Q&A about stress in dentistry

Aug 3, 2014

In her latest column, dental stress management expert Jen Butler answers some of the questions she hears most frequently.

How stressed are dentists, really?

The American Psychological Association and the ADA used the same Likert scaling question* to determine the perceived stress levels of the U.S. population and that of dentists, respectively. On the 10-point scale, Americans claim stress levels equal to a rating of 4.9 (mild-moderate),while dentists report levels of 9.1 (severe-burnout).

Perceived stress levels are important to understanding how stressed dentists feel but don't fully answer the question "How stressed are dentists?" Let's consider a more diagnostic approach using normed and valid assessments. Multiple studies and surveys using the Maslach Burnout Inventory (MBI) have determined that 86% of dentists, general practitioners, and specialists combined have stress levels that put them in the moderate-severe range. This coincides with only 49% of the U.S. population.

To sum things up, dentists and specialists have stress levels and perceived stress levels close to twice the average American. Yes, dentists are stressed, really!

Does stress impact the practice?

The above numbers correlate to 60 days out of every year dentists are so impacted by their stress that they disengage from the patient experience. So much so that they lose focus, miss possible treatment, don't gain case acceptance, delay starting necessary treatment, or cancel days altogether because they don't have the energy or mental capacity to do their jobs. Most failing practices are missing close or equal to 60 days of production.

This clearly demonstrates there is a tangible return on investment to taking those continuing education courses on learning how to manage stress or working with a stress management coach.

What keeps stress prevalent in dentistry?

Dentists are fix-it people and they think they can and should be able to fix themselves, their team, and their business. When they can't figure out solutions to their problems, instead of reaching out and partnering up with a mentor, consultant, or coach, they further isolate themselves because of embarrassment, intimidation, and fear of being exposed as a failure to their family and colleagues. They start skipping study club meetings, ignoring phone calls, and offering the proverbial, "I'm fine," when asked how they are doing. It's a stress cycle that leads to burnout.

This culture of silence keeps the dental industry from addressing the issue of stress head on. Conferences and study club meetings scarcely hire speakers to provide relevant information because of reduced numbers. Professional organizations offer limited tools and resources to dentists in the area of stress prevention and management. Until dentists break their silence and start demanding additional support, little will change in the culture.

What are the signs of stress for a dentist?

Dentists are taught in dental school that if a patient presents with A, B, and C symptoms and have D and E clinical findings, they have condition F. Stress is not that way, which is why the number of dentists that allow their stress to get to the severe-and-burnout levels is so massive. Instead of looking for "stress," dentists must become more aware of what stress looks and feels like in their lives. It's different for each dentist. Some of the common statements I hear from a dentist under stress are they are experiencing these symptoms.

Loss of energy: "I have the hardest time getting up and going to work every day. I feel anxious or dread in the pit of my stomach. When I'm there, I have to force myself to start treatment because I would rather schedule than start same day. After each patient, I run into my office and hide."
Loss of focus: "I don't know why I just can't seem to focus on anything. I'm all over the place! I'll enter notes and when I go back and read what I put in, it's nonsense. I'm totally spacing out. Sometimes I'll arrive home and realize I don't remember the drive."
Loss of concentration: "Crown preps used to take me 10 minutes. Lately my assistant is telling me to hurry because I'm going over 20! Procedures I used to do with my eyes closed now take every ounce of concentration I can muster."
Forgetfulness: "I find myself looking at x-rays and having to go back again and again, because I forgot what I just looked at. I'll be reading and have to go back and read the same sentence or page several times because I have no idea what I just read."

There are also the common stress signs:

Physical: Headaches, muscle tension, stomach distress, frequent illnesses, fatigue
Mental: Overwhelm, self-doubt, decreased self-assuredness, worry, insomnia
Emotional: Irritability, quick-tempered, anxiousness, apathy, indifference

What now?

Don't be another static for studies to use in research on stress in dentistry. Go against the grain and do one of these today:

Expand your social media following to include experts and organizations.
Demand that your study club balance out the clinical lectures.
Work with a stress management coach in group or one to one.
Encourage your professional organizations to increase their support tools and resources.

*On a scale of 1 to 10, with 1 being no stress and 10 being burnout, how would you rate your stress levels?

Jen Butler, MEd, certified professional coach (CPC), board-certified coach (BCC), has been working in the area of stress management and resiliency coaching for more than 20 years. She is available as a coach/consultant, speaker, and trainer. To learn more about her services, to sign up for her monthly "stressLESS" newsletter, or to take the Dental Stress Self-Assessment, please visit her website. Contact her at 623-776-6715 or [email protected] for more information.