomes included systolic blood pressure, diastolic blood pressure, heart rate, and postoperative pain measured on a visual analogue scale and patient satisfaction using a numerical rating scale.

RESULTS

Postoperative anxiety in Group D was significantly lower than preoperative anxiety (2 hours postoperatively mean difference [95% CI]: 2.83 [0.87-4.79], P = 0.036, 4 hours postoperatively mean difference [95% CI]: 3.29 [1.39-5.20], P = 0.005). Preoperative and postoperative anxiety in Group M was similar. Anxiety scores in Group D were also significantly lower than anxiety in Group M 2 hours (mean difference [95% CI]: 1.89 [0.52-3.26], P = 0.01) and 4 hours (mean difference [95% CI]: 3.32 [1.98-4.66], P < 0.001) postoperatively. Systolic blood pressure, diastolic blood pressure and heart rate were lower in Group D than in Group M after administration of sedative drugs until children left PACU (SBP mean difference [95% CI]: 13.87 [10.30-17.43], P < 0.001, DBP mean difference [95% CI]: 5.96[3.80-8.11], P < 0.001, HR mean difference [95% CI]: 10.36 [7.58-13.13], P < 0.001). Pain was also significantly lower in Group D than in Group M at 2 hours (median difference [95% CI]: 1 [0.26-1.34], P = 0.004), 4 hours (median difference [95% CI]: 1 [0.31-1.02], P = 0.003), and 1 day (median difference [95% CI]: 0 [0.22-0.76], P = 0.003) postoperatively. Patient satisfaction scores were significantly higher in Group D than in Group M 1 day (median difference [95% CI]: 0 [-0.83 to -0.24], P = 0.006) and somewhat higher 1 week (median difference [95% CI]: 0 [-0.67 to -0.04], P = 0.06) postoperatively.

CONCLUSION

Compared with midazolam, a single preoperative intravenous dose of dexmedetomidine appears to provide better postoperative anxiolytic effects for children undergoing same-day surgery.

Emotional exhaustion, burnout, and perceived stress in dental students

Objective

As in other health sciences, a career in dentistry is associated with numerous stressors in practitioners. The main objective of this research was to examine the prevalence of emotional exhaustion, burnout, and perceived stress among dental students in Mexico.

Methods

A cross-sectional study was conducted among 73 dental students attending a private university in Northern Mexico. Three scales were administered to students to identify emotional exhaustion, burnout, and perceived stress, and parametric data analysis was performed.

Results

Among participants (mean age 19.7 years), the proportion with emotional exhaustion, perceived high stress, and burnout was 52.0%, 42.3%, and 17.8%, respectively. All students with perceived stress also had burnout.

Conclusions

We found that emotional exhaustion and perceived stress are experienced by a large proportion of dentistry students enrolled in the third semester at this private university in Northern Mexico. The proportions were independent of age and sex.

Mental health in medical, dentistry and veterinary students: cross-sectional online survey

BACKGROUND

The mental health of university students, especially medical students, is of growing concern in the UK.

AIM

To estimate the prevalence of mental disorder in health sciences students and investigate help-seeking behaviour.

METHOD

An online survey from one English university (n = 1139; 53% response rate) collected data on depression (using the nine-item Patient Health Questionnaire), anxiety (seven-item Generalised Anxiety Disorder Assessment), alcohol use (Alcohol Use Disorders Identification Test), self-harm and well-being, as well as help seeking.

RESULTS

A quarter of the students reported symptoms of moderate/severe depression and 27% reported symptoms of moderate/severe anxiety. Only 21% of students with symptoms of severe depression had sought professional help; the main reason for not seeking help was fear of documentation on academic records.

CONCLUSIONS

The study highlights the extent of mental health problems faced by health science students. Barriers to help seeking due to concerns about fitness-to-practise procedures urgently need to be addressed to ensure that this population of students can access help in a timely fashion.

DECLARATION OF INTEREST

None.

Depression, anxiety, and stress and their association with khat use: a cross-sectional study among Jazan University students, Saudi Arabia

BACKGROUND

Depression, anxiety, and stress levels are considered important indicators for mental health. Khat chewing habit is prevalent among all segments of Jazan population in Saudi Arabia. Few studies have been conducted to evaluate depression, anxiety, and stress among Jazan University students, and information about the correlation between khat use and these disorders is scarce. Thus, this study aims to evaluate the prevalence of depression, anxiety, and stress and their correlation with khat chewing and other risk factors among Jazan University students.

METHODS

A cross-sectional study was conducted on 642 students from Jazan University. Multistage sampling was used, with probability proportional to size-sampling technique. The Depression, Anxiety, and Stress Scale 21 questionnaire was used to collect the data, which were analyzed using SPSS Version 20.0 software.

RESULTS

Moderate depression was prevalent among 53.6% of the sample, anxiety was found among 65.7%, while 34.3% of the students suffered from stress. Female gender was strongly associated with higher mean scores for symptoms of depression, anxiety, and stress, with P-values <0.05 for all. Moreover, anxiety symptoms scores were statistically associated with grade point average and caffeine consumption. Khat use was statistically associated with higher mean scores of anxiety among males and a higher mean score of depression and anxiety among females.

CONCLUSION

The results indicate a high rate of symptoms of depression, anxiety, and stress among Jazan University students. Khat use was associated with anxiety, and a higher rate of symptoms of depression, anxiety, and stress was indicated among female students. Therefore, strategy for the prevention and management of depression, anxiety, and stress is highly recommended to minimize the impact of these serious disorders.

Clinical Anxiety among Saudi Postgraduate Pediatric Dentistry Students in Jeddah City

Objective

To determine anxiety in relation to gender, Grade Point Average (GPA), level of education and academic and clinical situations in Jeddah, Saudi Arabia. Also, to identify academic and clinical anxiety levels among postgraduate pediatric dentistry students.

Methods

A cross-sectional study at governmental training hospitals was conducted. All registered postgraduate students in pediatric dental programs during the year 2015-2016 were included in the study. A self-administered questionnaire was distributed electronically to 60 postgraduate pediatric dentistry students aged between 25 and 45 years old. The questionnaire is composed of 55 questions that investigated demographic data, academic and clinical related situations including investigations, diagnosis, treatment, and complications in treatment.

Results

The study showed a higher anxiety level in younger age dental students (76.7% compared to 23.3%) and Saudi board residents (60%). Comparing gender differences in anxiety revealed that a significant difference (P ≤ 0.05) was found and anxiety seems to be more among female dental students (2% very anxious, 64% slightly anxious, and 34% not anxious) as compared to male dental students (8% very anxious, 69% slightly anxious, and 23% not anxious).

Conclusions

There was increased awareness, detailed understanding, and handling of the patients by senior postgraduate pediatric dentistry students compared to junior students.

Anxiety, Stress and Coping Patterns in Children in Dental Settings

BACKGROUND

Fear of the dentist and dental treatment is a common problem. It can cause treatment difficulties for the practitioner, as well as severe consequences for the patient. As is known, the level of stress can be evaluated thought electrodermal activity, cortisol measure in saliva, or indirectly by psychometric tests.

AIM

The present study examined the psychological influence of dental interventions on the child as well as coping patterns used for stress diminution.

METHODS

We examined two matched groups of patients: a) children with orthodontic problems (anomalies in shape, position and function of dentomaxillofacial structures) (N = 31, mean age 10.3 ± 2.02) years; and b) children with ordinary dental problems (N = 31, mean age 10.3 ± 2.4 years). As psychometric instruments, we used: 45 items Sarason's scale for anxiety, 20 items simple Stress - test adapted for children, as well as A - cope test for evaluation coping patterns.

RESULTS

Obtained scores confirmed the presence of moderate anxiety in both groups as well as moderate stress level. For Sarason's test obtained scores for the group with dental problems are 20.63 ± 8.37 (from max 45); and for Stress test 7.63 ± 3.45 (from max 20); for the orthodontic group obtained scores are 18.66 ± 6.85 for Sarason's test, while for the Stress test were 7.76 ± 3.78. One way ANOVA confirmed a significant difference in values of obtained scores related to the age and gender. Calculated Student t - test shows non-significant differences in obtained test results for both groups of examinees. Coping mechanisms evaluated by A - cope test shows that in both groups the most important patterns used for stress relief are: developing self-reliance and optimism; avoiding problems and engaging in demanding activity.

CONCLUSION

This study confirmed that moderate stress level and anxiety are present in both groups of patients (orthodontic and dental). Obtained scores are depending on gender and age. As more used coping patterns in both groups are developing self-reliance and optimism; avoiding problems and engaging in demanding activity. Some strategies for managing this problem are discussed.

Perceived Stress among French Dental Students and Their Opinion about Education Curriculum and Pedagogy

Objectives:

The purpose of this study was to identify the major sources of perceived stress and their relation to a student satisfaction questionnaire about the curriculum and the pedagogy among French dental students.

Materials and Methods:

All dental students (n = 178) from years 4 to 6 at the University of Montpellier (France) participated in this exploratory survey. In spring 2016, a 3-part questionnaire was distributed during clinical sessions: the first part asked about sociodemographic and living conditions, the second part aimed to assess the students' perceived stress (Dental Environmental Stress questionnaire), and the third part was a satisfaction questionnaire exploring the clinical organization and the teaching methodologies (Student Course Experience Questionnaire). A Spearman's correlation test and a principal component analysis were used to assess the relation between the variables of the questionnaire.

Results:

The response rate was 99.4%. The most stressful items were “the number of tasks to be performed during clinical practice,” “the waiting time before opinion from teachers,” and “the administrative part and computer problems.” Fifty-four percent of the students claimed to be satisfied with their studies, showing a score of seven or higher. There was a negative correlation between the level of student satisfaction and the level of perceived stress.

Conclusion:

Although most of the students were globally satisfied with their curriculum, this study highlighted dysfunctions in the clinical education with a level of stress correlated with the student's dissatisfaction. Most of all, students found that examinations were too stressful and that the clinical requested task quotas were overestimated.