Stress related illnesses take many familiar forms, with dental practitioners not only demonstrating a higher than normal risk for back issues, but also gastrointestinal disorders and cardiovascular issues. It is known that dental practitioners may experience increased stress in their lives which can lead to an increased risk of drug and alcohol dependency, mood disorders and even suicide.

Causes of stress

In order to better manage our stress and protect our health, we first need to consider the contributing factors that make dental practitioners prone to its effects.

Isolation – Whilst working in group practices and hospital settings has decreased the isolation of dental practice, this is still a recognised contributory factor to stress.  This is especially true for those practitioners working alone who have received a complaint or experienced an adverse incident

Many of us are lucky to work in supportive practices, or have a supportive network outside our practice, but not all of us have this luxury. When stress attacks and the walls start closing in, those who cannot reach out to their support network feel isolated and alone.

Confinement – We don’t get out much. Some of us don’t even have windows in our treatment rooms.  This restriction on our movements may mean that we can become unfit and sedentary, further increasing our risk for general ill health, and may result in an overall diminished sense of wellbeing and happiness.

Patient factors – Patients are often anxious about the treatment that we deliver and this anxiety can be compounded by the fact that patients are commonly attending under duress, making a ‘distress purchase’ due to pain or another problem. This combination of anxiety and pain may cause the patient’s stress level to rise, which they can end up taking out on you.

Internal stress – We endeavour to provide the highest standard of treatment at all times, and can become frustrated with ourselves if things don’t go to plan. This constant drive for perfection can only lead to bitter disappointment, as there are many factors outside our control that can negatively impact on the appearance, success and longevity of the work we do.

External stress – There are many factors impinging on our lives that will create more stress. Money is certainly at the crux of much practitioner stress, as we struggle to support ourselves and our loved ones, whilst often simultaneously paying off hefty student loans and other debts.

Practice stress – Many factors in practice are difficult to control, including running late, which can be particularly stressful. We run late for a wide variety of reasons, from squeezing in emergencies to human error. We do not run late because we want to or because we enjoy it, and no matter how you look at it, running late causes us stress.  Reflecting on the reasons for running late and involving the whole team in trying to reduce the frequency with which this happens, can help reduce the burden felt by the dental practitioner.

Social media – The societal tendency to hide our flaws and failures, and to promote only our strengths, is often seen on social media. Not only does this skew one’s view of what is good and what is right, but it can cause many practitioners to reflect on their own ability and consider themselves not ‘good enough’.  It is important to read social media posts with interest and to take away the key learning points, but not to critically compare the content to yourself. Truly great practitioners share their failures, as well as their successes, with others to help them grow.

Solutions for managing stress

Networking for a better ‘everything’ – Mentors and peer study groups help us to talk through the challenges of practice and exchange ideas about treatment modalities.  It is especially important for our personal development and continuing professional development.  Collective treatment planning and timely constructive feedback will help us to grow confidently as practitioners - through every stage of our career - and enable us to provide the best possible treatment to our patients. 

Networking outside the surgery will also reap rewards. Having a solid group of people you can trust to talk through your failures with is incredibly empowering, as a problem shared is truly a problem halved.

Closing the surgery door and engaging in some hobbies and relaxation will also help provide you with some balance in your life, and even possibly give you friends who don’t want to talk about teeth!

Don’t sweat the small stuff – Regretfully, the very nature of dental practice means that things can, and will, go wrong. It’s OK. A calm approach in the face of adversity will lead to a better outcome for both you and the patient. And, once the crisis is over, taking the time to talk about it, reflect on it and learn from it can help prevent it from happening again.

There is no shame in struggling with any dental procedure – whether this be an extraction or a root canal treatment. Talking about what went wrong will help you to recognise the warning signs in the future and avoid adverse incident of a similar nature. Similarly, if you are struggling because of time pressures, talk to your colleagues and let them know. If they are not prepared to give you more time, then this may well not be the best practice for you.

HALT

You may be more at risk of something going wrong if you are Hungry, Angry, Late or Tired (HALT). Don’t be scared to take a break between patients to clear your head if needed - taking the time for a quick break may help you avoid a lengthy complication later.

Patient factors

Accept that you don’t always see the best side of people when they come to you frightened and in pain, and that regardless of what might be said, your patients come to you because they DO like and trust you, so try not to take negative comments personally. Try to work with patients - within their time and financial constraints - to provide the best treatment you can. If you are unable to produce quality treatment within the constraints placed on you, then consider referring the patient to another practitioner who may be a better fit for them.

Recognise dependency

Be honest with yourself about your alcohol consumption and any drugs – prescribed or otherwise - that you take. The path to dependency is short and easily followed, but the road to recovery takes a lifetime. There is no place for drug dependency for those who choose to become a dental practitioner, and the use of both legal drugs and illicit drugs can lead to the loss of your registration. Alcohol may be legal, but it too is open to abuse. Recognising that you have a problem is the first step, but it is also important that you reach out and access one of the relevant support services as quickly as possible.

Bringing it all together

The key to health is multifaceted and complex, but we can start on the right path by caring for ourselves - mentally, physically and emotionally - by stepping away from the practice and developing some perspective. Eating right, exercising, enjoying some fresh air and finding a work life balance will all help to set the tone for a less stressful life.

For confidential counselling, wellbeing app, podcasts, webinars and more, visit Dental Protection's dedicated wellbeing service here.