Assessment of Stress among Doctors of Dental Medicine

Prevalence and Incidence of Stress Among UK Dental Students: A Systematic Review and Meta-analysis

OBJECTIVE

Dental professionals experience stress daily due to the nature of the excessively demanding working environment in addition to the trust laid upon them by the public. This review aims to evaluate the available evidence on the prevalence and incidence of stress in UK dental students. The paper critically assesses current evidence, shedding light on mental health issues faced by dental healthcare workers.

METHODS

The paper followed PRISMA guidelines and was preregistered on PROSPERO, CRD42024482310. Several databases were searched including PubMed, EMBASE, Web of Science, and Scopus. Studies included involved cohort and cross-sectional studies. The primary outcomes were the prevalence and incidence of stress in UK dental students. Additionally, sources of stress and coping strategies were considered as secondary outcomes.

RESULTS

Nine studies out of 2986 screened were included with a sample size of 1447. The pooled prevalence of stress was in 596/1198 (pooled prevalence = 0.498 95% confidence intervals = 0.466-0.530). The incidence rate is estimated to be 5% per year. Sources of stress were found to be examinations, grades, and fear of failing. Coping techniques were hobbies, and emotional support, in addition to maladaptive behaviours.

CONCLUSION

The outcomes of the papers suggest that dental professionals experience extreme levels of stress. While acknowledging the results, this review also underscores the need for further comprehensive research to fully evaluate the burden of stress on dentists. It also shows the importance of incorporating stress management in dental education.

Depression Levels in Relation to Oral Hygiene, Gingival Health Status, and Salivary Constituents in a Group of Dental Students: A Cross-Sectional Study

Aim

In this study, the effects of depression on oral hygiene, gingival health conditions, and some salivary components (total protein, magnesium, and calcium) were explored.

Materials and Methods

A total of 207 dental students aged 20-21 years (third grade) in a College of Dentistry, University of Baghdad, Baghdad, Iraq, were examined. They were distributed into four groups (normal, mild depression, moderate depression, and severe and very severe depression) according to the Patient Health Questionnaire for Depression Scoring. Oral examinations include oral hygiene (dental plaque and calculus) and gingival health status; samples were collected from 90 participants to serve as a sub-sample of the total sample and classified as follows: normal (22), mild depression (24), moderate depression (22), and moderately severe and severe depression (22) groups. Then, saliva samples were analyzed to determine the total protein, magnesium, and calcium. Statistical Package for Social Sciences version 21 was used to analyze the data.

Results

The mean value of oral hygiene and gingival indices increased significantly with increasing severity of depression. For salivary calcium and magnesium, their values decreased with increasing severity of depression, whereas total protein values increased. Salivary calcium and magnesium were negatively correlated with oral hygiene and the gingival indices, and the highest correlations of total proteins with plaque index, calculus index, and gingival index were positive.

Conclusions

Depressive feelings were observed in dental students. In reality, depression has a close link with oral hygiene and gingival health status, and normal constituents of saliva could be affected.

Stress and occupational burnout levels among Palestinian dentists, and associated factors: A cross-sectional study in 2023

Introduction

Stress and burnout rank among the foremost dentistry-related concerns. Understanding stress and burnout among Palestinian dentists is crucial for developing targeted interventions and support systems. The study aimed to assess stress levels among dentists in Palestine, identify factors contributing to stress, and determine the relationship between stress and burnout in this professional group.

Method

ology: A cross-sectional study was conducted, employing a self-administered questionnaire to gather data from 271 dentists from March to June 2023. The Maslach burnout inventory was utilized to measure burnout across emotional exhaustion, depersonalization, and reduced personal accomplishment dimensions, while the 10-item perceived stress scale was employed to measure stress levels.

Results

The findings revealed that 81% of Palestinian dentists reported experiencing moderate to high levels of stress. Emotional exhaustion was a prominent aspect of burnout, with 48% of participants reporting high levels. The multivariate linear regression analysis demonstrated a significant association between stress scores and female participants (p = 0.001), daily sleeping hours (p = 0.016), as well as emotional exhaustion and personal accomplishment burnout subscales (p ≤ 0.001 for both).

Conclusion

The study revealed high-stress levels among Palestinian dentists, which were associated with sex and daily sleep hours. Furthermore, burnout was prevalent among dentists, particularly in terms of emotional exhaustion and personal accomplishment, which were strongly associated with increased stress levels. The results underscore the need for targeted interventions and support mechanisms tailored to factors facing dentists, especially among females and those who receive inadequate sleep. The relationship between burnout and stress levels highlights the intricate connection between these phenomena.

The association of empathy and the work-family conflict in doctors of dental medicine

OBJECTIVES

Work-family conflict is a growing problem worldwide, because of changing work-family demographic trends and the spread of technology. Empathy, as the ability to understand and share the feelings of other people, is the essential component of emotional intelligence that plays a crucial role in healthcare settings. This study aimed to assess the level of emotional empathy and investigate its relationship with work-family role conflicts among dental medicine doctors.  Materials and methods: In this study participated 589 doctors of dental medicine from Croatia, Serbia, Bosnia and Herzegovina. The questionnaire included general and demographic data, the Emotional Empathy Scale questionnaire and the Work and Family Role Conflict Assessment Scale questionnaire.  Results: The research results indicate no significant association between empathy and conflict between work and family roles (R = 0.032, p = 0.435). Women have achieved significantly higher scores in Emotional Empathy Scale (p ≤ 0.001), while there was no difference in Work and Family Role Conflict Assessment Scale according to gender (p = 0.194). A difference in emotional empathy was observed depending on where the respondents were employed (p = 0.045) and depending on the specialisation of the dental medicine (p = 0.021).  Conclusion: Female doctors of dental medicine demonstrated higher emotional empathy while the work-family role conflict is experienced equally by both genders.

Levels of Depression, Anxiety, and Stress Among Saudi Arabia's Medical and Dental Practitioners: A Cross-Sectional Study Following the Covid-19 Pandemic

BACKGROUND Healthcare providers, particularly in dentistry and medicine, experience high stress levels, exacerbated by factors like patient anxiety, clinical work, and continuous training. The COVID-19 pandemic has further increased these risks. This study aimed to assess depression, anxiety, and stress (DAS) among dental and medical practitioners in Saudi Arabia, investigating influential factors on their psychological behavior. MATERIAL AND METHODS In this cross-sectional study conducted in July and August 2021, the depression, anxiety, and stress scale (DASS-21) was administered through a Google questionnaire. Data analysis involved stepwise mode modeling and bivariate analysis, with a significant P value <0.05, using the Statistical Package for the Social Sciences. RESULTS The study included 376 dentists and 201 medical practitioners. Most worked more than four days a week, slept under six hours nightly, and were non-smokers. DAS scores indicated depression (51.7-57.4%), anxiety (50.7-58.2%), and stress (54.2-60.1%). Significant differences (P<0.05) were observed among younger, single, female, and lower-income participants. Higher DAS scores correlated with less sleep, extensive social media use, and smoking history. Socio-demographic factors were mostly non-significant for medical practitioners, except social media use. Sleep duration significantly impacted stress levels, while specialty, income, and marital status influenced depression CONCLUSIONS DAS levels were notably higher in dentists compared to medical practitioners, particularly regarding anxiety. The impact of socioeconomic factors varied, being more statistically significant for dentists.

Levels of perceived stress according to professional standings among dental surgeons of Karachi: a descriptive study

Background

Globally, occupational stress is a common finding among dentists. The present study aimed to assess prevalence of perceived stress among practicing dentists of Karachi, Pakistan, and assess the perceived stress levels according to the professional standing among dental surgeons.

Methods

A cross-sectional survey was conducted using a convenience sampling technique in which 200 dentists from Karachi were recruited. A self-constructed questionnaire was used to collect data, including demographic and professional backgrounds. Stress level assessment was performed using the perceived stress scale (PSS).

Results

The response rate was 78.5%. In general, a moderate stress level (mean PSS = 18.35 ± 5.417) appeared in the sample size of 157 dentists, and the prevalence of perceived stress was 86%. The level of perceived stress was significantly lower in groups including 40 years old and above (mean diff; p = − 0.197), Rupees 1 lac (100,000) and more of monthly income (mean diff; p = 0.029), 11 and more years of experience (mean diff; p = 0.001) and Assistant Professor/Associate Professor/Professor (mean diff; p = 0.035).

Conclusion

All groups representing the senior status of dentists have appeared with lower stress than groups representing the junior status of dentists. Exploratory studies are required to discover an effective coping strategy to deal with occupational stress among the junior dentists of Karachi.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-022-02272-5.

Preventing Wrong Tooth Extraction

Objective of Work

Wrong-site tooth extraction (WSTE) is the most common serious patient safety incident in dentistry. Safety checklists have significantly reduced wrong-site surgery, although their benefit is unproven in primary care dentistry. Our quality improvement project developed and implemented a checklist optimised for oral surgery procedures in primary care to reduce WSTE risk.

Material and Methods

Local best practice for tooth extraction record-keeping (LBP), using national guidelines and standards was devised. We then retrospectively audited tooth extraction record-keeping against LBP. Deficiencies in current record-keeping practice were identified and used to design a checklist aimed at improving compliance. We provided a computerised safety checklist compliant with LBP to eleven clinicians at three general dental clinics within our region. The checklist included a pre-operative safety check, a pause to re-confirm the surgical site and a post-operative record-keeping proforma. The checklist was linked to our record-keeping software for use during tooth extraction. We audited checklist completion and compliance with LBP fortnightly for ten weeks.

Results

The introduction of a safety checklist resulted in increased compliance with LBP for tooth extraction record keeping. At week ten, 67% of records contained the computerised safety checklist. This resulted in a 50% increase in overall compliance with LBP for tooth extraction compared to baseline.

Conclusions

A computerised safety checklist for tooth extraction in primary care has potential to improve patient safety by adopting measures to prevent WSTE and standardising communication between clinicians. Checklists in general practice should be encouraged.

Occupational Stress among Dental Professionals

Stress at the work place was declared by the World Health Organization as a worldwide epidemic. The stress caused by work appears when the balance between one’s own possibilities and the environment demands is disturbed, which leads to a poor mental state. The fact is that the majority of dentists find they are under constant stress, which is caused by the nature of dental work. Literature describes dentistry as an extremely stressful profession. The main stressors include the tendency toward technical perfection, the causation of pain in patients, the lack of patient cooperation during dental treatment, the failure to maintain the given appointments. Adequate education and preparation, even during dental studies, non-neglect of symptoms and difficulties at the work place, adequate and timely response to the identification of the cause and its elimination or balancing, have a key role in solving this great problem in modern dentistry.

Survey of Mental Health of Dentists in the COVID-19 Pandemic in the UK

Aim

To assess the impact of work-related changes on the mental health (MH) of dentists during the peak of COVID-19 pandemic in the UK.

Materials and Methods

Dentists involved in certain treatments, for example, high-speed drilling procedures, generate infectious aerosols. These Aerosol Generating Procedures (AGPs) are at the highest risk of transmission of coronavirus. During the COVID-19 pandemic, a significant number of dentists in the UK were restricted from providing treatments to reduce the risk of viral transmission. Some of the dentists providing urgent dental treatment were involved in AGPs. Significant and sudden changes in the delivery of dental care in the current pandemic may have impacted the MH of dentists. An online survey was conducted, using validated tools to measure the MH symptoms and stress. Pearson's chi-squared test of independence was used for statistical analysis.

Results

Overall, 123 dentists participated in the survey. The prevalence of anxiety-related symptoms was 71% (95% CI 0.62-0.78), depression-related symptoms was 60% (95% CI 0.51-0.68), and stress was 92% (95% CI 0.86-0.96). Dentists working in the independent sector had more psychological symptoms compared with those in the public sector (P = 0.014).

Conclusions

Working in the public sector appeared to have a protective effect. Almost all the dentists in this survey were experiencing MH symptoms and stress. Further research is needed to assess the long-term effect of the COVID-19 pandemic on dentists.