It is well established that dentistry is a stressful profession, primarily due to the intensive nature and working conditions in the dental surgery. While this isn’t a new development, it’s only in recent years that the enormity of the problem has come to light, due in part to the greater availability of data and understanding of the issue.
With dramatic changes taking place in the profession in recent years, it is important to investigate not only occupational stressors but also the psychological distress of the job and what impact this has on dentists’ well-being and the care they provide to patients.
Stress and burnout among dentists
A recent survey published in the British Dental Journal conducted by researchers from the British Dental Association (BDA) found high levels of stress and burnout amongst a sample of more than 2,000 UK dentists.1
Analysis of the 2,053 valid responses showed that more than half (54.9%) of dentists reported that they were currently experiencing high job stress and when looked at by field of practice, GDPs reported the highest levels of stress.
The most common sources of stress related to threat of complaints/litigation (79%), dissatisfied patients (75.1%), concern about the GDC (72.8%), followed by work pressure such as NHS targets (72.4%), running behind schedule (64.9%), NHS work (63.2%) and difficult patients (61.2%).
Worryingly, nearly half of the dentists in this sample (43.8%) said they could not cope with the level of stress in their job and almost a fifth (17.6%) admitted they had seriously thought about committing suicide.
The authors concluded: “The high levels of self-reported stress, burnout and psychological distress found in this study are a serious concern to the profession.
“Although GDPs seem to be particularly affected, this research shows that all fields of dentistry exhibit elevated levels compared to the general population, other professions including veterinary surgeons, GPs or dentists in the same field of practice working in other countries – highlighting that this is a universal problem for dentists working in the UK.”
Increasing support for dentists
With this heightened awareness of the risk of mental health illness among dental professionals, paired with the decreasing social stigma and embarrassment surrounding these issues, dentists should be encouraged to open up about their experiences and the necessary services must be in place to cultivate a safe space for them to do so.
The BDA has already made a positive step in this direction, recently launching a partnership with Health Assured, the UK and Ireland’s largest award-winning employee assistance programme (EAP), to provide a fully funded confidential support service and increase the support available to dentists who are experiencing high stress or burnout.2
The service offers expert counselling, advice and tools for members or their dependents, alongside advice on any issues that cause anxiety or distress including debt management, accountancy, lawsuits, consumer disputes, property or neighbour disputes.
BDA Chair Mick Armstrong said: “Mental health matters. Evidence shows dentists are now in desperate need of support, and sadly all too often aren’t even offered signposts to basic services.
“We set out to guarantee that none of our members need to suffer in silence.”
Reforming the dental profession
The identified stressors indicate that future interventions should not solely focus on individual solutions such as stress management, but also look at global solutions such as changing aspects of the working environment – attention to remuneration, regulation and contract reform will be of paramount importance moving forward.
While the recent pay uplift for NHS doctors and dentists has been widely welcomed, BDA Vice Chair Eddie Crouch said: “Pay uplifts on the right side of inflation shouldn’t be exceptional, and represent a bare minimum in terms of government's duty of care to NHS dentists.
“This approach cannot be a one-off, or reserved for special occasions. Nor does it undo the damage wrought by ten years of cuts. NHS dentistry now requires consistency and investment, so all providers and performers can see the benefit.”
One of the authors of the study, Dr Vicki Collin, BDA Research Analyst, said it was evident that aspects relating to regulation and the fear of litigation were key concerns among UK dentists, adding: “Implementing regulatory changes by reducing the amount of regulatory burden could go a long way in reducing the amount of stress experienced by dentists.”
Moreover, the current dental contract implemented in England and Wales in 2006 which remunerates dentists purely on activity, is not fit for purpose. Many dentists feel that working to activity targets is like ‘being on a treadmill’ and wrongly puts the focus on meeting UDA targets, rather than on patient care.3
It is clear that a reformed contract that is not so target driven is much needed and prototypes are already being tested in practices across the UK to explore new ways of providing NHS dental care, with an increased emphasis on preventing future dental disease, which serves to benefit both dentists and their patients.
If you are at all concerned about your health or the health of a friend or relative you can contact your doctor or you may find useful information from one of the sources below.
Dentists with a BDA membership can visit the website here for more information on the BDA Member Assistance Programme. You can access their free helpline 24/7, 365 days a year.
Alternatively, Samaritans are available 24 hours a day to provide confidential emotional support for people who are experiencing feelings of distress, despair or suicidal thoughts.
- 116 123 (free to call from within the UK and Ireland), 24 hours a day
 Collin, V. et al. ‘A survey of stress, burnout and well-being in UK dentists’. British Dental Journal 2019: 226, 7.
 British Dental Association, Health Assured: BDA launch a lifeline for profession under stress. https://www.bda.org/news-centre/press-releases/Pages/Health-Assured-BDA-launch-a-lifeline-for-profession.aspx [accessed 6.9.19]
 British Dental Association, Can we ditch the UDA system for good? https://bda.org/news-centre/blog/dental-contract-reform-can-we-ditch-the-uda-system-for-good [accessed 6.9.19]
 Department of Health and Social Care, Dental contract reform: evaluation report 2016 to 2017. https://www.gov.uk/government/publications/dental-contract-reform-evaluation-report-2016-to-2017 [accessed 6.9.19]