By Sara Jalloul, Orthodontic Therapist & Student Dental Therapist
Burnout in dentistry is often discussed in terms of individual wellbeing. However, its implications extend far beyond how clinicians feel, influencing patient safety, team dynamics, and the sustainability of dental services.
This three-part series explores burnout through a wider lens:
- Part 1 examines how burnout directly affects clinical performance and patient safety
- Part 2 explores its impact on teams, patients, and organisations
- Part 3 considers how reframing burnout as a shared responsibility can support meaningful change
Together, these articles aim to highlight why clinician wellbeing is not just central to practice — but central to safe, effective care.
Dentistry ranks among the most stressful healthcare professions, shaped by time pressure, high patient expectations, technical precision, and a heavily regulated, complaint-prone environment. [1] A 2025 Dental Protection survey of more than 1,600 UK dental professionals found that 63% felt frequently burnt out or exhausted, 50% felt pressure to take on extra work or hours, 48% reported feeling disillusioned or disengaged, and 18% described their mental wellbeing as “of concern”. [2] These figures are reinforced by the MINDSET UK Survey 2023, which captured the views of 1,507 dental team members across all four UK nations and found high levels of burnout, depressive symptoms, and experienced trauma throughout the workforce. [3] Together, these findings signal a profession under serious strain, one where burnout threatens not only individual clinicians, but also patient safety, team functioning, and the long-term sustainability of dental services.
If the human cost is steep, the professional cost is steeper. Burnout is not just a personal challenge; it is a risk to patient safety, team stability, and organisational reputation. We need to shift our lens: clinician wellbeing is not a soft issue, it is a core pillar of safe, sustainable dental practice. [4]
What is burnout?
The World Health Organization classifies burnout as an occupational phenomenon, characterised by three dimensions: emotional exhaustion, depersonalisation, and reduced personal efficacy. [5] In dentistry, these are compounded by repetitive physical strain (sustained static postures, fine motor work), tight scheduling, heavy regulatory and administrative demands, and a persistent fear of complaints or fitness-to-practise investigations. The GDC’s 2021 Rapid Evidence Assessment confirmed these systemic stressors are among the most significant drivers of poor mental health in the dental team. [4]
In orthodontic settings, where patient flow is high and protocols are rigid, these pressures can become normalised until chronic overload is seen as “just part of the job”. The MINDSET UK qualitative findings identified six core themes driving this: workload, the NHS system, regulatory compliance and litigation, financial pressures, leadership and management, and self-worth. [3] Over time, this normalisation means warning signs of burnout are missed or minimised.
How burnout affects patient safety
Burnout does not just change how clinicians feel, it changes how they practise. Across healthcare, the evidence is clear. A 2022 systematic review and meta-analysis published in the BMJ, involving researchers from the University of Manchester and the NIHR Greater Manchester Patient Safety Translational Research Centre, found that physician burnout is significantly associated with increased errors, lower patient satisfaction, reduced career engagement, and higher intention to leave. [6] These findings translate directly to dentistry:
- Errors and near-misses rise: burned-out clinicians are more likely to self-report clinical mistakes. [6]
- Quality and safety indicators decline: poorer staff wellbeing is linked to higher rates of safety incidents. [6]
- Complaints and legal risk increase: burnout has been identified as a predictor of patient complaints and malpractice claims. [7]
- Protocol adherence suffers: exhaustion and disengagement reduce compliance with clinical guidelines and checklists. [3]
- Workforce loss accelerates: in 2021, 58% of NHS general dental practitioners reported intentions to leave or reduce their NHS commitment within five years. [8]
In a dental or orthodontic setting, these risks become very concrete hazards: incomplete consent documentation, lapses in infection control, missing steps in treatment protocols, inadequate follow-up, recall failures, or simply rushing procedures. In aggregate, these “small slips” are exactly the kinds of failures that escalate into patient harm, complaints, and regulatory or legal consequences. [7]
The real impact of burnout
Practitioner A is a skilled clinician with years of experience. Over time, their clinic’s patient load increased, staff shortages emerged, and administrative demands escalated. Clinically, A began skipping the usual pause between patients, rushing explanations of risk, sometimes failing to re-check orthodontic appliance alignments fully, and occasionally neglecting to update charts immediately.
On one occasion, a patient’s retainer instructions were not clearly documented. Weeks later, a complaint about inadequate follow-up was lodged. The root cause was not incompetence; it was exhaustion stacking upon cumulative pressure until small errors crept in.
Following the complaint and with support from their practice and indemnity organisation, Practitioner A reviewed their workload and working patterns. They reduced their clinical days, established clearer boundaries around administrative time, and built in micro-breaks between sessions. Over several months, A reported their concentration, empathy, and satisfaction gradually returning, with fewer near-misses and a more sustainable work–life balance.
This resolution does not remove all pressures, but it illustrates a key principle of burnout recovery: meaningful change often requires structural adjustments to workload and working patterns, not just more individual “resilience”.
Behind the Mask - The ripple effect of burnout in the dental team
Burnout does not occur in isolation. When one member of the dental team struggles, the impact ripples out across colleagues, patients, and the wider organisation. [3]
Impact on teams
Within teams, burnout often shows up first as subtle shifts: morale dips, sickness absence increases, small conflicts flare more easily, and the humour disappears from the day. Colleagues take on additional workload to cover for unwell or disengaged team members, feeding a cycle of overwork and resentment. Over time, this contributes to higher staff turnover, the loss of experienced team members, and increasing pressure on those who remain. [8]
The emotional burden intensifies as team members witness each other struggle but feel unsure whether it is “safe” to speak up. Without structures for open discussion and support, burnout silently erodes trust and psychological safety in the workplace. [3]
Impact on patients
Burnout also changes the way we show up for patients. Reduced empathy and emotional exhaustion can lead to shorter consultations, less eye contact, and a sense of detachment that patients readily perceive. Research consistently links burnout with weaker therapeutic relationships, decreased patient satisfaction, and more frequent complaints. [6]
In orthodontic practice, this may look like a clinician who no longer has the bandwidth to explore patient concerns about aesthetics or discomfort, or who becomes less tolerant of missed appointments and non-compliance. Patients may experience this as feeling “talked at” rather than listened to, undermining trust and adherence.
Impact on organisations
At the organisational level, the cumulative effect of burnout is profound. Recruitment becomes harder in practices known for high stress or poor support. Absenteeism rises, leading to costly locum cover and appointment cancellations. The dental workforce recruitment and retention crisis in the UK has already been well-documented – burnout is one of its leading drivers. [8]
These issues compound existing challenges, such as NHS contract pressures and access difficulties, creating a feedback loop where system stress fuels staff burnout, which in turn worsens system performance. Left unaddressed, burnout gradually erodes the foundations of practice – often unnoticed until the damage is unmistakable. [4]
Breaking free from burnout – a multi-level approach
Burnout cannot be solved at a single level. Sustainable change requires coordinated action from individuals, teams, and system leaders. [9]
Individual strategies
- Awareness and early recognition: regularly check in with yourself for signs such as chronic fatigue, cynicism, sleep disturbance, or feeling like you’re “just going through the motions”.
- Micro-breaks and recovery pauses: even 1–2 minutes of breath work, stretching, or stepping away between patients can reduce physiological arousal and help reset focus.
- Reflective practice and journaling: brief structured reflection at the end of the day helps process emotional load, make sense of challenging encounters, and consolidate learning.
- Continuing professional development: engaging in CPD that feels meaningful can restore a sense of progress and mastery, countering feelings of stagnation.
Team-based strategies
- Peer support and buddy systems: regular check-ins, informal debriefs after difficult sessions, and shared responsibility for complex cases can reduce isolation and normalise help-seeking.
- Normalising wellbeing conversations: leaders and team members can model non-judgemental discussions about stress and mental health, making it acceptable to say “I’m struggling”.
- Rotating challenging cases: avoid concentrating the most demanding patients or clinics on one clinician; spread the emotional load more evenly.
- Recognition and celebration: intentionally highlighting small wins, positive feedback, and team achievements helps balance the emotional labour of the work.
System and leadership strategies
- Rota design with recovery built in: incorporate buffer time, realistic activity targets, and predictable scheduling to reduce chronic overload.
- Provision of wellbeing resources: ensure access to counselling, employee assistance programmes, peer support, and, where possible, protected time for wellbeing activities.
- Leadership training in compassionate culture: leaders who understand burnout and model healthy boundaries create safer environments for honest conversations and early intervention.
- Embedding wellbeing metrics: monitor burnout, sickness absence, turnover, and staff feedback alongside clinical and financial indicators, treating them as core measures of system health.
- Policy alignment: integrate wellbeing commitments into contracts, performance frameworks, induction processes, and safety protocols so that support is not seen as an optional extra.
The Wellbeing Support for the Dental Team resource, developed in collaboration with the BDJ and launched in 2021, exemplifies this system-level approach, recommending that wellbeing be placed at the heart of practice policy rather than added on when problems arise. [9] The systematic review by Plessas and colleagues (2022) further underlines this, concluding that individual-level interventions alone are insufficient and that organisation-directed approaches are more effective in sustaining improvements to dental workforce mental health. [10]
In addition, a range of external support mechanisms are available to dental professionals, including services provided by indemnity organisations and professional bodies. For example, Dental Protection offers access to confidential counselling and wellbeing support for its members. Signposting and normalising access to these services can offer an important additional route of support for clinicians experiencing stress or burnout.
Behind the Mask – Reframing the narrative: from individual weakness to shared responsibility
In part one and part two of this series, we explored what burnout is, how it impacts patient safety, and the multi-level strategies that can help break the cycle. The final step is to shift the narrative that surrounds burnout in dentistry. [4]
Moving away from self-blame
Too often, clinicians experiencing burnout interpret their symptoms as a personal failing. They may feel weak, inadequate, or “not cut out” for the profession, which can delay help-seeking and deepen distress. This is a misframing. Burnout is a predictable occupational hazard when high demands are combined with insufficient resources, support, and control, exactly the conditions that UK dental professionals have been navigating for years. [1] [2]
Reframing burnout as a workplace and systems issue, rather than a purely individual problem, is essential. Just as we investigate and address root causes when a clinical error occurs, we must look upstream at workload, culture, and organisational factors when staff wellbeing is compromised.
Wellbeing as a safety-critical priority
When viewed through a risk-management lens, burnout’s relevance to patient safety becomes unmistakable. Unchecked burnout acts as a latent safety threat, quietly weakening defences and making errors more likely. Protecting clinician wellbeing is therefore as critical to patient safety as robust infection control or radiation protection measures. [6]
Every complaint avoided, every error prevented, and every experienced colleague retained saves time, money, and, most importantly, patient trust. Investment in wellbeing infrastructure is not a luxury or a “nice to have”; it is a strategic choice that underpins quality, safety, and the long-term sustainability of our services. [7]
A shared duty of care
Wellbeing should no longer be seen as a private, after-hours “self-care” matter that individuals are expected to manage alone. It is a shared professional responsibility that calls for action from regulators, indemnity providers, educators, practice owners, and every member of the dental team. [4]
Regulators can continue to develop supportive, proportionate responses to concerns about health and performance. Indemnity organisations and professional bodies have also begun to take important steps in this space, providing resources, training, and direct wellbeing support for their members. For example, some indemnity providers offer access to confidential counselling services and wellbeing resources, alongside funding research initiatives, such as those delivered through the MPS Foundation, aimed at improving clinician wellbeing and advancing safer patient care.
Educators can help students and trainees develop skills in reflection, boundary-setting, and help-seeking from the outset of their careers. Dental hygiene and therapy programmes, in particular, have a role to play given the evidence that DHTs in England report wellbeing levels below the general population and high levels of anxiety. [11] Practices can build cultures where talking openly about workload and stress is as normal as discussing a complex clinical case. [4] [7]
Looking ahead
As I embark on my journey into dental hygiene and therapy, after 15 years working across dental nursing, technology, and orthodontics, I am convinced that the future of dentistry depends not only on clinical innovation and technique, but on the resilience and health of the people delivering care. We cannot remove all pressures, but we can manage the risk.
That means:
- Recognising burnout early in ourselves and others.
- Supporting each other through honest conversations and practical adjustments.
- Embedding wellbeing into systems, policies, and leadership decisions.
- Valuing a healthy workforce as the foundation of safe, effective, and compassionate care.
Because ultimately, a healthy clinician is the bedrock of safe, high-quality patient care – and the most important asset any dental practice has.
References
[1] Collin, V., Toon, M., O’Selmo, E., Reynolds, L., & Whitehead, P. (2019). A survey of stress, burnout and well-being in UK dentists. British Dental Journal, 226(1), 40–49. https://doi.org/10.1038/sj.bdj.2019.6
[2] Dental Protection. (2025, February 26). Two-thirds of dental professionals burnt out and exhausted. Medical Protection Society Limited. https://www.dentalprotection.org/uk/articles/two-thirds-of-dental-professionals--burnt-out-and-exhausted
[3] Knights, J., Young, L., Humphris, G., & Newton, T. (2025). Me, we, they: identifying the key stressors affecting the dental team – findings from the MINDSET UK Survey 2023. British Dental Journal, 239, 196–202. https://doi.org/10.1038/s41415-025-8645-z
[4] General Dental Council. (2021). Mental health and wellbeing in dentistry: A rapid evidence assessment. GDC. https://www.gdc-uk.org/about-us/what-we-do/research/our-research-library/detail/report/mental-health-and-wellbeing-in-dentistry-a-rapid-evidence-assessment
[5] World Health Organization. (2019, May 28). Burn-out an occupational phenomenon: International Classification of Diseases. WHO. https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases
[6] Hodkinson, A., Zhou, A., Johnson, J., Geraghty, K., Riley, R., Zhou, A., Panagopoulou, E., Chew-Graham, C. A., Peters, D., Esmail, A., & Panagioti, M. (2022). Associations of physician burnout with career engagement and quality of patient care: systematic review and meta-analysis. BMJ, 378, e070442. https://doi.org/10.1136/bmj-2022-070442
[7] Dental Protection. (2019). Breaking the burnout cycle: keeping dentists and patients safe. Medical Protection Society Limited. https://www.dentalprotection.org/docs/dentalprotectioninternationallibraries/dpl-publications/ireland/1907310561-ire-dp-burnout-policy-paper.pdf
[8] Evans, D., Mills, I., Burns, L., Bryce, M., & Witton, R. (2023). The dental workforce recruitment and retention crisis in the UK. British Dental Journal, 234(8), 573–577. https://doi.org/10.1038/s41415-023-5737-5
[9] Cameron, J., Hannon, L., Keeton, R., McMullan, R., Nayee, S., O’Connor, R., Shirlaw, P., & White, S. (2021). New mental health and wellbeing resource for the dental team launched. British Dental Journal, 230(3), 120. https://doi.org/10.1038/s41415-021-2685-9
[10] Plessas, A., Paisi, M., Bryce, M., Burns, L., O’Brien, T., Witton, R., & Hanoch, Y. (2022). Mental health and wellbeing interventions in the dental sector: a systematic review. Evidence-Based Dentistry, 23(4), 90–98. https://doi.org/10.1038/s41432-022-0831-0
[11] Hallett, G., Witton, R., & Mills, I. (2022). A survey of mental wellbeing and stress among dental therapists and hygienists in South West England. British Dental Journal. https://doi.org/10.1038/s41415-022-5357-5