Stress crisis uncovered

27 May, 2015 / indepth
 Stewart McRobert  

Now, the challenge for UK dentists is clear: they must tackle the aspects of their work that bring high levels of stress and undermine job satisfaction. That’s one of the significant conclusions of the BDA’s report on wellbeing and working conditions in the profession.

Compiled by Martin Kemp and Henry Edwards, it sets out results from two surveys undertaken in June-July 2014 to measure dentists’ wellbeing and compare it against the UK adult population as a whole.

Two groups were surveyed – dentists working in community dental services, and BDA members who work as associates or practice owners in general dental practices (GDP). Their responses were judged against four indicators of personal wellbeing: life satisfaction, happiness, anxiety levels, and how worthwhile they saw the activities they engage in.

The most dramatic and undesirable manifestations are, of course, stroke, cancer or heart attack

Community dentists

Almost half (47 per cent) of the community dentists reported low levels of life satisfaction. A similar number (45 per cent) expressed low levels of happiness and 55 per cent said they experienced high levels of anxiety.

Between 2013 and 2014 there was a significant fall among community dentists on two indicators – in 2014 they were less likely to say they felt happy or that the things they do in life are worthwhile.

Notably, those who work part-time saw the things they do as more worthwhile compared with their full-time counterparts. And those who said they were more satisfied with their work reported higher levels of personal wellbeing.

This group illustrated the strong relationship between work-related stress and wellbeing; community dentists who reported high levels of work-related stress also displayed low levels of wellbeing.

As far as health goes, three out of four said they were in good general health, while around one in 20 described themselves as in bad health. Those with high levels of stress at work were significantly less likely to say they were in good health.

Although dentists aged under 35 rated their health most highly, there was no simple decline with age – for example, community dentists aged over 55 were more likely to perceive their health positively than those aged 34 to 54.

General dental practitioners

As with community dentists, almost half of the GDPs (47 per cent) reported low levels of life satisfaction, with 44 per cent reporting low levels of happiness, and around six out of 10 experiencing high levels of anxiety in the day before the survey. There was a significant reduction in personal wellbeing across all four indicators.

Although there were no marked differences between associates and practice owners, the proportion of NHS or private care that GDPs provide was important; dentists who do mainly NHS work reported lower levels of wellbeing than those who do mainly private work. Unlike community dentists, there was a strong link between hours of work and wellbeing among associates.

For example, associates who work 30 hours or less a week reported higher levels of wellbeing than those who work full-time.

There was a distinct relationship between feelings of personal wellbeing and work-related stress. Job morale and satisfaction influenced how GDPs rated their wellbeing more generally.

Four out of five GDPs said their general health was good, and almost 40 per cent said they were in very good health. As with community dentists, GDPs under 35 rated their health most highly, but contrary to community dentists, the likelihood of GDPs saying they were in good health gradually diminished with age.

Once again, there was a significant relationship between levels of work-related stress and health perceptions. Those with low levels of stress at work were more likely to say they were in good health.

Wider population comparisons

The research confirms a ‘wellbeing gap’ between the dental profession and the wider population; all dentists rated their wellbeing at lower levels than the UK population.

As the report speculates, the cause of this gap could be the much higher levels of work-related stress faced by dentists.

On a positive note, they were as likely to perceive their general health as ‘good’ as the wider adult population; 81 per cent of GDPs recorded this response, as did 74 per cent of community dentists. Younger people in the dental and wider populations were most likely to say they were in good health.

The stress factor

Kemp and Edwards believe the findings reinforce the view that high levels of stress at work are a crucial factor in dentists’ wellbeing.

Earlier studies revealed that UK dentists face challenging working conditions and specific conditions that can increase work-related stress. Moreover, there is evidence that high levels of stress at work can affect mental wellbeing, and lead to lower levels of job satisfaction.

The pressures dentists face may help explain why they report lower life satisfaction and higher anxiety compared to other UK adults. The report concludes that rising to the wellbeing challenge means learning more about the factors that promote stress and how they vary across the settings dentists work in and the roles they perform. Kemp and Edwards emphasise the need for more research to understand how exposure to high levels of stress at work impacts upon dentists and their work. And they suggest that the link between NHS commitment and wellbeing should be further investigated.

Now that this stage of research is complete, the BDA says that over the next 18 months it will explore the relationship between working conditions, high job stress, and mental wellbeing.

Identify the enemy within

Stress and stress-related illness hits dentists and doctors harder than any other profession. Mental Wealth offers expert guidance on how to look after your mental health

Just what causes stress? When we identify a situation as a “threat”, we activate the emergency “fight or flight or freeze” response. This is our natural self-preservation in the face of physical attack.

However, there are many other stressful situations, such as abuse, criticism by patients and peers or colleagues, family and friends, too much to do in too little time, juggling work, home and family commitments. The list is long.

When under stress, we notice immediate symptoms such as a racing heart, shortness of breath, sweating, muscle tension and shaking. But there are also long-term responses, including under-eating or over-eating, having difficulty falling asleep, waking early, or interrupted sleep and difficulty getting up in the morning. Then there can be headaches, muscle tension, frequent colds or infections, heartburn, nausea and diarrhoea, as well as being angry or irritable.

As if that were not enough, additional signs include difficulty in making decisions, forgetfulness and constant tiredness. The most dramatic and undesirable manifestations are, of course, stroke, cancer or heart attack.

In the first instance, on the road to dealing with stress it is imperative that you take the following key steps:

1) identify the sources and/or cause of your stress

2) recognise the unhealthy ways that you may be coping with stress

3) learn healthier ways to cope.

If you have recognised any of the symptoms listed above, then it is time to address the problem.

You are stressed!

More info

Barbara Gerber is a psychologist and founder of the Equilibria Psychotherapy Clinic offering comprehensive mental health and counselling services.

For more information on methods of coping with stress, go to and read the next Mental Wealth self-help column from Barbara Gerber.

Tags: Barbara Gerber / Dentists Stressed / Stress

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