Self-care and wellness in dentistry—a mini review

Introduction

Stressors exist and are on the rise in many healthcare professions. The dental profession is inundated with stressors, and workplace stressors are evident (1). Dental practitioners (DPs) are frequently exposed to challenging and demanding circumstances that can negatively impact their physical, mental, and emotional wellness. Stress in the work environment has been shown to negatively impact work performance, including lapses in provider attention, increased risk of serious consequences such as failure to recognize contraindicating medical conditions, and other patient safety issues (1,2). A questionnaire-based study by the Dental Defense Union (DDU) revealed 78% of dental members surveyed stated they “feel stressed and/or anxious on a weekly basis in 2021” (3).

Self-care is a conscious and intentional effort to protect and nourish oneself physically, mentally, and emotionally to maintain overall wellbeing (4,5). Self-care involves taking proactive steps to promote personal growth, reduce stress, and cultivate joy. Partaking in self-care may include engaging in activities that align with one’s core values, practicing mindfulness, connecting with others, or simply taking a break to recharge. Doing so can lead to decreased stress and anxiety and increased life satisfaction (6,7). Self-care is a personal practice that can take many forms, and individuals can explore and identify what method works best for them. To manage the stress and pressure associated with their profession, DPs should prioritize self-care practices. By focusing on physical, mental, and emotional wellness, DPs can partake in self-care routines (1).

This mini review addresses concerns and provides recommendations to help DPs recognize and manage stressors that may be affecting routines associated with professional life.

Concerns in the dental profession

In dentistry, recognizing how DPs communicate information to diverse populations is crucial (8). Inability to actively communicate with patient populations and colleagues could be considered a stressor for the DP. Communicating effectively involves speaking directly to the patient and listening intently to their concerns and questions (9). This art of communication also incorporates active listening and cultural competence, which are factors that can affect success for DPs (10). Active listening is done with intentionality and allowing for the person to speak without interruption. Further, the person listening may provide a summary at the end to confirm what they have heard and understood what was shared (10). Having the ability to recognize a struggle in communication will help DP to reflect on other areas needing further attention.

International studies have been conducted on the effects of stress and burnout on dental procedures (11-13). Burnout for a DP was described as “gradual erosion of the person” and from a multifactorial standpoint “deteriorates the efficiency of the person” (12,13). Research has been published on topics regarding stress and burnout, and further provides recommendations for DPs and new graduates within the dental profession (1,11-16). Specifically high stress factors and burnout emphasized long work hours and new graduates not owning a practice (15). Within dental education, another concern was the need for counseling to help high levels of stress (16).

Burnout syndrome in dentistry has identifiable effects on DPs that are multifactorial and considered high risk. Burnout is commonly defined and measured using the Maslach Burnout Inventory (MBI). Burnout syndrome is often split up into three categories: emotional exhaustion, depersonalization, and reduced personal accomplishment (17). Emotional exhaustion as a healthcare provider is a logical result of working in the healthcare field where providers must regularly deal with disease and demonstrate empathy toward their suffering patients (12,17).

Depersonalization considers the behavior of pulling away from colleagues and becoming less involved within the profession as a symptom. Reduced personal accomplishment includes DPs having reduced self-esteem and do not regard their work as commendable (13,18).

Management with self-care

For DPs, wellness coaching is available and incorporates identifying and working with an individual to help promote health holistically (19). Wellness coaching may help reduce the likelihood of developing chronic conditions that can negatively impact quality of life and can be implemented as part of a self-care routine (19-22). DPs are often multitasking, switching continuously between the roles of oral healthcare provider, customer service representative, receptionist, to repair technician. Each of these facets presents a different type of challenge and stressor which can affect mental and emotional wellness (12,19).

DPs who prioritize self-care are better equipped to communicate effectively with their patients, make informed clinical decisions, and deliver high-quality care (8,20). Self-care routines can not only give the DP peace of mind but can also allow for patients to feel more comfortable during treatment. Ultimately, self-care is critical for DPs to maintain their wellbeing and provide the best possible care to their patients (1,5,20,21). Examples of alternative management strategies include incorporating exercise, sound meditation, and use of aromatic essential oils in dental clinics to help reduce workplace stress levels (22,23). Further, literature supports benefits of yoga such as self-care exercise, and deep breathing (24,25).

Management with mindfulness

Along with the practice of dentistry comes stressors that cannot necessarily be removed, so it falls on the DP to engage in evidence-based strategies to mitigate these stressors. These strategies include mindfulness, stress management training, communication skills training, exercise, self-care efforts, and participation in small-group programs oriented around promoting community, connectedness and meaning (21). Mindfulness is defined by Merriam-Webster’s dictionary as “the practice of maintaining a non-judgmental state of heightened or complete awareness of one’s thoughts, emotions, or experiences on a moment-to-moment basis” (25).

Participation in mindfulness-based programs, such as the Mindfulness Based Stress Reduction (MBSR) program, may have a positive impact on stress reduction amongst DPs. The MBSR program uses clinically standardized meditation on healthy individuals, and authors have recommended further study (21). Interventions of this nature can make a substantial difference in the health and performance of DPs. As alluded to earlier, DPs need to recognize their own stressors and possible consequences, as well as the strategies that may help them with management of their individual stressors (21,22).

Within the workplace, there are techniques such as deep breathing exercise and use of lavender essential oil to reduce the stress and anxiety for the managing DP (23,24). Mindfulness and reflection are essential in managing the stressors that DPs regularly encounter (3). Reducing the impact of stressors within the dental workplace is an important strategy to help improve wellbeing (26,27).

An autonomy-supportive management style that promotes a sense of self-realization, meaningfulness, and connectedness can significantly reduce burnout risk. In addition, building a sense of community and fostering supportive relationships with colleagues outside of work can help mitigate stress and help with improving the DP-patient relationship (3,23). Each of these aspects cannot be done alone but relies on the multifactorial approach to help in the overall benefit for the DP. Mindfully recognizing a stressor exists is not the only solution. The choice to apply other strategies gives the DP a better result overall.

Prevention and wellness (Table 1)

Prevention of mental health and wellbeing issues in the workplace can be managed using three levels of intervention—primary, secondary, and tertiary prevention (23,26-28).

Primary prevention

Primary prevention involves the elimination of stress origins within the work environment. Reduction of identified stressors has a positive impact on the individual. Some examples of what a dental practice can incorporate to reduce stressors include educating team/employees about the effects of stress on their wellbeing, providing mindfulness training, and encouraging team/employees to use break time to engage in meditation exercises (23,26). As mentioned in previous sections, engaging in yoga and deep breathing has been shown to be helpful for stress reduction (22).

Secondary prevention

Secondary prevention is concerned with the detection and management of stress, mental health, and wellbeing issues through increasing awareness, and improving the individual’s coping skills through education and psychoeducational interventions. A study by Chapman and colleagues collected data and employed psychoeducational interventions with DPs to measure stress, depression, burnout, and anxiety over a 6-week period (27). A self-help cognitive behavioral therapy package and a face-to-face workshop were offered to the DPs. Results from the study revealed that stress and depression were significantly reduced over the 6-week period and the reduction was maintained after 6 months. Additionally, participant’s anxiety and burnout scores also improved (27,28). Furthermore, another study using the MBSR strategy found improved well-being and decision making, with implications for improved patient safety (29).

Tertiary prevention

Tertiary prevention involves the treatment, rehabilitation, and recovery process of individuals who currently or previously have suffered from psychological issues, and typically includes counseling services. In a study conducted by McColl and colleagues, the DP support services were evaluated in DPs experiencing high stress (30). The study included an initial assessment by a counselor, followed by 6 one-hour counseling sessions that were conducted in a personalized, problem focused manner. The counseling covered personal issues like high expectations of oneself, work-life balance, and unresolved traumatic experiences. Additionally, stressors in practice, such as administrative paperwork and patient complaints, were also covered. Through this level of intervention, a statistically significant and clinically meaningful decrease in psychological health and distress was observed. Overall, the DP participants found this treatment acceptable and thought their progress in coping with stress was improved (3,30).

Conclusions

Self-care plays a vital role in the well-being and professional success of DPs.

Incorporating self-care strategies is essential to help mitigate the challenges of stressors inherent to the dental profession. Mindfulness-based programs such as the MBSR have demonstrated positive effects in reducing stress and increasing wellbeing among DPs. Engaging in self-care and mindfulness practices can enhance self-awareness, resilience, and overall job satisfaction, leading to better patient care.

Acknowledgments

The authors would like to acknowledge: J. Phen DDS, A. Oberoi DDS, G. Oberoi DDS, and S. Manzoor DDS for help in organization of manuscript and initial discussion of concept.

Funding: None.

Footnote

Peer Review File: Available at https://joma.amegroups.com/article/view/10.21037/joma-23-39/prf

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://joma.amegroups.com/article/view/10.21037/joma-23-39/coif). B.A.F. serves as an unpaid editorial board member of Journal of Oral and Maxillofacial Anesthesia from October 2023 to September 2025. The other authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

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