Depression, anxiety and stress in dental students

Depression, Anxiety, and Stress in Undergraduate Dental Students During Viva and Case Presentation Oral Examinations Using the DASS-21 Scale

INTRODUCTION

Stress among dental students is mainly driven by the demanding nature of dental education which is exaggerated during exams and specifically final year oral examinations.

OBJECTIVE

This study aimed to assess the emotional status (depression, anxiety, and stress) of fifth-year dental students undergoing two forms of oral examinations: conventional viva (CV) and case presentation (CP) based examinations using a DASS-21 scale, and to explore the effects of gender, origin, accommodation, grade point average, and satisfaction with friends and college on the students' DASS-21 scores within each group.

METHODS

Three hundred-thirty fifth-year students did one CP for a clinical case they completed in removable prosthodontics, and also attended a viva exam as a requirement for graduation. Then, an online survey, originated from the DASS-21 survey, was sent to all fifth-year dental students one week after completing both exams.

RESULTS

One hundred twenty-nine students completed the survey with a response rate of 38%. The overall prevalence of depression, anxiety, and stress in the CV group was 22.37%, 21.49%, 19.05% and 24.70%, 24.41%, 21.75% in the CP group, respectively. The severity levels among undergraduate dental students were as follows: moderate levels of depression, moderate to severe levels of anxiety, and normal levels of stress which were not relevant to the oral examination type. High achieving students showed overall higher scores in both study groups, while females showed higher depression scores in the CP group.

CONCLUSION

Dental students at our institution were experiencing increased levels of depression and anxiety in both forms of oral examinations. Sources of depression and anxiety should be outlined and different support strategies should be implemented to help students overcome emotional distress during oral exams.

Metaphorical perceptions of dental students toward dental education: a cross-sectional study from Türkiye

BACKGROUND

Understanding the complex, multifaceted, and often subconscious emotional and cognitive perspectives of undergraduate dental students regarding their education is crucial. Personality types and stress levels are believed to play a significant role in shaping these perceptions. Employing metaphors-using a familiar and concrete concept to explain an unfamiliar or abstract one-is an effective cognitive transfer technique for exploring students' views on dental education. This cross-sectional study aims to investigate dental students' perceptions of their education through metaphor analysis. Additionally, it aims to examine the relationship between students' personality types and stress levels, offering deeper insights into the factors influencing their educational experiences.

METHODS

This cross-sectional study included 1038 undergraduate dental students enrolled in faculties of dentistry at three universities in Türkiye during the 2023-2024 academic year. Data were collected via an electronic survey consisting of four sections. The first section gathered demographic information (gender, age, academic level, and occupational preference). In the second section, participants completed the sentence: "Dental education is similar to … because …" to illustrate their mental representations of dental education. The third section included the Perceived Stress Scale (PSS) to assess stress levels, while the fourth section comprised a personality inventory to determine personality types. All survey data were transferred to Excel for analysis. Metaphors were systematically evaluated, and the most representative ones were identified. Data analysis incorporated both qualitative (metaphor analysis and chi-square tests) and quantitative (linear regression) methods.

RESULTS

Metaphors were categorized into seven conceptual groups: 'master-apprentice training', 'challenging process-race', 'art-skill-creativity', 'patience-labor', 'union of differences', 'discipline-order-power', and 'unknowability-incomprehensibility-indispensability'. A significant gender difference was observed (p = 0.013): female students predominantly used metaphors in the 'patience-labor' category, while male students favored the 'art-skill-creativity' category. Academic year differences were also significant (p < 0.001), with advanced students more frequently using 'discipline-order-power' metaphors. Stress levels did not significantly differ among groups (p = 0.127), with 72.1% of participants reporting moderate stress, most commonly linked to the 'challenging process-race' category. The majority of participants (64.5%) exhibited a Type B personality. A statistically significant regression model was found between PSS scores and both age (p < 0.001) and personality type scores (p = 0.011).

CONCLUSION

This study highlights the influence of personality types and stress levels on dental students' perceptions of their education. Metaphor analysis proved to be an effective tool for identifying these perceptions. The most frequently reported category was 'challenging process-race'. A significant association was found between students' metaphorical categories and their gender and academic level. However, no significant relationships were observed between metaphor categories and occupational preference, stress levels, and personality types.

Adapting new norms: A mixed-method study exploring mental well-being challenges in dental technology education

BACKGROUND

The present study, grounded in the Stress-Adaptation-Growth theory, aims to explore the mental well-being among dental technology students during the post-pandemic period.

MATERIALS AND METHODS

A mixed-method approach was employed among undergraduate dental technology students in Malaysia. The Depression, Anxiety, and Stress Scale (DASS-21) was adapted and modified for dental technology students. The content of the questionnaire was validated by two experienced faculty experts. Construct validity and internal consistency were measured. An online survey was created using Google Forms and disseminated to 10 Bachelor of Dental Technology (BDT) students. Meanwhile, qualitative data were obtained through one-on-one semi-structured interviews, employing a phenomenology approach and thematic analysis to explore students' experiences in the new educational landscape.

RESULTS

All students answered the survey, predominantly females. Prevalence of depression (60% normal, 10% mild, 30% moderate), anxiety (30% normal, 30% mild, 10% moderate, 10% severe, 20% extremely severe), and stress (70% normal, 10% mild, 10% moderate, 10% severe) was reported. Qualitatively, three major themes emerged: "Problems with adaptations", "Anxious about returning to campus", and "Concern about the future". The first theme included sub-themes: "Difficulties in transitioning to hybrid learning" and "Disruption in study-life balance". The second theme had four sub-themes: "Fear of being infected", "Fear of being stigmatized", "Increased vigilance in personal safety measures", and "Confusion about standard operating procedure". The third theme included sub-themes: "Fear of another lockdown" and "Concerns about timely completion of academic requirements".

CONCLUSIONS

This study highlights the complex mental health challenges dental technology students faced post-pandemic, underscoring the need for flexible academic policies, global collaborations, and targeted strategies to support their resilience and well-being.

Educators' Readiness in Supporting Dental Students' Mental Health: A Cross-Sectional Study

Background

The mental health of dental undergraduates can significantly influence their overall well-being. Educators can be pivotal in identifying various mental health concerns. The aim of this study was to assess knowledge, experience, self-efficacy, and attitude of dental educators regarding the mental health of their students.

Methods

A cross-sectional study involving a convenient sample was conducted on a group of faculty members from different dental schools in Riyadh Region. A validated self-administered online survey was carried out between June and August 2022.

Results

A total of 80 faculty members participated in the study. A high percentage of participants were knowledgeable about the effect of mental health on students' academic performance and retention (72.5%). About 56.3% of educators did not receive previous preparation to deal with students' mental health issues, and 50% faced cases of mental health issues among their students. Even though 40% were not confident in their knowledge about mental health issues, the majority 85% agreed that getting a course on mental health issues and how to deal with them is crucial.

Conclusion

The findings of this study indicate that while dental educators generally understand the impact of mental health on students' academic performance, they face notable gaps in preparedness and confidence. Key barriers include insufficient training, limited awareness of institutional resources, and difficulties in accessing mental health information. These results emphasize the need to equip educators with the necessary knowledge and resources to effectively support students' mental well-being.

Anxiety, stress, and depression levels among dental students: gender, age, and stage of dental education related

Dental students may experience psychological disturbance due to the highly stressful dental education process, with no consensus regarding the influence of age, gender, and stage of education. Therefore, the present study aimed to identify sources of stressors that may influence the levels of stress, anxiety, and depression experienced by dental students and examine them based on gender, age, and stage of dental education. A cross-sectional study was conducted in the 2023 academic year with a total of 131 (male = 53, female = 78, mean age = 26.69, range = 22-33) undergraduate dental students. The psychological well-being was assessed using the Depression Anxiety Stress Scale (DASS-21), and the various sources of stress were evaluated using the Dental Environment Stress (DES) questionnaire. The overall prevalence of depression, anxiety, and stress was 52%, 57%, and 55%, respectively. Students in their fifth year (transition between preclinical and clinical years) showed higher depression symptoms compared to students in their fourth or sixth years (p = 0.039). No statistically significant differences were found between gender (males or females) and age regarding DASS symptoms (p > 0.540). The stressors identified as most stressful by all the students were related to academics (amount of classwork, examinations, and grades). The levels of depression, anxiety, and stress among dental students were relatively high. The depression levels among fifth-year students were the highest. Therefore, modifying the academic process to create a positive educational environment should be recommended.

Comparison Between Ecological Momentary Assessment and Self-Report of Awake Bruxism Behaviours in a Group of Healthy Young Adults

OBJECTIVE

The aim of this investigation was to compare the self-reported frequency of awake bruxism (AB) behaviours by means of a validated single-observation point questionnaire (i.e., Oral Behaviour Checklist [OBC]) with the frequency reported in real-time with an Ecological Momentary Assessment (EMA) over 1 week.

MATERIALS AND METHODS

One hundred healthy young adults took part in the study. The frequency of some activities belonging to the spectrum of AB behaviours (i.e., teeth contact, mandible bracing, teeth clenching, teeth grinding) was evaluated using the EMA approach with smartphone technology support over 1 week. The OBC questionnaire was used to evaluate the self-reported frequency of the same AB behaviours. Spearman's rank correlation coefficient was adopted to test the correlation between the average score of each OBC question considered (i.e., teeth contact, mandible bracing, teeth clenching, teeth grinding) and the average frequency of the corresponding EMA item.

RESULTS

Statistical analysis showed a weak-to-moderate level of correlation between the two different AB assessment methods. Mandible bracing showed the highest level of correlation, while teeth grinding had the lowest one.

CONCLUSIONS

While the OBC represents a valid and easy-to-administer screening tool for evaluating bruxism behaviours, the EMA approach provides a more detailed real-time report on AB behaviours.

Clinical anxiety among a sample of dental students in South Sinai

BACKGROUND

Anxiety may be induced in the dental clinics, which is an essential learning environment for undergraduate dental students. This could have a negative impact on clinical performance. This study aimed to estimate the incidence of clinical anxiety among a sample of Dental students and to determine possible precipitating factors for clinical anxiety among them.

METHODS

A cross-sectional study was carried out among 3rd and 4th year dental students at King Salman International University using the modified 34 items of Moss and McManus clinical anxiety questionnaire.

RESULTS

263 students participated. Dental students reported higher incidence of clinical anxiety (60.8%), particularly with different dental treatment plan procedures related clinical situations fulfilling 31.2 out of mean score of anxiety all (74.0 ). Females had higher anxiety score in all domains than males, the same trend noticed in students who reported dental phobia and previous bad dental experiences (P < 0.001, P 0.016, P 0.003 respectively). Participants rated the clinical anxiety precipitating situations in a descending order as follows: extracting wrong tooth (39.5%), giving wrong treatment (37.6%), tearing of the cheek/lips due to catching on a dental burr (35.7%), fracturing a tooth (34.4%), wrong diagnosis (28.1%), inadvertently hurting the patient (22.1%), inability to meet requirements before exams (19.1%), dealing with a fainting patient during dental treatment (18.7%). Two clinical anxiety precipitating situations had almost the same score including restoration failure/recurrent caries and endodontic retreatment procedures 14.8% and 14.4% respectively. Also, extracting tooth and arresting postoperative bleeding had the same score of 13.7%, while the rest of other clinical situations ranged from 11.8 to 1.1%.

CONCLUSIONS

dental students had a comparatively high level of anxiety during clinical classes especially females and those with dental phobia and previous bad dental experiences. Dental students may benefit from stress management classes, mentorship programs, and improved clinical supervision in order to reduce clinical anxiety and build resilience.

Impact of COVID-19 on Depression, Anxiety and Stress of Dental Students: A Systematic Review

AIM

To determine the impact of the COVID-19 pandemic on depression, anxiety and stress of dental students by way of a systematic review.

MATERIALS AND METHODS

This review was conducted following the Cochrane Handbook for Systematic Reviews. An electronic search was conducted for the period January 2020 to February 2023. Quality assessment was evaluated in accordance with the Newcastle-Ottawa Scale. Frequency distribution was calculated for stress, anxiety and depression associated with students' gender, year of study and living circumstances.

RESULTS

Twenty-three studies were eligible for inclusion in the final review. Variables contributing to stress, anxiety and depression of dental students include gender, year of study and living circumstances. Being female is the most significant factor impacting on mental health.

CONCLUSIONS

Results emphasise the need for dental institutions to develop targeted intervention programmes for more vulnerable students. Failure to act in a future pandemic event could result in ongoing psychological issues that persist following graduation, resulting in unfit dentists who may potentially affect the quality of the dental workforce.

A Qualitative Analysis of Students' Perceptions and Experiences of Stressors and Well-Being in Dentistry

INTRODUCTION

Well-being is increasingly regarded as an integral component of a graduating dentist's professional responsibility, yet studies demonstrate significant levels of stress and poor mental health in the dental student population. The aim of this qualitative study was to explore final-year dental students' perceptions of stressors in dentistry and their experiences of managing their individual well-being and supporting the well-being of their colleagues and patients.

METHODS

A literature search was performed to guide the development of an interview framework which included questions centred around three higher domains based on self, peers and patients. Participants were randomly sampled and the interviews audio recorded and transcribed verbatim. An inductive-deductive approach was adopted for thematic analysis of the results.

RESULTS

Fourteen interviews were conducted, revealing four themes and 15 subthemes. Students were acutely aware of poor well-being symptoms amongst themselves and their peers. Treating dental patients with mental illness was common but some students expressed uncertainties in managing these patients. The key stressors were assessments and clinical stress. Students frequently sought support from peers and half had received professional help. Barriers to approaching faculty staff were identified. The role of stigma in preventing students from openly sharing their well-being experiences was discussed.

CONCLUSION

A range of curricular and clinical stressors, and potential sources of support to manage these stressors, have been explored from the perspectives of final-year dental students. From these experiences, action points have been proposed to address knowledge gaps and enhance faculty-level wellness support for dental students.

An Analysis of Students' Perceptions of Strategies to Improve Well-Being in Dentistry

INTRODUCTION

A number of papers have reported on stressors to students in the dental curriculum. This paper analyses perceptions of strategies to improve well-being among final-year dental students in a dental curriculum.

METHODS

A literature review was performed to create a question guide to explore issues of wellness and stress in a dental curriculum. Final-year dental students were invited to an interview using random sampling and issues related to strategies for well-being were analysed by an inductive-deductive approach.

RESULTS

Fourteen interviews were conducted, yielding three themes under the overarching domain of strategies to improve dental student well-being. Under the theme of well-being management, students wished for training on stress reduction for their personal well-being and guidance on communication, referral and mental health support to manage the well-being of colleagues and patients. The second theme, mentoring, covered peer support in the form of a 'buddy system' and sharing from recent graduates to help students gain practical and career advice about post-graduation challenges. Finally, suggestions for institutional support included providing in-house counsellors in the dental hospital with specialised knowledge about the unique concerns of dental students and clear leave of absence policies that treat mental and physical health equally to encourage help-seeking and reduce the fear of disclosure.

CONCLUSION

The experiences of final-year dental students were sampled to explore potential approaches to improve well-being in the dental school environment. Guided by these student perspectives, specific strategies have been implemented and recommended to improve the wellness support provided by the faculty for dental students.

Anxiety, mental suffering, and bruxism in dental students in the COVID-19 postpandemic moment

OBJECTIVES

The COVID-19 pandemic was devastating, causing deaths, economic and social problems, and mental disorders in the lives of many people. After 3 years, the mental repercussions caused by the pandemic are unclear, especially in young adults. This study assessed the occurrence of mental disorders, anxiety, and bruxism in dental students during the postpandemic moment and determined the factors that influenced the occurrence of bruxism.

METHODS

The cross-sectional study enrolled 126 dental students. Sociodemographic information, COVID-19 experience, and remote teaching/learning were collected using questionnaires. Mental state and disorders were collected using the State-Trait Anxiety Inventory (STAI-T) and the Self-Reporting Questionnaire-20 (SRQ-20) of mental disorders. Bruxism was self-reported. Data were analyzed using chi-square test, bivariate and multivariate logistic regression (α = 0.05).

RESULTS

Moderate anxiety manifested in 62.7% of the students. Common mental disorders and bruxism were identified in 35.7% and 59.5% of the students. The odds ratio for bruxism self-report was 6.44 (95% confidence interval [CI] 2.49-16.66) times higher for those who suffered economic impact during the pandemic and 2.39 (95% CI 1.04-5.47) times higher for those reporting anxiety during the pandemic. Bad sleep was also associated with the occurrence of bruxism.

CONCLUSION

In the postpandemic period, dental students exhibited high rates of common mental disorders, anxiety, and bruxism. The increased occurrence of bruxism was linked to the economic impacts experienced during the pandemic, self-perceived anxiety during the pandemic, and poor sleep.

A cross-sectional examination of the relationship between learning environment and anxiety among dental hygiene students

OBJECTIVE

This study's purpose was to determine if the learning environment impacts student anxiety in a dental hygiene program by evaluating the two main learning environments: the dental clinic and the traditional classroom. This study also examined educational tasks and their association with anxiety in each learning environment.

METHODS

A web-based survey was conducted using a convenience sample of dental hygiene students enrolled in a two or four year CODA-accredited dental hygiene program in the United States. The Beck Anxiety Inventory was used to determine each participant's anxiety levels in both learning environments. Data analysis included descriptive statistics, correlation, and an analysis of variance.

RESULTS

According to the Beck Anxiety Inventory scoring, dental hygiene students experience a moderate level of anxiety when learning in the dental clinic and a low level of anxiety when learning in the classroom. Nervousness was the most reported anxiety symptom in both the dental clinic and the traditional classroom. Test results from the Spearman correlation show that all dental clinic and classroom educational tasks have a significant correlation (p < 0.01) to a student's anxiety level. Anxiety reported by students did not statistically differ by the year in which they were in the dental hygiene program.

CONCLUSION

Findings suggest anxiety does exist at a moderate level in dental hygiene students. The dental clinic learning environment is associated with greater anxiety among dental hygiene students. Results from this study will be beneficial in understanding how to facilitate student success in a dental hygiene program.

Exploring the Levels of Stress, Anxiety, Depression, Resilience, Hope, and Spiritual Well-Being Among Greek Dentistry and Nursing Students in Response to Academic Responsibilities Two Years After the COVID-19 Pandemic

Background: Dentistry and nursing students experience significant anxiety, negatively impacting their well-being and academic performance. Objectives: This study aims to assess the prevalence and relationships of stress, anxiety, depression, resilience, hope, and spiritual well-being among dentistry and nursing students, identify demographic influences and propose strategies to enhance resilience and well-being. Methods: This study surveyed 271 students attending Greece's departments of dentistry and nursing at the National and Kapodistrian University of Athens, using an electronic questionnaire aimed to assess stress, anxiety, and depression (depression, anxiety, stress scale-DASS-21); resilience (resilience assessment questionnaire-RAQ8, brief resilience scale-BRS); hope (adult hope scale-AHS); and spiritual well-being (functional assessment of chronic illness therapy-spiritual well-being scale-FACIT-Sp-12). The survey also collected demographic data to identify factors influencing these variables. Statistical analyses, including hierarchical multiple linear regression and t-tests, were performed to analyze the relationships between variables. Results: The sample included 145 dentistry and 126 nursing students, with 68.6% female and 80.1% undergraduate. Half of the students reported mild or higher levels of stress (48.7%), anxiety (51.3%), and depression (53.5%). The prevalence of depression was the highest in our sample, followed by anxiety and stress. Higher family wealth was associated with reduced stress levels, while female undergraduate students reported higher levels of anxiety than their male counterparts. Hope was a strong predictor of resilience, but stress and worry had a negative correlation. Conclusions: Promoting students' well-being and academic success requires effective stress-reduction and resilience-building techniques to improve students' performance and support future healthcare professionals' personal sustainability and holistic growth.

Current challenges in dental education- a scoping review

INTRODUCTION

This scoping review aimed to review the various challenges facing dental education. Dental education faces multiple institutional, student and faculty-based challenges. Institutional challenges include updating infrastructure resources, recruiting qualified faculty, and implementing administrative policies that enhance dental education. Student-based challenges include implementing teaching/learning strategies that will enable students to acquire adequate knowledge, skill, and logical reasoning to identify and execute evidence-based treatment. Faculty-based challenges include regular updating of the dental curriculum, including recent advances in teaching methodology, and adding elective courses that can enhance the readiness of future dentists to address the evolving oral health needs of the public.

METHODOLOGY

The scoping review was conducted using the PRISMA-ScR, focusing on the current challenges in dental education. Articles were identified via searches of Google Scholar, PubMed, Web of Science and Embase for the period 2019 to 2024. Only English language papers detailing challenges in dental education were included. At the culmination of the search protocol, twelve articles were selected for inclusion in this scoping review.

RESULTS

Analysis of these twelve papers identified several themes, which apply to the dental education systems of many, but not all, nations: (1) the correlation between the basic science and clinical phases of the curriculium remains poor; (2) dental students receive inadequate patient care experience to truly develop the competency needed for unsupervised dental practice after graduation; (3) dental students often graduate with inadequate foundational knowledge and clinical experience to provide care for geriatric, specialized pediatric and medically compromised patients, and recieve limited clinical experience in public health settings; (4) dental schools struggle to provide students with training in the technology advancements that are increasingly prevalent in dental practice; (5) difficulties in hiring, training and retaining dentists in faculty positions diminishes the quality of the education experience for students; and (6) an increased number of graduates in some countries struggle to find employment.

CONCLUSION

A variety of studies and advocacy papers over the past 25 years have identified or described similar challenges facing dental education in many nations of the world. The fact that these challenges persist signals the urgent need for curricular and infrastructure reform to better prepare dental students for the realities of dental practice in the 21st century and to provide an environment that will provide an attractive workplace for dentists who desire to participate in the education of the next generation of dentists.

Managing Stress and Somatization Symptoms Among Students in Demanding Academic Healthcare Environments

INTRODUCTION

Stress is a common concern among healthcare students, due to the demands of their coursework and the elevated expectations they face. Especially among dentistry and nursing students, the phenomenon, although well-documented, covers psychosocial and physiological dimensions, with somatization symptoms being less explored. These manifestations are crucial to identify discipline-specific stressors and health impacts that can lead to targeted interventions for both disciplines.

AIM

This study investigates stress perceptions, somatization, and coping strategies among 271 nursing and dentistry students at the National and Kapodistrian University of Athens.

METHODOLOGY

An e-questionnaire was open for submissions during February and March 2024.

RESULTS

Females reported higher stress somatization (M = 10.22, SD = 5.23) than males (M = 7.94, SD = 6.14; Cohen's d = 0.412, p < 0.05). The interpretation of stress as "restlessness and psychological pressure" was more prevalent in dentistry students compared to nursing students. Moreover, nursing students who perceived stress as the "inability to manage unexpected or difficult situations, insecurity, panic" were more likely to experience stress somatization symptoms, while for dentistry students, stress somatization was related to "pressure to meet daily obligations/long-term goals". Physical symptoms for all students included chest discomfort, digestive issues, and headaches/nausea. Also, dentistry students reported more teeth clenching or grinding than nursing students. Short-term coping strategies included emotional balance, managing stressors, situation analysis, and breathing techniques. Long-term strategies involved distraction and entertainment, physical exercise, and patience. A higher willingness to seek coaching support correlated with higher stress somatization among dental students. Nursing students favored psychological support, while dentistry students suggested curriculum revision and improved infrastructure.

DISCUSSION/CONCLUSIONS

Females exhibited higher stress somatization levels, with themes of insecurity and physical symptoms. Nursing students reported higher somatization linked to insecurity, while dental students associated stress with daily obligations and goals. The study highlights the need for improved support systems, flexible academic procedures, and better communication to address stress in healthcare academia.

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.

A classification system based on improved global exploration and convergence to examine student psychological fitness

Anxiety is an important issue that affects their academic performance, mental health, and overall educational journey. To address this issue, it is important to accurately assess anxiety levels and provide evidence-based techniques. However, due to the complexity of anxiety and individual differences, analyzing clustering algorithms to efficiently classify psychological levels is challenging. Traditional clustering techniques face certain challenges in accurately classifying anxiety levels, such as slow convergence, sensitivity to initial conditions, and difficulties in handling constraints. To address these issues, clustering with an improved Mayfly-based optimization algorithm (IMOA) is proposed based on the dynamic variable for better performance to classify psychological levels. Initially, IMOA is validated using 23 standard benchmark functions, confirming its ability to find optimal solutions. Then, IMOA is applied to the student dataset, classifying them into Cluster A and Cluster B. The average scores for both clusters across all test cases are 76.7% and 53.07%, respectively. These results demonstrate the formation of dissimilar student groups with homogeneous emotions and performance, highlighting the importance of addressing emotional stress. Finally, by assigning students to clusters, educators and mental health professionals can better support those who may struggle, ensuring they receive the attention and resources they need. The obtained results show that IMOA with a dynamic variable effectively classifies student anxiety, improving the learning environment and helping teachers better understand students' needs. This identification allows them to provide more effective support and adapt their teaching to meet the specific needs of those seeking support.

Prevalence of Alexithymia and Associated Factors Among Dental Students in Saudi Arabia: A Cross-Sectional Study

Background: Mental health challenges among university students are pervasive, with alexithymia posing a particularly significant yet understudied challenge. This condition significantly affects an individual's ability to cope with stress due to difficulties in recognizing, describing, and processing emotions. Objectives: This study aims to evaluate alexithymia prevalence and its associated factors among dental undergraduate students and interns enrolled at King Saud University in Riyadh, Saudi Arabia. Methods: Data were collected through a self-administered online survey that assessed alexithymia symptoms (using the Toronto Alexithymia Scale [TAS-20]), sociodemographic profiles, lifestyle-related factors, and health-related factors. The associations between participant factors and alexithymia were assessed using chi-square and multiple logistic regression analyses. Results: Of the 421 eligible participants, 369 completed the survey (87.6% response rate), revealing a significant prevalence of alexithymia (37.9%). Female gender (AOR = 1.7, p = 0.04), depression (AOR = 5.6, p < 0.0001), chronic diseases (AOR = 3.5, p = 0.003), and childhood abuse (AOR = 2.2, p = 0.047) were independent factors significantly associated with alexithymia. Conclusions: These findings highlight the pressing need for mental health support within dental education. Early interventions targeting alexithymia could mitigate its adverse consequences, promoting better student well-being and academic success.

Effect of early clinical exposure to GRIT among Indian undergraduate dental students

Dental education is acknowledged for its inherent stress, demanding a multifaceted skill set from students. Early Clinical Exposure (ECE) has emerged as a potential tool to enhance students' interest and perseverance in the face of challenges. Therefore, it is of interest to explore the influence of ECE on GRIT levels among first-year dental students. GRIT is the combination of passion and perseverance for long-term goals. It reflects an individual's ability to stay committed to their objectives despite challenges or setbacks. GRIT is considered a key predictor of success, especially in demanding fields like education, where sustained effort is crucial. A modified 12-item GRIT survey was electronically administered to first-year dental students, measuring their perseverance and passion for long-term goals. The study also investigated potential confounding factors such as age, gender and whether dentistry was the first choice for undergraduate studies. The GRIT scale's internal consistency was found to be high (Cronbach's α = 0.88) and test-retest reliability was established (Intra class Correlation Coefficient = 0.98). Data shows a statistically significant positive correlation between early clinical exposure and GRIT levels in first-year dental students. The majority of respondents demonstrated a substantial degree of grit, with 47.5% categorized as "Very Much Gritty." Interestingly, no individuals were classified as "Not Gritty at all." Additional analyses explored the influence of age, gender and dentistry as the first choice on GRIT levels. While no significant impact was observed based on these factors; female students exhibited slightly higher GRIT levels than their male counterparts. This study's findings contribute valuable insights to dental education, emphasizing the potential benefits of integrating ECE into curricula. Dental schools and educators are encouraged to recognize the motivational impact of early clinical exposure, fostering GRIT development among students.

The interplay of academic procrastination, self-generated stress, and self-reported bruxism among medical and dental students: a cross-sectional study

BACKGROUND

Academic procrastination (AP), a common behavior among students, is influenced by factors such as fear of failure, task aversiveness, anxiety, and stress. Self-generated stress (SGS) refers to the subjective experience of tension that occurs in response to an existing situation. Individuals often overestimate the difficulty and attainability of a task, resulting in increased stress and extended stress duration. SGS can worsen mental and physical health problems, including bruxism. Therefore, this study investigates the possible underlying connections by examining the relationship between AP, SGS, and self-reported (SR) bruxism in medical and dental students.

METHODS

The present cross-sectional study was undertaken among a sample of 379 students pursuing medical and dentistry degrees in Turkey. The questionnaire, including the Academic Procrastination Scale-Short Form, SR bruxism Scale, and SGS Scale, was administered to the students. According to the responses given to the SR bruxism Scale, 3 types of SR bruxism groups were created as sleep, awake, and compound. A comparative analysis was conducted on AP, SGS, and SR bruxism among medical and dental students. Furthermore, the associations among AP, SGS, and SR bruxism were assessed using the utilization of correlation tables and regression analysis.

RESULTS

The prevalence of awake bruxism was higher among dental students (46.6%) compared to medical students (34.7%), suggesting a faculty-dependent trend. A significant positive correlation was observed between SGS and AP (r = 0.212, p < 0.001). Median AP values differed significantly based on awake bruxism (p = 0.007) and compound bruxism (p = 0.013), but not sleep bruxism (p = 0.352). SGS exhibited statistically significant differences across all SR bruxism types: sleep (p < 0.001), awake (p < 0.001), and compound (p < 0.001). Multiple regression analysis identified SGS as a significant risk factor for SR bruxism, with a one-unit increase in stress score elevating the SR bruxism risk by 1.086 times.

CONCLUSIONS

This study revealed that self-generated stress significantly increases the risk for the development of SR bruxism. A significant relationship was found between academic procrastination and self-generated stress, and this relationship was particularly associated with an increased risk for the development of compound and awake bruxism. Stress-reducing therapy methods should be recommended for students to both increase academic success by reducing academic procrastination and prevent the negative effects of stress-related SR bruxism.

Electronic cigarettes and their association with stress, depression, and anxiety among dental students in the UAE-a pilot cross sectional study

Background

During dental school, students may encounter stressful events that contribute to stress, anxiety, and depression; in response to these factors, some students use vaping or electronic cigarettes.

Objective

To evaluate the relationship between electronic cigarettes use and stress, anxiety, and depression among dental students.

Methods

A cross-sectional study included 142 dental students in their preclinical, clinical, or internship year was conducted. The 142 participants were split evenly between two groups: smokers and nonsmokers. The average age of the study's male and female participants was 21.6 years. Using the DASS 21 scale, participants were instructed to complete an electronic questionnaire assessing the association between electronic cigarettes use and stress, anxiety, and depression in smokers and nonsmokers.

Results

According to the findings of this study, stress, anxiety, and depression were significantly associated with electronic cigarette use. Compared to non-smokers, electronic cigarette smokers reported higher levels of severe/extremely severe depression (OR: 10.34, 95% CI: [4.23-24.1]), anxiety (OR: 13.8, 95% CI: [5.4-30.1]) and stress (OR: 27.6, 95% CI: [8.9-85.8]). Compared to males, females were 2.5 times (95% CI: [1.02-6.1]) more likely to report severe/extremely severe anxiety (P < 0.05).

Conclusion

This study demonstrates a significant correlation between the use of electronic cigarettes and elevated levels of stress, anxiety, and depression among dental students in the UAE.

The Use of Coffee Aroma for Stress Reduction in Postgraduate Dental Students

OBJECTIVES

This study aimed to investigate the potential reduction of academic stress related to a graded oral presentation in postgraduate dental students using coffee aromatherapy.

METHODS

Healthy postgraduate dental students in a seminar class were divided into coffee (n = 32) and control (n = 26) groups. There were 3 modes of aroma distribution: personal distribution with a coffee pad attached to a lanyard, a lanyard plus a personal fan for ventilation of the aroma, and the typical method of the diffuser to spread the aroma in the ambient air. Stress markers comprised levels of salivary alpha-amylase (sAA), cortisol (sCort), and chromogranin A (sCgA). Pulse rates were also measured.

RESULTS

Levels of sAA increased 176.62% ± 30.26% between pre- and postpresentation in the control group. Inhaling coffee aroma during the presentation period significantly ameliorated sAA increase at 81.02% ± 14.90% (P = .015). sCort levels tended to decrease in the coffee group, but not significantly. Surprisingly, sCgA levels increased more in the coffee group. Also, pulse rates decreased in the coffee group (-2.07 ± 2.81 bpm) and increased in the control group (6.90 ± 3.22 bpm; P = .035). Subgroup analysis did not reveal differences in salivary markers amongst the 3 aroma distribution modes.

CONCLUSIONS

Coffee aroma could have an anxiolytic effect on postgraduate dental students, as evidenced by changes in sAA levels and pulse rates. Personal aroma distribution was also a useful and effective mode of aromatherapy.

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.

Quality of Life of Healthcare College Students in Riyadh, Saudi Arabia

AIM

The aim of this study was to assess the quality of life (QOL) and its influencing factors among healthcare college students in Riyadh, Saudi Arabia.

METHODS

A cross-sectional study was conducted among healthcare students at King Saud University. A modified version of the Arabic World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire, including 25 questions, was used to assess students' QOL. Data were collected through an online survey and analyzed using IBM SPSS Statistics version 26 (IBM Corp., Armonk, NY). Descriptive and regression statistics were used.

RESULTS

A total of 547 healthcare students completed the questionnaire during the data collection period. Of all the students, 39.7% were from applied medical college, 62.5% were females, 98.9% were single, and 91.8% were non-smokers. Regarding academic status, 58.3% did not participate in any extracurricular activity, 42.6% had an academic advisor, and 80.4% had a grade point average (GPA) higher than 4.1. The average QOL score across all domains was moderately good (60.30 ± 16.0), whereas the physical domain showed the poorest score (46.89 ± 14.8) while the environmental domain had the greatest score (68.04 ± 20.6). The environmental domain was the only domain that showed significant differences between healthcare colleges (p < 0.001). Moreover, students who were male (p = 0.009), non-smokers (p = 0.023), reported living with family/friends (p = 0.031), and from families with high monthly income (p < 0.001) had significantly higher environmental QOL scores than their counterparts.

CONCLUSIONS

The study found that healthcare students had moderately good mean QOL scores. The environmental domain was the only QOL domain that showed significant differences between healthcare colleges with the greatest score among medical college students. Gender, smoking status, residence status, and family monthly income were found to have a strong association with students' environmental QOL scores. Institutions need to focus on the regular measurement of students' QOL, which facilitates implementing strategies that can promote their overall QOL and subsequently positively impact their performance academically and practically.

Burnout, stress, and their correlates among bank employees of South India: a cross-sectional study

BACKGROUND

The banking sector is one of the job sectors that experience high stress, workload, complex interpersonal relationships, and job burnout as it involves interaction with the public and financial responsibilities, which leads to high burnout and stress. The present study was conducted to assess the prevalence of burnout and stress among bank employees and to find the associated factors.

METHODS

This cross-sectional survey was conducted among 282 bank employees of Kollam district, Kerala, India. Data was collected using a self-administered questionnaire related to the socio-demographic and professional details. We used the Oldenburg Burnout Inventory (OLBI) to screen for burnout levels. Depression Anxiety Stress Scale (DASS 21) to screen for the levels of depression, anxiety, and stress among study participants. Descriptive statistics were used to summarize the data, and logistic regression was used to identify the factors associated with the levels of burnout and stress.

RESULTS

Of 282 study participants, moderate to high levels of burnout were observed in 232 participants (82.2%), and 74 participants (26.2%) had mild to extremely severe levels of stress. Daily average working duration showed an association with higher levels of burnout (adjusted odds ratio [ORAdj]: 2.391; 95% confidence interval [CI]: 1.12-5.10) and stress (ORAdj: 3.37; 95% CI: 1.58-7.16).

CONCLUSIONS

A high prevalence of burnout and stress was observed in the present study. The duration of working hours was associated with both burnout and stress. Therefore, regulating the working hours may help adequately manage stress and burnout, thereby improving the mental health of bank employees.

Well-being of undergraduate dental students: Questionnaire design, findings and future directions

INTRODUCTION

The recent pandemic has highlighted the importance of addressing well-being in the overall health of students. There is a need for support systems within dental schools to help students demonstrate resilience, adapt to learning environments and thrive in their professional careers.

OBJECTIVES

The main aim of the study was to evaluate Bachelor of Dental Surgery (BDS) students' understanding and experience of well-being. The objectives were to create a suitable survey to assess students' well-being, investigate the factors affecting dental students' well-being and develop a student well-being action plan based on the analysis of the survey.

METHODS

A literature review was conducted to identify and critically assess existing measures of well-being in dental students. Four domains of well-being (emotional, physical, social, intellectual) relevant to dental students were identified. Through a comprehensive iterative process, a two-part survey was developed and tested, which measured individual experiences of well-being across the four domains and collected feedback on proposed initiatives to support student well-being. The survey was disseminated to all 452 dental students from Years 1 through 6, of which 71% (321) responded.

RESULTS

The survey revealed low levels of overall well-being among the dental student population, which worsened with increasing years of clinical study. Fear of failing exams presented the biggest challenge with regard to emotional well-being, while sleep deprivation and occupational health hazards most affected the physical well-being domain. Intellectual well-being was compromised by insufficient free time to pursue extracurricular interests and concerns about achieving the required skills. Despite a majority experiencing positive relationships with their peers and tutors, less than a fifth agreed that the Faculty of Dentistry 'supported my well-being as a dental student'.

CONCLUSION

As the first investigation of the well-being of dental students in Hong Kong, the key stressors identified were examinations, long schedules and the physical burden of dental work, which are consistent with international literature. The findings reveal students' needs and preferences for well-being initiatives which will be optimized in the implementation of student-centred curricular activities.

The prevalence of depression, anxiety, and sleep disorder among dental students: A systematic review and meta-analysis

BACKGROUND

Despite the increasing concern, the literature lacks a comprehensive synthesis of the prevalence of depression, anxiety, and sleep disturbances among dental students.

METHODS

We conducted a systematic review following Cochrane Manual for Systematic Reviews of Interventions and PRISMA guidelines. Our search, spanning databases like Medline, Web of Science, and Scopus, covered data until June 5, 2023. A random effect model was utilized for the meta-analysis.

RESULTS

From 508 initially identified articles, 45 studies met eligibility criteria. The pooled prevalence of depression, anxiety, and sleep disorders among dental students was estimated as follows: depression [38%, 95% confidence interval (CI): 32%-44%; I2 = 98%], anxiety [48%, 95% CI: 41%-55%; I2 = 97.7%], and sleep disorders [31%, 95% CI: 24%-38%; I2 = 85.7%]. Subgroup analyses based on geographical regions and assessment scales revealed significant between-subgroup differences. Meta-regression identified associations between the prevalence of depression and the year of publication and between the prevalence of anxiety and total sample size, participant age, and year of publication. Publication bias assessments demonstrated a lack of significant bias, strengthening the validity of the findings.

CONCLUSIONS

The prevalence of depression, anxiety, and sleep disturbances in dental students is significant. This study highlighted the need for targeted interventions and support systems within dental education to alleviate the mental health challenges students face, ultimately ensuring their well-being and competence as future healthcare providers. Further research should explore the effectiveness of interventions in this population.

Perceived stress among dental students and the role of parental influence in career decision-making

OBJECTIVES

The current study aimed to assess perceived stress levels among dental students at Riyadh, Saudi Arabia, and to explore the influence of parental roles in their decision to pursue dentistry as a potential source of social stress.

METHODS

This cross-sectional study employed the validated Dental Environmental Stress (DES) Scale to evaluate perceived stress, and incorporated additional questions to fulfill the research aim. We approached all undergraduate dental students at King Saud University, both male and female, across all academic years, using online channels (such as emails, WhatsApp, Twitter, etc.) and hard copy distribution. Data collected were analyzed using SPSS version 20, utilizing descriptive and correlation statistics.

RESULTS

A total of 326 students participated in the study, with an even distribution of male and female students. Female students reported higher levels of stress compared to their male counterparts across most DES domains. A notable correlation emerged between mean DES scores in certain domains and influence of parents in the decision to pursue dentistry.

CONCLUSION

Our findings indicate that female dental students experience higher stress levels than males in all examined areas, barring social stressors. Furthermore, the study underscores the significant impact of parental involvement in choosing dentistry as a career on students' stress level.

Awake bruxism behaviors frequency in a group of healthy young adults with different psychological scores

OBJECTIVE

To assess the frequency of awake bruxism (AB) behaviors in a group of undergraduate dentistry students and correlate it with the status of anxiety and depression.

MATERIALS AND METHODS

The frequency of five oral behaviors (i.e., relaxed jaw muscle, teeth contact, mandible bracing, teeth clenching, teeth grinding) was evaluated using a smartphone-based ecological momentary assessment (EMA) approach. The anxiety and depression status was investigated with the four-item patient health questionnaire for anxiety and depression (PHQ-4). ANOVA with Tukey post-hoc test was used to assess the difference in frequency of AB behaviors among the four PHQ-4 groups.

RESULTS

Among the four groups, there was a statistically significant difference in the frequency of relaxed jaw muscle, teeth contact, mandible bracing, and teeth clenching, but not for teeth grinding.

CONCLUSION

Based on this cross-sectional study's findings, psyche seems to have a determinant impact on AB behaviors, which is significantly higher in individuals with anxiety and depression traits.

Depressive symptoms and their correlates among predoctoral dental students in the United States

OBJECTIVE

To investigate the prevalence of self-reported depressive symptoms among predoctoral dental students in the United States and examine potential correlates.

METHODS

A survey was emailed to all 66 dental schools in the United States, inviting them to distribute it to their predoctoral students. Depressive symptoms were assessed using the Patient Health Questionnaire-9. Data collection occurred from February to April 2020. Multivariable ordinal logistic regression was used to assess associations between demographic variables and depressive symptom severity category, adjusting for potential confounding.

RESULTS

Of an estimated 25,000 predoctoral dental students at the 66 schools, 631 students from 21 schools completed the survey. A total of 24.1% were categorized as having minimal or no depressive symptoms, 33.6% as having mild depressive symptoms, and 42.3% as having moderate, moderately severe, or severe depressive symptoms. Gender (p = 0.015) and race/ethnicity (p = 0.002) were significant predictors of severity, adjusting for other variables. Students identifying as female had higher odds of self-reporting greater depressive severity symptoms compared with students identifying as male. Students identifying as African American/Black (non-Hispanic) and Asian/Pacific Islander had higher odds of self-reporting greater depressive severity symptoms compared with students identifying as White.

CONCLUSION

There is evidence of a high prevalence of depressive symptoms among predoctoral dental students in the United States. Demographic variables may be risk indicators within this population. Approaches to reduce depressive symptoms among US predoctoral dental students are needed.

Psychophysiological wellbeing in a class of dental students attending dental school: anxiety, burnout, post work executive performance and a 24 hours physiological investigation during a working day

Aim

To the best of our knowledge, dental school students have never been evaluated for stress, anxiety, burnout, physiological indexes during a 24-h working day, and executive function performance post-work and post-work after returning from vacation; therefore, this research has been conducted.

Methods

Data were acquired at the Dental School of the University of Padua on 16 students in their 4th year, far from the exam session. While performing clinical activity on the dental chair and during a working day, electrodermal activity (EDA), heart rate variability (HRV), and heart rate (HR) were recorded. Participants' stress was measured with the Perceived Stress Scale (PSS-10 scale) and anxiety with the General Anxiety Disorder Questionnaire (GAD-7) and State-Trait Anxiety Inventory (STAI-Y-2), while burnout with the Maslach Burnout Inventory (MBI-HSS). Executive functions were evaluated using the Tower of London test (TOL-R).

Results

Three students (2F/1M) had a GAD-7 score ≥ 10. Five students (4F/1M) showed trait anxiety. Moderate levels of perceived stress were reported in 85% of participants. MBI-HSS showed that 7 participants scored high on emotional exhaustion and 7 on depersonalization. TOL-R performance (M = 15.85, SD = 4.01) was below the normative value p < 0.00001. A second test, after the holidays, showed normal values. EDA was higher during children's treatment (p < 0.05), ANOVA showed high HR during working time (p < 0.001), and HRV was higher in males (p < 0.001).

Conclusion

Based on the sample size evaluated, it is reported that being a dental student has a moderate impact on stress, anxiety, and burnout while a strong impact on executive functions buffered by rest.

Connecting chronic stress and anxiety: a multi-dimensional perspective

Studies show a connection between anxiety and stress, but with little differentiation between different domains of stress. In this article, we utilize a multi-dimensional approach to better understand the relationship between different chronic stress domains and anxiety. This will allow researchers to identify and address those areas of stress that are most relevant with regard to anxiety. We used data from a sub sample of the LIFE-Adult-Study (n = 1085) to analyze the association between nine different areas of chronic stress (Trier Inventory for Chronic Stress, TICS) and anxiety (General Anxiety Disorder 7, GAD-7), controlling for sociodemographic variables, personality, and social support. There was a significant and positive association between Work Overload, Pressure to Perform, Social Tensions, Social Isolation, Chronic Worrying, and anxiety. After including the control variables, only Work Overload and Chronic Worrying remained significant. By focusing on Work Overload and Chronic Worrying researchers, practitioners, and policy makers can help to mitigate anxiety and related health problems in the population in an efficient way.

The triangle of anxiety, perfectionism, and academic procrastination: exploring the correlates in medical and dental students

INTRODUCTION

Academic procrastination is a common phenomenon among medical science students. This issue can negatively affect the students' academic performance. The aim of this study was to investigate perfectionism and anxiety as potential predictors of academic procrastination in medical and dental students.

METHODS

This cross-sectional study was conducted among medical and dental students of a public medical sciences university in the south of Iran. Students were assessed using the procrastination assessment scale for students (PASS), Tehran multidimensional perfectionism scale (TMPS), and anxiety subscale of the general health questionnaire (GHQ). Predictors of academic procrastination were evaluated using multiple regression analysis with adjustments made for gender and academic semester.

RESULTS

A total of 176 medical and 79 dental students participated in the study. None of the perfectionism components were predictors of academic procrastination. However, anxiety was a significant predictor of academic procrastination in the total sample of students (standardized β = 0.404, p < 0.001), as well as dental (standardized β = 0.356, p < 0.001) and medical (standardized β = 0.478, p < 0.001) students. Anxiety and academic procrastination were both negatively correlated with students' grade point averages.

CONCLUSIONS

The findings of this study suggest that anxiety, as opposed to perfectionism, has a more significant influence on academic procrastination among medical and dental students. Interventions aimed at lowering anxiety may be beneficial for reducing academic procrastination, thereby enhancing the academic performance of the students.

Dental Students' and Dental School Graduates' Practical Skills: An International Survey of Perceptions of National Dental Associations in Europe

PURPOSE

Dental students learn knowledge and practical skills to provide oral health care to the population. Practical skills must be maintained or continuously developed throughout a professional career. This cross-sectional survey aimed to evaluate the perception of practical skills of dental students and dental-school graduates by national dental associations (NDAs) in international comparison in the European Regional Organization of the FDI World Dental Federation (ERO-FDI) zone.

MATERIALS AND METHODS

A questionnaire of 14 items collected information on pre-/postgraduate areas.

RESULTS

A total of 25 countries participated (response rate: 69.4%), with 80.0% having minimum requirements for practical skills acquisition and 64.0% starting practical training in the 3rd year of study. In countries where clinical practical work on patients begins in the 2nd year of study, practical skills of graduates are perceived as average, starting in the 3rd year of study as mainly good, starting in the 4th as varying widely from poor to very good. In total, 76.0% of respondents feel that improvements are needed before entering dental practice. Improvements could be reached by treating more patients in dental school (32.0%), increasing the quantity of clinical training (20.0%), or having more clinical instructors (12.0%). In 56.0% of the countries, it is possible to open one's own dental practice immediately after graduation, and in 16.0%, prior vocational training is mandatory.

CONCLUSIONS

All participating countries in the ERO-FDI zone reported practical training in dental school, most starting in the 3rd year of study. The perception of practical skills of dental students and dental-school graduates among NDAs is very heterogeneous. Reasons for the perceived deficiencies should be further explored.

Assessing students' mental health in two American dental hygiene programs

OBJECTIVES

Dental hygiene students adapt to new environments while learning technical skills and providing clinical care during their education. Understanding how stress affects students in their professional healthcare program warrants exploration. This study assessed stress among dental hygiene students in two educational settings in the Southeastern United States.

METHODS

First and second-year dental hygiene students (N = 136) from a community college setting (n = 67) and a university setting (n = 69) were invited to complete an anonymous online survey on mental health in fall 2019. Validated surveys on depression, anxiety, social support, and burnout were included. Data analysis included chi-squared and Mantel-Haenszel statistics, depending on the scale of measurement, with the level of significance set at 0.05 for all analyses.

RESULTS

Participants included 54 dental hygiene students from a community college (Response rate = 80.6%) and 69 dental hygiene students from a university (RR = 100%). There was a statistically significant difference in the proportion of students reporting moderately severe or severe anxiety (p = 0.007), with 56% (n = 30) of the community college respondents and 36% (n = 24) of the university reporting these anxiety levels. Students attending a community college were also more likely to express feelings of worry (n = 34) compared to students in a university setting (p = 0.005). There was no statistically significant difference in depression (p = 0.07) or suicidal thoughts (p = 0.41).

CONCLUSION

Dental hygiene students enrolled in these two programs reported high levels of self-reported stress, mental and emotional concerns that may increase suicidal tendencies.

Sociodemographic determinants of depression, anxiety, and stress immediately after the COVID-19 pandemic: a cross-sectional study among university students in Saudi Arabia

Background

The public health measures taken in educational institutions during the COVID-19 pandemic had complex influences on students' mental health. This study aimed to evaluate the prevalence and sociodemographic determinants of Depression, Anxiety, and Stress immediately after the COVID-19 pandemic among students at Qassim University, Saudi Arabia.

Methods

We conducted a cross-sectional study among Qassim University students in Saudi Arabia. All students registered for the academic year 2022 were invited to participate in a survey through social media. A total of 453 participants completed an online survey that included the DASS-21 for assessing the emotional states of Depression, Anxiety, and Stress..

Results

The mean scores for Depression, Anxiety, and Stress, were 10.70, 11.18, and 10.40, respectively. At least 18% of the students reported experiencing moderate-to-severe levels of Depression, Anxiety, and Stress. The study showed that the feminine gender was associated with higher Depression, Anxiety, and Stress scores.

Conclusion

Students in the current study described experiencing higher levels of Depression, Anxiety, and Stress during the COVID-19 pandemic. The findings of the present study can help universities take targeted measures to address the impact of a pandemic like COVID-19 on students' mental health.

Stress experienced by dental students performing clinical training in different dental disciplines: a cross-sectional study

OBJECTIVES

To assess the stress level, the impact of stress factors, and discrepancies between fourth- and fifth-year undergraduate clinical students at the University of Jordan.

METHODS

A cross-sectional study was conducted in the academic year 2022/2023. The study group included fourth- and fifth-year dental students at the University of Jordan (n = 382) who were asked to voluntarily fill in an online dental environment stress (DES) questionnaire. Analysis was conducted using Mann-Whitney U test, independent t-test, χ2 test, and Spearman ρ rank correlations. Statistical significance was inferred when P < .05.

RESULTS

Fourth-year students reported higher levels of nervousness before treating patients for the first time. Fifth-year students faced more difficulty, higher stress, and/or fear regarding the amount of assigned work, provided treatment, completed requirements, failing the course, time to finish assignments, patient comprehensive care, and financial expenses of the course. Comparison between groups revealed that the fifth-year students scored higher levels of stress on the total DES score and all partial DES scores. Furthermore, the total DES questionnaire scores were significantly correlated with grade point average (GPA) among the total study sample and the prosthodontics clinical course marks among the fourth-year students' group.

CONCLUSIONS

The stress level among students in clinical courses was influenced by their academic performance, gender, year level, and the type and time needed for the provided treatment. Completing course requirements was among the most commonly faced stressors. Future research endeavors might be considered to study each clinical factor, its impact on students' stress level, and how to manage and positively improve these factors.

Associations of academic environment, lifestyle, sense of coherence and social support with self-reported mental health status among dental students at a university in Brazil: a cross-sectional study

OBJECTIVES

The study evaluated the association of academic environment, lifestyle, sense of coherence (SOC) and social support with self-reported mental health status among dental students.

DESIGN

Secondary analysis of data from a cross-sectional, questionnaire-based survey conducted from August to October 2018.

SETTING

Dental school of a public-funded university in the south-eastern region of Brazil.

PARTICIPANTS

233 undergraduate dental students recruited across all years of the course.

OUTCOME MEASURES

Socioeconomic and demographic characteristics, city of origin and student's academic semester were obtained through self-completed questionnaires. Perception of the academic environment (Dundee Ready Education Environment Measure (DREEM)), individual lifestyle (Individual Lifestyle Profile Questionnaire (ILPQ)), SOC (SOC Scale (SOC-13)), social support (Medical Outcomes Study Scale (MOS)), and depression, anxiety and stress (Depression, Anxiety and Stress Scale-21 (DASS-21)) were assessed using validated instruments. The relationships between variables were investigated through multivariable negative binomial regression to obtain the rate ratios (RRs) and 95% CIs.

RESULTS

Female sex was associated with greater scores of anxiety (RR 1.74, 95% CI 1.10 to 1.97) and stress (RR 1.52, 95% CI 1.12 to 2.06). Students who perceived a better academic environment and those reporting a greater SOC had a lower probability of depression, anxiety and stress. Furthermore, a favourable lifestyle was associated with lower depression scores (RR 0.99, 95% CI 0.97 to 0.99). Social support did not remain associated with depression, anxiety and stress after adjustment.

CONCLUSIONS

The present findings suggest that self-reported mental health status is associated with students' sex, academic environment, SOC and lifestyle. Enhancing the educational environment and SOC, and promoting a healthy lifestyle may improve the psychological health of dental students.

Depression and Anxiety among Undergraduate Health Science Students: A Scoping Review of the Literature

Background: Health science students in post-secondary institutions experience high levels of depression and anxiety due to increased stress levels, workload, low socioeconomic status, and history of family mental illness, among other factors. Given the significant negative impact that depression and anxiety can have on undergraduate health science students, it is essential to understand the prevalence and correlation of these conditions in this population. In light of this, this scoping review aims to identify, document, and analyze the literature on the prevalence and determinants of anxiety and depression among undergraduate health sciences students and identify gaps in knowledge for future research. Methods: This scoping review was planned and executed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for the Scoping Reviews statement. A comprehensive and systematic search was carried out for five databases, namely MEDLINE, Scopus, EMBASE, CINAHL, and PubMed. Results: From the literature identified by our search strategy, the lowest prevalence for anxiety was 5.8%, and the highest was 82.6%, with a median of 44.25%. The prevalence of depression ranged from a high of 88.8% to a low of 2.1%, with a median value of 34.8%. Our analysis revealed that correlates of anxiety and depression among health science students include sociodemographic factors such as age, sex, gender, relationships, ethnicity, and family history, personal health conditions, and academic and socioeconomic issues. Conclusions: With the high incidence of anxiety and depression among health science students, there is an increasing need to find practical remedies to support these students. It is also essential for policymakers and university authorities to implement interventions such as supportive text messages and other strategies geared toward providing support and improving the psychological well-being of health science students.

Prevalence, Symptoms, and Triggering Factors of Panic Attacks among Dental Students in Riyadh Saudi Arabia-A Cross Sectional Survey

Panic disorder by definition is an anxiety disorder of unexpected and repeated episodes of intense fear. Panic attacks are usually diagnosed by four or more of a set of symptoms that include palpitations, sweating, trembling, shortness of breath, chest pain, nausea, dizziness, and hot flushes. They usually interfere with daily life situations and also interfere with education. Hence, the aim of this study was to assess the prevalence of panic attacks, their symptoms, and triggering factors among dental students in Riyadh, Saudi Arabia. Data were collected from 394 students using a structured and validated questionnaire. The prevalence of panic attacks among dental students in Riyadh, Saudi Arabia, was 42.9%. Most of the participants who experienced higher episodes of panic attacks were females (53.4%) when compared to males (24.5%). Third year students displayed greater (58.3%) episodes of panic attacks compared to their respective counterparts. The most reported symptom of panic attacks was rapid or pounding heartbeat followed by breathlessness, chest pain, and shaking or trembling. It was also noted that most of the participants (63.31%) encountered a panic attack for the first time after joining dental school. The situations where dental students frequently experienced panic attacks were during exams, clinic procedures, giving presentations, and especially while under a lot of stress. The high occurrence of panic attacks among dental students highlights the importance of providing support programs and implementing preventive measures to help students, particularly those who are most susceptible to higher levels of these psychological conditions. Dental students experiencing panic attacks should be provided with necessary counseling sessions or psychiatric consultation in order to overcome such scenarios. Dental schools should consider these findings when planning the dental curriculum. Hence, the role of the faculty members is essential in these situations to provide support for the affected students.

Association between history of academic failure during dental school and self-reported depression, anxiety, and stress: A retrospective cohort

OBJECTIVE

To investigate the association between history of academic failure (HAF) and self-reported depression, anxiety, and stress among undergraduate dental students.

METHODS

This study involved 244 dental students from one university. An online questionnaire collected information on the following variables: socioeconomic status, behavior, use of licit/illicit drugs, and the choice of dentistry as an undergraduate field of study. The 21-item Depression Anxiety Stress Scale (DASS-21) was applied. HAF in at least one subject during a participant's undergraduate tenure was defined as the main outcome. Bivariate and multivariate analyses were performed using Poisson regression with robust variance. In addition, a subgroup analysis was performed for the variable "dentistry as the first choice for undergraduate studies."

RESULTS

The prevalence of HAF was 25.00% (n = 61). Among those students, the mean number of academic failures was 5.41 ± 6.38 (range: 1-33). Higher rates of HAF were observed among older and non-white dental students. Moreover, those who self-reported at least severe depression presented a 79% higher HAF prevalence ratio (PR) (95% confidence interval [95% CI]: 1.15-2.80). Similar findings were detected among those who reported (PR: 1.79; 95% CI: 1.06-4.46) or did not report (PR: 2.21; 95% CI: 1.10-4.46) interest in dentistry as a first undergraduate option. Conversely, among women and students who did not choose dentistry as their first option, HAF was significantly lower (PR: 0.41; 95% CI: 0.21-0.80).

CONCLUSION

Higher HAF rates are observed in students who are older, non-white, and self-report at least severe depression. However, dentistry as a first option for undergraduate studies was not associated with HAF.

Clinical activities suspended: How the COVID-19 affected the self-confidence of Italian dental students

INTRODUCTION

COVID-19 emergency caused several effects on the dental educational system, especially affecting courses including practical activities. The study aims to evaluate the impact of the suspension of dental clinical activities on the Italian dental students' self-confidence. Furthermore, the other purpose of the research is to find an integrative didactics solution to improve the clinical training of dentistry during the COVID-19 pandemic.

MATERIALS AND METHODS

A questionnaire was administered to evaluate the impact of the suspension of clinical activities on dental students' self-confidence. A 67-questions survey tested the students' self-confidence in several dental disciplines (Conservative Dentistry, Endodontics, Oral Surgery and Dental Emergency). The study reached a sample of 193 dental students and the answers from 9 different Italian dental schools were analysed.

RESULTS

The degree of students' self-confidence for all the dental disciplines investigated was found statistically different between the periods before and after the interruption of clinical activities. The students proposed, as a potential solution to improve their practice during the COVID-19 pandemic, to combinate the use of a video tutorials and dental simulators.

CONCLUSION

The interruption of the training in clinical practice significantly affected the educational career and the self-confidence of students. An alternative teaching method involving the use of video tutorials as support in teaching clinical procedures deserves to be considered.

The psychological impact of the ongoing COVID-19 pandemic on health-care workers in primary health-care centers in resource-poor settings

Background

Health-care workers' psychological status is essential to Preventive control measures in a weak and unstable health system with poor infrastructural constraints. This study examines the psychological impact of the ongoing coronavirus disease 2019 (COVID-19) pandemic on the health-care providers working in primary health-care settings in Sudan.

Materials and Methods

This is a health facility-based cross-sectional study conducted in primary health-care units in White Nile State, Sudan. The psychological impact of stress and anxiety was determined using the Depression Anxiety Stress Scale 21 (DASS-21). A self-administered questionnaire measured depression, anxiety, and stress. The population of this study included health professionals working in health centers, including physicians, nurses, technicians, pharmacists, and other support staff.

Results

A total of 167 health professionals were systematically recruited. The mean anxiety score in the study population was 8.26 & 9.0 (corresponding to mild anxiety). Participants without anxiety constituted 26.35% (n = 44) of the participants. Women were significantly more likely to be affected than men (P = 0.0). Age (21-40 years), female nurses, and other health-care workers (anesthesiology, public health, health education, occupational health, psychiatry, etc.) could be strong predictors of psychological disorders (P-value of 0.0).

Conclusion

This study provided evidence for primary health care at its preparatory levels, as they are the first line of protection against the COVID-19 pandemic. Addressing the high-risk population is a high priority in the preliminary phase.

The impact of COVID-19 on dental education in Tunisia

INTRODUCTION

Coronavirus disease 2019 (COVID-19) pandemic might have an unprecedented impact on dental education.

AIM

The main aim of this study was to investigate the impact of COVID-19 among Tunisian dental students.

METHODS

This was a cross-sectional study carried out from January to March 2022, at the Faculty of Dental Medicine of Monastir (FDMM), Tunisia. The population consisted of the 3rd, 4th, 5th and 6th year dental students registered for the academic year 2021/2022 at the FDMM. The potential number of participants was 881 according to the administration of the faculty. The applied questionnaire was made of 17 questions adapted to the Tunisian context. Incomplete answers were considered as exclusion criteria.

RESULTS

A total of 446 students responded to the online survey giving an overall response rate of 50.6%. The study revealed that the FDMM was not doing its best to solve the challenges associated with the COVID-19 pandemic for 88.8% of the responders. Dental students were concerned about the impact of COVID-19 pandemic on their dental education (69.6%) especially about graduating on time (63.0%) since changes made in dental medicine education due to the pandemic were stressful for 61.1% of them. The students reached emotional support from their family and friends (46.5%) whereas only 9.8% of them requested assistance from faculty's staff.

CONCLUSION

This study provides information about the impact of the COVID-19 pandemic on dental education. These findings may sensitize officials in the FDMM to take measures in order to deliver better education to dental medicine students.

Student support services: Perceptions and recommendations for the next generation

PURPOSE

Student support services/student affairs are central to the student academic experience and success at US and Canadian dental schools. This manuscript evaluates student and administrator perceptions of support services and offers recommendations for best practices in student services in predoctoral dental education to help institutions improve the student experience.

METHODS

A survey of administrators and dental students found perceptions of student support services vary between these groups.

RESULTS

Seventeen student services administrators and 263 students started the survey, and 12 administrators and 156 students completed the full survey. Survey comments indicated access to student support services is a concern. Results of the student survey, in conjunction with current literature, were utilized to develop recommendations for dental student support services.

CONCLUSION

Recommendations for student support services in dental schools include accessibility of student services, and ensuring students have access to support in the domains of wellness, academic support, and peer support as well as implementation of humanistic practices. Wellness supports should include behavioral health services, physical health services, and access to mindfulness interventions. Academic support services should include study skills, time management training, and academic supports such as tutoring. Structured peer support programs should also be implemented. Dental schools should also be mindful of the changing support needs of incoming dental students.

Prevalence of Depression and Associated Factors among Adults in Saudi Arabia: Systematic Review and Meta-Analysis (2000-2022)

Introduction. Depressive disorders are the leading causes of disability and disease burden worldwide. They were ranked fifth among the top causes of death and disability in Saudi Arabia, with subsequent impacts on productivity and economics when affecting adults. Objectives. The study aimed to systematically investigate the prevalence of depression and its associated factors among Saudi adults during 2000-2022. Methods. A systematic review and meta-analysis were conducted in accordance with the PRISMA guidelines using Medline/PubMed, ResearchGate, Google Scholar, and Ovid databases during 2000-2022 with predetermined inclusion and exclusion criteria. The quality of the included papers was determined, and heterogeneity between studies was assessed using the Q statistic to estimate theI2value. A random effects model was used to drive the pooled depression prevalence with 95% confidence intervals (CI). A forest plot was generated to show estimates for individual studies. Publication bias was assessed visually with the funnel plots symmetry and Egger’s test (p<0.05). A sensitivity analysis was conducted to explore the effect of individual studies on the overall prevalence estimate. A subgroup analysis by the study, population characteristics, and depression tools were also run. Results. Forty-six cross-sectional relevant studies were identified, including 25814 participants. The pooled depression prevalence was 37.35% (95% CI: 33.61–41.98%) with high heterogeneity (I2=94.8%,p<0.001). In the subgroup analysis, the prevalence estimates were higher among females (34.5%), the singles (49.5%), undergraduate university students in university settings (47.7%), northern region (62.3%), and studies that utilized the Center for Epidemiological Studies-Depression (CES-D) scale (58.8%). Among the risk factors significantly associated with depression were female gender, being single, low education level, financial problems, poor housing condition, having medical problems, sleep disorders, presence of psychiatric/psychological conditions, life events, lack of social support, exposure to stress, educational/personal problems, and smartphone addiction. Conclusion. Almost more than one-third of Saudi adults had depression. Appropriate surveillance, early interventions, and depression management strategies are needed to decrease the prevalence and its consequences among adults.

Psychological Stress as a Determinant of Increased Maximum Voluntary Bite Force - A Clinical Observational Study

Background Psychological stress is a known risk factor and modulator for several oral diseases. It is among the critical etiological factors of bruxism and several other disorders. The quantum of bite force is one of the prime determinants of wear resistance and the clinical performance of restorations. Thus, the present study aims to investigate the relationship between the maximum voluntary bite force (MVBF) and the amount of perceived stress experienced by an individual.  Materials and methods Patients (n=111) fulfilling the exclusion and inclusion criteria were divided into high, medium, and low-stress groups based on their stress scores deduced from the Perceived Stress Scale questionnaire (PSS). Bite force measurement was recorded in Newtons (N) for each subject using a portable customized bite recording FlexiForce sensor (B 201). The data were analyzed using Kruskal-Wallis and independent samples t-test. Results  Among the females, the bite force in the medium and high-stress groups was greater compared to the low-stress level group. On the other hand, there was no difference in bite force between any of the stress level groups among male participants.  Conclusion The results show that higher MVBF is associated with higher perceived stress scores in adult females. Practical Implications Psychological counseling can be included in the dental treatment plan of individuals with a high-stress score to counteract their stress-related higher occlusal forces, parafunctional jaw movements, and risky oral health behaviors, thereby potentially reducing the incidence of adverse outcomes such as temporomandibular joint dysfunction and restoration failure by careful choice of restorative materials.

Patient-specific virtual simulation in the clinical training for prosthetic dentistry

INTRODUCTION

Dental education always involves live patient treatment, and clinical training for each patient is different for students. Using an intraoral scanner and Simodont Dental Trainer, we can provide students with an opportunity to train on actual patient cases in a virtual environment before real preparation. This study aimed to develop, implement and test patient-specific virtual simulation training in prosthetic dentistry curriculum.

MATERIALS AND METHODS

Before the actual preparation, the students' patients were scanned using 3Shape intraoral scanner. Thereafter, the .stl file was uploaded to Simodont Dental Trainer (Nissin dental products) where all the scanned teeth were prepared virtually. The 'prepared' .stl file was downloaded and submitted to the teacher. Instruction manuals for virtual simulation patient-specific tasks were provided. The students were asked to voluntarily complete the survey, at the end of the course.

RESULTS

Forty-two 4th year students from the Faculty of Dentistry performed a patient-specific virtual simulation training task and completed a survey. The created training materials served as guidelines for students to perform all the steps on their own without teacher assistance, except in the final step, where the teacher evaluated the digital preparation. Students appreciated the amount of information provided regarding the technologies used and patient-specific tasks. Students admitted that the patient-specific task was more interesting than standard tasks. However, they were not satisfied with the technical performance of Simodont Dental Trainer or the reflection of reality.

CONCLUSION

Patient-specific virtual simulation can be accepted by students for training before actual teeth preparation in the clinic. However, technical improvements are required in this regard.

A pilot study of the depression, anxiety and stress in Greek military personnel during the first year of the COVID-19 pandemic

INTRODUCTION

The ongoing SARS-CoV-2 pandemic is a global health crisis which poses many psychological research challenges. The objective of this study was to evaluate the responsiveness and validity of depression, anxiety and stress in a representative cohort of Hellenic military personnel using the short version of the Greek military version of the Depression-Anxiety-Stress Scales-21 (DASS-21) questionnaire.

METHODS

A total of 158 participants were voluntarily surveyed using an electronically developed structured questionnaire. The anonymous e-questionnaire included a social demographic section and the DASS-21 scale section. It was distributed in September 2020 to the military personnel of the Hellenic Tactical Air Force Units using an intranet network during government restrictive measures due to the COVID-19 crisis.

RESULTS

Our DASS-21 survey indicated a positive outcome at the psychometric level of our military sample population. Age, sex and systemic medications were statistically correlated with anxiety. Inter-correlations between the DASS-21 statements showed that individuals with low-level depression also experienced some degree of stress. Factor analysis indicated the reliability and validity of the questionnaire.

CONCLUSIONS

The low levels of depression and stress among our military sample population demonstrate the importance of periodic monitoring of the psychometric items of the DASS-21 subscales to design and implement psychological prevention strategies, especially during the ongoing and future healthcare crises.

A Study on the Assessment of Anxiety and Its Effects on Students Taking the National Eligibility cum Entrance Test for Undergraduates (NEET-UG) 2020

Background Test anxiety is a major, often overlooked, mental health concern among students. We live in a society that decides a person's future by their performance in an examination. In our country, issues about test anxiety, academic-related depression, and stress are less discussed. Most of the institutions don't guide students with stress management. The present study was conducted to measure the anxiety levels and their effect on the mental health of students taking the National Eligibility cum Entrance Test for Undergraduates (NEET-UG) 2020. Methods A cross-sectional study was done among 200 students of a private junior college taking the NEET-UG 2020 exam using the Westside Test Anxiety Scale questionnaire. The results obtained were analyzed by appropriate statistical tests using SPSS Statistics version 25 (IBM Corp. Released 2017. IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp.). Results Out of 200 students, the results showed that, overall, 151 (75.5%) were stressed out before the exam, and 49 (24.5%) were not stressed out. This study revealed that the majority of the students didn't receive any professional help to combat their mental health problems or any professional counseling to improve their morale. Conclusion It is evident from the results of the study that the majority of the students faced difficulties in their academic performance due to test anxiety, and the effects were prominent irrespective of the age and gender of the students. Professional psychological counselors, guidance, and the availability of healthcare professionals in institutions to address the mental health needs of students will yield better outcomes.