Analysis of anxiety variables in dental students

Stress levels amongst Turkish dental students, general dentists and paediatric dentists during performing paediatric dentistry: a questionnaire-based cross-sectional study

PURPOSE

This study aimed to evaluate stress levels and stressors amongst dental students, general dentists and paediatric dentists treating paediatric patients.

METHODS

This study was conducted on 664 dentistry students, general dentists and paediatric dentists in Turkey. Data were collected through an online questionnaire consisting of demographic characteristics and the Pedodontic Practice Stress Scale (PPSS). Stressors when treating paediatric patients were compared between the groups. The scores obtained from the questionnaire were analysed. Compliance with normal distribution was analysed according to Kurtosis-Skewness values. One-way analysis was used to compare the scale scores (p < 0.050).

RESULTS

Of the participants, 74.54% were female and 25.46% were male. The females showed a significantly higher level of stress, compared to the males (p = 0.001).When compared according to the level of education, the mean total stress scores did not differ (p = 0.211), but the mean complication score was found to be statistically significantly higher in paediatric dentists (p = 0.001). In addition, the lowest mean stress score was found in dental students. Statistically significant differences were found in all sections of the PPSS scale in terms of the ability to manage a paediatric patient as an adult patient and the importance of knowing child psychology theories.

CONCLUSION

Factors, such as the educational status, the number of patients treated, the behaviour of the patient's relatives and the potential to communicate with them, cause variable stress in dental students and general and specialist dentists working with children.

The Relationship between Stress and Preclinical Dental Students' Performance: A Longitudinal Study

Background

The aim of this study was to evaluate the changing levels of stress among dental students during 8 months of a basic manual skills course in the preclinical year and to examine the association between stress and dental performance.

Methods

A longitudinal study was conducted in the 2023 academic year in a total of 58 (male = 17 and female = 41; mean age = 26.43, range 22-33) undergraduate dental students at Tel Aviv University of dentistry during their fourth year of study. Depression Anxiety Stress Scale (DASS-21) and Dental Environment Stress (DES) questionnaires were used to assess the psychological well-being and the severity of DASS symptoms experienced by the students. The students' dental performances were assessed using two manual tests on plastic teeth. The questionnaires and the manual tests were used at three periods of time, T0, T1, and T2. Wilcoxon signed-rank tests were performed to compare the DASS scores and DES stressors of dental students between T0, T1, and T2. Kendall's nonparametric correlations were calculated to investigate the relationships of DES stressors and depression, anxiety, and stress scores with manual performance.

Conclusions

The perception of high stress by dental students is due to the stressful education process of the preclinical year. There is an inverse correlation between the lower level of anxiety and the increase level of dental performance with 74% of the variance in dental performance explained by the anxiety score. Work-related stressors such as manual skills might reduce dental performance in contrast to non-work-related factors such as financial obligations, personal issues, and family factors, which might increase student dental performance.

Comparative Analysis of Manual Dexterity of Dental Students at Ajman University following One Academic Year of Preclinical Training Sessions: A Longitudinal Cohort Study

OBJECTIVES

 Dental students must complete two stages of training, namely, preclinical training on phantom head models and clinical training on actual patients to acquire the practical skills required by their Bachelor of Dental Surgery program.Our objectives are to evaluate the level of improvement of the manual skills obtained by third-year dental students after one full academic year of preclinical training courses using dexterity tests under direct and indirect vision and to compare the improvement among male and female dental students under the same conditions.

MATERIALS AND METHODS

 A total of 72 preclinical students participated in our cohort trial, each of whom was assigned a random identification number that was only known to the researchers. After the beginning of the academic year, the experiment was performed under identical conditions for both the O'Connor Tweezer Dexterity Test and the Purdue Pegboard Test. The examinations were conducted at two distinct times: T0 before phantom laboratory training (the beginning of preclinical sessions) and T1 after phantom laboratory training (9 months after T0).

STATISTICAL ANALYSIS

 Signed-rank test of Wilcoxon over two separate periods (T0 and T1), comparisons were made between the direct and indirect visual dexterity test scores. In addition, the Mann-Whitney U test was used to compare results across gender. The statistical significance (p-value) was set at below 0.05 with a confidence level of 95%.

RESULTS

 A statistically significant difference was detected between the T0 and T1 assessments on the Purdue Pegboard Test and the O'Connor Tweezer Dexterity Test for all selected dentistry students in both direct and indirect conditions (p < 0.001).

CONCLUSION

 Further investigation in other dental departments or schools, particularly those with different entry standards, is required prior to making a definitive conclusion about the use of these dexterity assessments as predictors of prospective dental students' performance.

Evaluation of the Undergraduate Learning Environment at Dental Schools in Syria

OBJECTIVE

The learning environment plays a vital role in dental education. A positive learning environment could improve students' satisfaction, psychosocial well-being, and academic achievement. This study set out to measure the quality of the learning environment according to the Dundee Ready Educational Environment Measure (DREEM) at different dental schools in Syria.

METHODS

The study included dental schools at Damascus University (DU), Tishreen University (TU), and University of Hama (HU). DU and TU are considered 2 of the largest universities in Syria. Students across all years of study were invited to complete an Arabic version of the DREEM questionnaire.

RESULTS

In total, 1205 students completed the questionnaire: 650 were from DU, 309 from HU, and 243 from TU. Cronbach's alpha value of the DREEM instrument was 0.927. The total DREEM score for all universities was 108.8 ± 31.5 (n = 1205), which is 54.4% of the total score; DU scored the lowest on the DREEM scale (105.9 ± 28.5) followed by TU (111.1 ± 34.3) and HU (113.3 ± 34.4). There was a significant difference amongst the 3 universities (P = .001) with a small effect size (eta-squared = 0.01). At the subscale level, students' perception of learning (SPL) at DU and TU was perceived unfavourably, and the social self-perception of students (SSP) was negatively perceived across all universities. Clinical students scored significantly lower than their preclinical counterparts. No significant difference emerged between male and female students.

CONCLUSIONS

This study provides a baseline data on the learning environment at dental schools in Syria. Although the study suggests a more positive than negative perception of the learning environment, Syrian dental schools scored considerably lower than their Arab and international counterparts. Aspects related to SPL and SSP were the most serious areas requiring improvement, and future research should focus on designing proper interventions to address them.

Major Stress Sources Amongst Dental Students at Damascus University, Syria

INTRODUCTION

Stress amongst dental students is frequently reported. Various environmental, socioeconomic, and cultural factors affect students' perceived stress levels. The aim of this study was to investigate stress levels and sources amongst undergraduate dental students at Damascus University, Syria.

METHODS

A cross-sectional design was used. A questionnaire was undertaken in 2019 at the Faculty of Dentistry at Damascus University. Students participated voluntarily in the survey. The sample comprised students at the preclinical and clinical stage. A modified 29-item version of the validated Dental Environmental Stress (DES) questionnaire with a 5-point scale (1 = not stressful to 5 = extremely stressful) was used as the measurement tool. Ethical approval was granted by Damascus University.

RESULTS

In all, 365 students participated in the study, with a response rate of 96% (365/379). Cronbach's alpha was 0.83, indicating good reliability of the measurement tool. The overall mean score of the perceived stress was 2.64 (95% confidence interval [CI], 2.5-2.7). The mean scores for clinical factors, academic work, educational environment, personal factors, and living accommodation were 3.22 (95% CI, 3.1-3.3), 3.17 (95% CI, 3.1-3.2), 2.99 (95% CI, 2.9-3.0), 2.15 (95% CI, 2.1-2.2), 2.15 (95% CI, 2.0-2.2), respectively. The specific stressors with the highest mean scores were lack of dental equipment and difficulty in finding requested clinical cases; the respective means were 4.1 (95% CI, 4.0-4.2) and 3.9 (95% CI, 3.8-4.0).

CONCLUSIONS

The findings revealed moderate stress levels amongst students. The major stress factors pertained to stressors from the clinical, academic, and educational environment domains. Certain clinical and environmental stressors, such as difficulty in finding clinical cases and lack of dental equipment, were more powerful than the strongest academic stressors, such as examinations and grades and amount of assigned work.

Stress and anxiety in orthodontic residents during the coronavirus disease 2019 pandemic

INTRODUCTION

The coronavirus disease 2019 pandemic has had far-reaching effects on health care providers and health professional students; however, little is known about the factors related to stress and anxiety levels, specifically among orthodontic residents during this time.

METHODS

A 2-part questionnaire, which included modified stress and anxiety inventories, was disseminated electronically to U.S. orthodontic residents between June and July 2020. Descriptive and comparative statistics were used to analyze the data.

RESULTS

Overall, 261 participants responded (56% female), representing a response rate of 26.8%. Significant gender differences were found in 18 stress items, with female respondents expressing more stress than their male counterparts. Only 1 stress item (ie, fear of being unable to catch up if behind) varied as a function of the difference on the basis of respondents' stage in the program. First-year residents reported more stress in relation to this than more senior residents. Responses to all anxiety items but 1 item varied by gender, with females reporting higher scores. Residents in the middle stages of their program responded with higher anxiety scores with significant differences on 3 anxiety items.

CONCLUSIONS

Although financial responsibilities and travel plans were the most stressful and anxiety-inducing items for orthodontic residents during the early aspect of the coronavirus disease 2019 pandemic, multiple items contributed to their stress and anxiety. In addition, both gender and stage of progress in a residency program impacted the level of stress and anxiety reported by respondents.

Relationship between temporomandibular dysfunctions, sleep disorders, and anxiety among dentistry students

Introduction: This study aimed to evaluate the relationship between temporomandibular dysfunction (TMD), anxiety, and sleep disorder (DS) among dentistry students, relating the periods in which they are enrolled.Methods: The study consisted of 90 students: Group 1: 30 first-period students; Group 2: 30 fifth-period students; Group 3: 30 students from the ninth period. The participants responded to the RDC/TMD, Fletcher & Luckett questionnaires, and the Beck Anxiety Inventory to analyze symptoms of TMD, DS, and anxiety.Results: There was an association between TMD, DS, and the period studied. When related to moderate and severe anxiety, the group that had the highest incidence was Group 1 (first period students).Conclusion: The apprehension for what is new can influence the TMD and DS indices, while the greater concern for academic/professional performance can generate higher levels of anxiety.

Masseter muscle surface electromyography in college students with a high degree of anxiety and temporomandibular disorder

ABSTRACT Objective: to compare the electrical activity of masseter muscles, bilaterally, according to the presence or absence of Temporomandibular Disorder (TMD) in college students with a high degree of anxiety. Methods: the study was conducted with a randomized sample of 31 Speech Therapy students aged between 17 and 32 years; 61.3% (n = 19) were females and 38.7% (n = 12) were males. They were divided into two groups, Group 1 (G1), comprising 11 students with TMD, and Group 2 (G2), composed of 20 students without TMD. The college students answered the State-Trait Anxiety Inventory (STAI) for anxiety investigation, and were evaluated by the protocol Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) for TMD diagnosis. The evaluation of muscular electrical activity took into account the records in the conditions of rest, Sustained Maximum Voluntary Activity (SMVA) and habitual chewing (HC). The data were analyzed using the version 22 IBM Statistical Package for Social Sciences (SPSS) software. The statistical analysis was performed using Student t test to compare means between groups, considering < 0,05 as the significant p-value. Results: college students, of both groups, presented high levels of anxiety traits. Significant statistical differences were observed on the percentage of electrical activity of right masseter muscle in chewing function, as well as muscle fibers recruitment during chewing, which were higher on the group without TMD. Conclusion: college students with TMD and a high degree of anxiety presented lower means of masseter muscle electromyografic activity during chewing, in most conditions assessed, as compared to volunteers without TMD, except for the left masseter muscle in rest and chewing.

Avaliação de sinais e sintomas da disfunção temporomandibular e sua relação com a postura cervical

Introdução As disfunções temporomandibulares (DTM) podem acarretar alterações gerais nos movimentos mandibulares devido à modificação nas condições musculares e articulares. Objetivo Avaliar os sinais e sintomas da disfunção temporomandibular e sua relação com a postura cervical. Material e método Estudo transversal e descritivo, com abordagem quantitativa, realizado na Universidade de Fortaleza, de agosto de 2011 a abril de 2012, em que 23 participantes com disfunção temporomandibular responderam o questionário ProDTMmulti sobre os sinais e sintomas da patologia, e foram fotografados para avaliação da postura da cabeça e mensuração da lordose cervical. Resultado A idade média das participantes foi de 34,7 anos. A média do ângulo cervical foi de 29,7 graus e da lordose cervical, 3,6 cm. A cefaleia (82,6%), a dor muscular (78,3%) e o ruído na articulação temporomandibular (73,9%) foram os sinais e sintomas mais referidos pela amostra. A otalgia (26,1%) também figurou entre os sintomas, sendo o menos relatado. A maioria dos participantes relatou os sinais e sintomas bilateralmente. Não se observou correlação entre a medida do ângulo cervical e os sinais, sintomas e dificuldades pesquisados. Foi constatada uma correlação moderada entre a medida da lordose cervical e a dificuldade em abrir a boca (r= –0,4; p= 0,03). Conclusão Evidenciou-se que, na população do estudo, dentre os sinais e sintomas de DTM, a cefaleia é a mais referida, e que a maior dificuldade apresentada pelos participantes com disfunção foi a de mastigar. Evidenciou-se ainda correlação entre a dificuldade de abrir a boca e a lordose cervical.

Do stages of dentistry training affect anxiety provoking situations?

Background:

Undetected and unaddressed anxiety negatively affects performance in clinical learning environments.

Aim:

The aim was to investigate the anxiety provoking situations in clinical dental care delivery among students of preclinical and clinical years and house officers.

Subjects and Methods:

A 38-item modified Moss and McManus clinical anxiety questionnaire, general health questionnaire-12 (GHQ-12) and the Zung self-rating anxiety scale were the data collection tools.

Results:

Of the 84 recruited, 79 completed the study giving 94.0% (79/84) response rate. The median age of the participants was 25 years with 50.6% (40/79) being 20-25 years. Gender distribution revealed that males constituted 60.8% (48/79) of the participants. House officers constituted 29.1% (23/79), clinical students 36.7% (29/79), and preclinical students 34.2 (27/79) of the participants. The top anxiety provoking situations using the modified Moss and McManus clinical anxiety questionnaire were extracting wrong tooth 3.24 (1.06), inability to pass examination 3.32 (1.01), achieving examination requirement 3.19 (1.01), fracturing a tooth 3.08 (0.98) and accidental pulp exposure 2.96 (1.04). Getting diagnosis wrong, help in faint episode, not developing radiograph properly and coping with children were the anxiety provoking situations that showed statistically significant difference in the 3 studied training stages of dentistry. Bonferroni post-hoc analysis significant difference was in the preclinical and clinical students’ pair for getting diagnosis wrong, not developing radiograph properly and coping with children while house officers/clinical students and house officers/preclinical students’ pairs were for help in faint episode. Overall, 2.5% (2/79) had severe, 69.6% (55/79) moderate, 26.6% (21/79) mild clinical anxiety while 1 (1.3%) of the participants expressed no clinical anxiety.

Conclusion:

Data from this study revealed that the clinical anxiety of moderate severity was prevalent among the studied dental healthcare students. The anxiety-provoking situations were also found to be majorly similar in preclinical, clinical and post-graduation clinical stages of dental training stages in Nigeria.

Second and third year oral health and dental student perceptions of future professional work

OBJECTIVES

To explore and compare the ways dental and oral health students characterise their future professional work (FPW) at the end of their second and third professional years.

MATERIALS AND METHODS

Questionnaires were given to a cohort group of 48 dental students and 31 oral health students at the end of their second and third professional years at the University of Otago. Students' characterisations of their FPW were identified using an inductive approach, and the emphasis on each characterisation was confirmed using a 'weighted' table.

RESULTS

Dental student response rates were 92% (in 2010) and 85% (in 2011); and oral health student response rates were 100% (in 2011) and 97% (in 2011). Students characterised their FPW in ten broad ways: in reference to treatment-related concerns, patient-related concerns, oral health promotion, oral health education, disease prevention and monitoring, communication, teamwork, maintaining an ideal clinical environment, maintaining a sense of self and improving quality of life. In both years, dental students emphasised treatment-related concerns as central to their FPW and dealing with patient-related concerns as a primary source of difficulty. Oral health students emphasised oral health promotion, oral health education, disease prevention and monitoring and restorative tasks as central to their FPW and dealing with patient-related concerns as a primary source of difficulty.

CONCLUSION

Students' broad perceptions of their FPW changed little as they progressed through their programmes; however, their responses suggested the need for greater attention within their programmes to patient management and teamwork.