Page 10 - GP Fall 2024

The Role of Stress on the Mental Health of Dental Professionals

Author: Audra Haynes, RDH, MPH

What is Mental Health? Common causes of long-term stress include: Factors leading to burnout include time
Mental health includes the emotional, psy- 1. Routine stress from demands pressures, patient-related problems, and
chological, and social well-being of an in- of work, school, family needs, management of auxiliary staff, but lack of
dividual. It affects how people think, feel, money problems. 4 career perspective was a most crucial fac-
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and act; mental health determines how in- 2. Stress from sudden, difficult tor. The highest level of burnout seemed to
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dividuals handle stress, relate to others and changes in life, such as di- be associated with general dentists and oral
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make healthy choices. The mental health vorce, illness, and unemploy- surgeons, the least being orthodontists. 6
of individuals is important at every stage of ment. 4
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life from childhood to adulthood. Mental 3. Traumatic stress which hap- Burnout syndrome may also play a role in
health can lead to other long-lasting health pens when an individual is job related errors. Studies have looked at
problems such as diabetes, heart disease, in danger of serious harm or the effect of burnout on medical health pro-
stroke, respiratory illness, and disorders death. 4 fessionals, but very few have looked at the
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affecting muscles, bones and joints. The effect on dental health professionals. One
reverse can also be said that these long-last- Symptoms of long-term stress include: study conducted by the University of Cal-
ing health conditions can lead to mental 1. Getting sicker more often ifornia, San Francisco, School of Dentistry;
health problems. Mental health is among than usual, stress weakens the Harvard School of Dental Medicine, and the
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the most common health conditions in the body’s ability to fight germs. 4 University School of Texas Health Science
United States. More than one in five adults 2. Stomach or digestion issues 4 Center at Houston, School of Dentistry,
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are living with some form of mental illness. 3. Trouble sleeping 4 Houston looked at the relationship between
About 71% of adults experience at least one 4. Feeling sad, angry, or being burnout work engagement, and self-report-
symptom of stress which include headaches, easily upset 4 ed dental errors within a sample of Amer-
feeling overwhelmed, or anxious. More ican Dental Association (ADA) member
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than one in five youth aged 13-18 either cur- Serious health problems that can develop as dentists. The errors that the study focused
rently or at some point have dealt with a seri- a result of long-term stress include: on were failure to follow infection control
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ously debilitating mental illness. About one 1. Depression protocol, failure to ascertain patient allergy
in twenty-five adults have a serious mental 2. Anxiety or medical/dental history, failure to use a
illness such as schizophrenia, bipolar dis- 3. Heart disease rubber dam when indicated, improper clini-
order, or major depression. Mental health 4. High blood pressure cal technique, and misdiagnosis. Results of
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accounts for approximately 40% of disabil- 5. Diabetes this pilot study found results consistent with
ities, absenteeism, and underperformance in similar medical studies, suggesting an asso-
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the workplace. The cost of treating mental Stress is present in everyday life, however ciation between burnout and dental errors.
illness is about 7% of the gross domestic the stress among health care workers ap- The study suggests that anxiety and worry
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product (GDP). A survey conducted by the pears to be higher than most. Understand- from dental malpractice is a larger concern
World Health Organization (WHO) in 2008, ing the role of occupational stress has not for dentists than long work hours and auxil-
found that mental illness accounts for 38% been widely researched among dental pro- iary staff. There are limitations to this study
of all ill health in rich countries. Mental ill- fessionals. The studies that have been done due to the low response rate of the ADA
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ness accounts for over half of all illness up have shown that prolonged stress can lead members. Only 391 member dentists re-
to age forty-five, the most important disease to burnout syndrome, ill mental health, turned the survey out of the 20,228 surveys
of those in the working age population. 3 anxiety, depression, clinical hypertension, emailed out, and of those, only 82.3% were
coronary heart disease, gastric disorders, completely filled out. Other limitations in-
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The Stress of the Dental Profession and increased suicide risk. The dental pro- clude that the errors were self-reported and
Stress fession is considered to be highly stressful not independently observed in a written or
with one in two professionals experiencing
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The Centers for Disease Control (CDC) symptoms of burnout. 5 electronic record. While the survey strived
states that there are more than 200 types to perceive errors at the provider level, other
of mental illnesses, one of those identified Burnout Syndrome and Stress Among confounding factors were not included such
is stress. Stress is how the body and brain Dentists as relationship status, debt status, children,
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respond to challenges and demands. When Herbert Freudenburger first identified Burn- age of children, and methods of compensa-
an individual is stressed, hormones are re- out syndrome in 1974. It is described as the tion, which were adjusted for in previous
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leased into the bloodstream making a person potential end point resulting from extend- studies. Another limitation in the study was
alert and ready to act. The release of these ed, high-magnitude periods of distress. a variation in the measurement of burnout.
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hormones can cause a rise in blood pressure, Burnout is identified by three coexisting Despite these limitations the authors feel
heart rate, and blood glucose levels. Stress characteristics; mental or emotional exhaus- this pilot study is an important first step in
can be short-term or long-term. Short-term tion, developing a negative, indifferent, or exploring the relationship between burnout
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stress can be helpful in getting a particu- cynical attitude towards patients, clients or and dental errors.
lar task accomplished, however long-term co-workers known as depersonalization or Another study of more than 3500 dentists
stress can be harmful to the individual’s dehumanization, and a tendency for people found that 38 percent of the dentists sur-
health. Long-term stress can last for weeks, to feel dissatisfied with their accomplish- veyed always or frequently feel anxious or
months, or for longer periods of time. ments and evaluating oneself negatively. worried, 34 percent of dentists expressed to
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