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Br Dent J 2017;223: 22–26; http://dx.doi.org/10.1038/sj.bdj.2017.583

Credit: ©Gary Waters/ Ikon Images/Getty

We hear about stress in dentistry all the time these days. It can be perceived in different ways and is dependent on the individual, but stress is often described as linked to anxiety, pressure or gloom. It is more often than not thought of as something to be avoided if possible.

It's a very real problem in dentistry and one which is being investigated by groups all over the world, including the BDA. Indeed, BDA research shows that 39% of community dentists and almost half of GDPs report high levels of stress. When you consider that the average for British workers is 15% this is a very significant figure indeed.1 There is also good evidence that the stress faced by dentists begins early with levels of stress and psychological distress being high amongst dental students.2

In their BDJ paper, Marina Harris and her co-authors investigate two aspects of stress in dentistry that we don't usually consider. Rather than focussing on dentists or student dentists, this study explored the stress levels and well-being of dental hygiene and dental therapy students during their undergraduate training. Also, rather than assuming, as we are prone to do often with good reason, that stress purely has a negative impact on our performance, health and welfare, the team wanted to find out if a stressful life also contributed to a sense of positive well-being among the students.

Psychological studies have shown that stress can lead to a sense of meaning in life – with the pursuit of goals feeding a sense of purpose, and the short-term costs of stress and anxiety perhaps leading to a better life in the long term.

Students from Years 1, 2 and 3 of the BSc course in Dental Hygiene and Therapy at the University of Portsmouth were interviewed about their perceived causes of stressful experiences and whether they found stress at university enhancing or debilitating. As well as looking at stress, the team also explored the students' motivations for their choice to become a clinician in the first place.

We must be careful to remember that this is a qualitative study with a small sample, but the findings did corroborate previous quantitative work which showed that the students were coping well with what they perceived as a highly stressful training period. It also indicated that the stress the students felt was linked to meaningfulness, so, as one student interviewed said, maybe what doesn't kill you does make you stronger? It's a hell of a gamble though!

By Ruth Doherty

Watch the author talking about this paper in their video abstract via the BDJ Youtube channel http://bit.ly/BDJYouTube

Author Q&A Marina Harris University of Portsmouth

Why did you decide to explore stress in this cohort?

I have been teaching dental hygienist and therapy students for the last twelve years. Over that time, my colleagues and I have recognised that students experience varying levels of stress, at different stages (preclinical and clinical) of their undergraduate programme, and at different points across the academic year. Stress in dental students has been studied extensively over the last thirty years, so it was decided to investigate if stress in dental hygienist and therapy students was similar to that of dental students, but also more importantly to examine the impact of stress on psychological well-being. Just because the two programmes are similar, the student body is different; with often the dental hygiene and therapy students being older; and having worked in the dental environment extensively, unlike dental students who still normally come straight from A-level studies.

Did anything surprise you in this study?

Although we suspected there was a link to the meaningful nature of stress within the undergraduate programme, the study provided a great insight into how our students, as high-achieving individuals, appeared to thrive on stress that gave meaning and purpose, which seemed to act as a 'buffer' in stressful situations.

What would you like to do next?

I intend to carry out further studies at other centres, and in other countries, to see if we have similar results. It is extremely important that we use the knowledge we have gained from this research to identify pinch-points in the curriculum, and offer specific stress-resilience interventions that will enhance our students' well-being, thus preparing them as well-rounded individuals able to contribute to our profession.