Stress In Dentistry - It Could Kill You! - Oral Health Group (2023)

Recent Studies reported in dental literature confirm that dentists are subject to a variety of stress-related physical and emotional problems.

These problems included an alarmingly high incidence of cardiovascular disease, ulcers, colitis, hypertension, lower back pain, eye strain, marital disharmony, alcoholism, drug addiction, mental depression and suicide.


* The suicide rate of dentists is more than twice the rate of the general population and almost three times higher than that of other white collar workers.

* Emotional illness ranks third in order of frequency of health problems amongst dentists, while in the general population it ranks tenth.

* Coronary disease and high blood pressure are over 25% more prevalent among dentists than in the general population.

* Dentists suffer psycho-neurotic disorders at a rate of 2 1/2 times greater than physicians.

* The #1 killer of dentists is stress-related cardiovascular disease.

* The dental profession in North America loses the numerical equivalent of one large dental school class each year.

RELATED VIDEO: Dr. Preety Desai Talks Stress [And What It’s Doing To You]


Why is our profession so prone to stress-related physical, mental and social problems? Since it is unfortunately too late for most of us to switch into law or engineering, at least we can examine some of the causes of stress in dental practice and then see if we can find some solutions to them and hopefully live a little longer and happier.

* Confinement

The average dentist spends most of his or her life confined to a small, sometimes windowless, 7ft. by 9ft. operatory, which is smaller than the cells in our penal institutions. The work is intricate and meticulous and is performed in a small, restricted oral space. The procedures are both physically and mentally taxing and as a result, strain, back troubles, circulatory disorders and fatigue are common. It is relatively easy, over a period of time, for a dentist to become both physically and emotionally “burned-out.”

* Isolation

Most dentists practice alone. Consequently they do not have the opportunity to share and solve problems with their colleagues the way other professional groups do through peer support.

The problem of isolation is compounded by the fact that dentists tend to be competitive with one another. This trait is unfortunately a bi-product of our competitive dental school training. It is then reinforced after graduation by the intense competition created by the surplus of dentists that now exists in many cities and large metropolitan areas.

* Stress of perfection

The relentless pursuit of perfection and permanence in an inhospitable oral environment is a major cause of stress and frustration for dentists. The stress of perfection is instilled in dental school. However, it must be tempered with the realization that the most perfect restoration will ultimately be rendered imperfect by time and patient neglect, despite the efforts of the dentist.

* Economic pressure

During the early part of his or her career, the typical dentist is paying off huge loans to cover the cost of dental school and the cost of setting up a private practice . These two figures can easily exceed $250,000. Once in practice, the dentist soon learns that office overhead rises to meet income. It often then surpasses it.

Economic pressure forces many dentists to work through their lunch — an hour that is the single most important period of the work day. Instead of using the time to get proper nourishment and much needed rest, he or she will often accommodate an additional patient or two. This inevitably leaves the dentist tired and exhausted by the end of the day.

Another result of the economic pressure of practice is that dentists often feel that they literally cannot afford to be sick or take holidays. When a dentist is absent from the office, the income totally stops, but the high overhead expenses continue to grow relentlessly.

The dentist who works all the time and never takes time off might make a few dollars more, but there is a high price to pay — BURNOUT! And when dentists burnout, they become emotionally and mentally exhausted, develop a negative, indifferent or cynical attitude towards both their patients and their staff, and evaluate themselves negatively.

RELATED ARTICLE: Dentistry’s Suicide Dilemma

* Time pressures

Attempting to stay on schedule in a busy dental practice is a chronic source of stress. Dentistry, unfortunately, seems to be governed by Murphy’s Law — “If any thing can go wrong, it will go wrong and usually at the worst possible time.” Also, dentists often find that the first 90% of a complicated dental procedure takes 90% of the allotted time and the last 10% takes another 90%. And as we all know, once we are behind schedule there is no way to catch up.

* Compromise treatment frustration

A dentist spends four years in dental school learning perfection and “ideal” treatment for his or her future patients. Yet the realities of private practice are that many patients, due to financial restraints, poor insurance plans or low appreciation of quality dental care, will not accept “ideal” treatment plans. The result is that the dentist is continually forced to compromise treatment and is frustrated in not being able to reach his or her ideal treatment goals.

Consequently, the dentist is often forced to operate a “fix-and-repair” business, providing compromised treatment for patients who refuse the full spectrum of dental care. The dentist then ends up emotionally carrying the responsibility for less than ideal results while the patient continues to express unrealistic expectations.

* Patient anxiety

The psychological stress of working with apprehensive and fearful patients can be devastating to the dental practitioner. There is now considerable evidence that dentists experience patterns of physiological stress responses (increased heart rate, high blood pressure, sweating, etc.) that parallel the patient’s responses when performing dental procedures that evoke patient fear and anxiety. This in turn can lead to an early heart attack for the dentist.

* Dentist’s personality

Researchers are finding that many personality traits that characterize a good dentist are also traits that predispose to depression in mid-life, drug and alcohol abuse and the attendant risk of suicide. Among such traits are:

(1) compulsive attention to details;

(2) extreme conscientiousness;

(3) careful control of emotions;

(4) unrealistic expectations of himself or herself and others (i.e. employees and patients);

(5) a marked dependence on individual performance and prestige.

* Lack of exercise

The Pankey Institute in Miami evaluated the health of 2,400 dentists. It found that the dentist’s life was characterized by Dormancy, Degeneration and Stress (i.e. DDS). Also, dentists do not exercise enough to prevent progressive deterioration of connective tissue, small blood vessels, muscles and circulation in general.


Stress can never be totally eliminated from dental practice. However, it must be minimized as much as possible in order to avoid the many stress-related physical and emotional problems that it causes.

The key to managing stress successfully is to first recognize and understand its causes. Once the causes have been identified and understood, preventive steps can be taken.

Some of the preventive measures that could minimize the stress of dental practice are as follows:

* Improving the working environment at the office;

* Becoming less isolated and sharing problems with fellow practitioners;

* Wor
king more sensible hours and taking time each day for a leisurely lunch break;

* Taking holidays whenever the pressures of practice start to build;

* Learning how to better handle patient anxiety and hostility;

* Adopting a program of physical exercise, such as regular walking or working out at a local health club;

* Most important, being kinder to yourself and less critical and demanding of your efforts.

Courses on managing stress should be made available to all dentists and should also be included in the dental curriculum at our dental schools. If 99% of dental courses are now devoted to the patient’s health, couldn’t just 1% be devoted to the future health of the dentist?


* ADA Bureau of Public Information News Release. Temple University School of Dentistry Study of dentist suicide rates, Jan. 31, 1997.

* Alexander RE. Stress-related suicide by dentists and other health care workers: fact or folklore? JADA 2001; 132:786-94.

* American Psychiatric Association. Diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV). Washington: American Psychiatric Press; 1994.

* Atkinson JM, Millar K, Kay EJ, Blinkhorn AS. Stress in dental practice. Dent Update 1991; 18 (2):60-4

* Bourassa M, Baylard JF. Stress situations in dental practice. J Can Dent Assn 1994; 60:65-71.

* Blikhorn AS. Stress and the dental team: a qualitative investigation of the causes of stress in general dental practice. Dent Update 1992; 19:385-7.

* Bureau of Economic Research and Statistics. Mortality of dentists, 1968 to 1972. J.A.D.A., 90:195-198, 1975.

* Cooper, K.H., and Christen, A.G. Dentist, “Heal thysef”: Modification of life style. D.C.N.A., Vol 22, No.3, July 1978.

* Cooper C, Watts J, Kelly M. Job satisfaction, mental health, and job stressors among general dental practitioners in the UK. Br Dent J 1987; 162:77-81.

* Forrest, W. R. Stress and self-destructive behaviors of dentists. D.C.N.A., Vol 22, No 3, July 1978.

* Gale EN. Stress in dentistry. N Y State Dent J 1998; 64(8):30-4.

* Godwin W, Starks D, Green T, Koran A. Identification of sources of stress in practice by recent dental graduates. J Dent Educ 1981; 45:220-1.

* Humphris G. A review of burnout in dentists. Dent Update 1998; 25:392-6.

* Moore R, Brodsgaard I. Dentists’ perceived stress and its relation to perceptions about anxious patients. Community Dent Oral Epidemiol 2001;29:73-80.

* Newbury-Birch D, Lowry RJ, Kamali F. The changing patterns of drinking, illicit drug use, stress, anxiety and deptression in dental students in UK dental school: a longitudinal study. BR Dent J 2002; 192:646-9.

* Neilsen, N., and Polakoff, P. It hurts the dentist too. Job Safety and Health, 3:21-25, 1975.

* Occupational hazards of dentistry: speculations on dentists, stress and suicide. Dental Currents, Vol 8, Issue 2, Jan. 1977.

* Schaufeli W. Burnout. In: Firth-Cozens J, Payne RL, eds. Stress in health professionals: Psychological and oranisational causes and interviews. New York: Wiley; 1999:16-32.

* Simpson, J.C. Dentists grow richer but feel the pressure: suicide rate is high. Wll Street Journal, Dec. 17, 1976.

* Sword, R.O. Stress and suicide among dentists (two-part series). Dent. Surv., Mar.1977, pp.12-18, and Apr. 1977, pp.10-16.

* Wilson, RF, Coward PY, Capewell J, Laidler TL, Rigby AC, Shaw TJ. Perceived sources of occupational stress in general dental practitioners. BR Dent J 1998; 184:499-502.

Dr. Lang is an orthodontic lecturer at the University of Toronto and past president of the Ontario Association of Orthodontists. He maintains an orthodontic practice in Mississauga and Etobicoke, ON. Dr. Lang is co-chair of Oral Health’s editorial board.


Why is dentistry high stress? ›

Time management is a major factor of stress for dentists. Working long hours as a dentist can be extremely stressful and demanding, which requires great time management. Every patient needs the dentist's undivided attention, but as time passes and one grows weary, it can be challenging to offer the greatest care.

What is an example of stress in dentistry? ›

For example, professional isolation, perfectionism, economic pressure, and patient fears are all key sources of stress.

What are the most stressful dental specialties? ›

The findings of the study showed that the highest stress among dental professionals from different fields was observed in the field of oral and maxillofacial radiology; fields of oral medicine, endodontics, oral and maxillofacial surgery and pediatric dentistry ranked later.

How does stress affect dental health? ›

Stress can lead to teeth grinding.

This can be quite problematic for your oral health—particularly your teeth and jawbone. Nighttime teeth grinders can wear down their dental enamel and cause a lot of damage. It can also cause TMJ syndrome, which is characterized by pain in the jaw and face.

How stress affects dental? ›

Because of the way chronic stress impairs your immune system, it can lead to chronically inflamed gums, which leads to gum disease. The damage to your gums that chronic stress causes can loosen up the foundations holding your teeth in place, damage the supporting bone, and result in tooth loss.

What are the 5 examples of stressful situation? ›

The top five most stressful life events include:
  • Death of a loved one.
  • Divorce.
  • Moving.
  • Major illness or injury.
  • Job loss.
Jul 2, 2015

What are 5 examples of stress? ›

What kind of situations can cause stress?
  • Illness or injury.
  • Pregnancy and becoming a parent.
  • Infertility and problems having children.
  • Bereavement.
  • Experiencing abuse.
  • Experiencing crime and the justice system, such as being arrested, going to court or being a witness.
  • Organising a complicated event, like a holiday.

How do dentists calm anxiety? ›

Your dentist may prescribe anti-anxiety drugs, such as diazepam (Valium), that you can take one hour before a scheduled dental visit. Your dentist may also recommend conscious sedation, such as nitrous oxide (or “laughing gas”), which can help calm nerves.

How can a dentist tell if you are stressed? ›

During routine dental examinations and cleanings, dentists can detect oral symptoms of stress, including orofacial pain, bruxism, temporomandibular disorders (TMJ), mouth sores and gum disease. If you're feeling tense or anxious, you should keep a watchful eye for signs of the following stress-related disorders.

Can stress make dental pain worse? ›

Yes, a toothache caused by stress is possible. Stress and nerves can cause tension effects on the jaw, with stress often causing a person to grind their teeth. When you are clenching the jaw due to stress you can easily cause aches and pains, which is typically a result of wearing down the enamel.

What stresses do dentists face? ›

In addition to heart-related problems, dentists are also 2.5 times more likely to experience mental health issues such as anxiety, breakdowns, depression, and more, according to Oral Health Group. Each of these health concerns make it increasingly important to create strategies to decrease their impact.

What dental work hurts the most? ›

Root canals are considered to be the most painful because they require removing the nerve tissue on a tooth's root. The removal of the nerve tissue is not only excruciatingly painful but also commonly leads to infection.

What is the least stressful dental specialty? ›

Orthodontics is also known for being a relatively low-stress occupation.

How does dental anxiety affect oral health? ›

If you're currently feeling anxious and overwhelmed by stress, you might experience these oral conditions: Canker sores. Dry mouth. Lichen planus (lacy white lines, red areas or mouth ulcers on the cheek, gums or tongue)

Can stress and anxiety cause dental problems? ›

Stress, anxiety, and depression can all affect oral health and lead to the onset of gum disease and tooth decay. It's important that people suffering from mental health issues remember to take proper care of their teeth each day, to keep their mouth in good condition.

Can stress cause mouth inflammation? ›

Stress increases your risk of gingivitis and gum disease.

And when you're stressed, you release a hormone called cortisol, which can deplete your immune system and allow bacteria to thrive. These bacteria then wreak havoc on your gums, causing them to become inflamed.

What will be important to stress for her to maintain her oral health? ›

Helping them get enough sleep by setting an appropriate bedtime and keeping a routine around sleep schedules. Ensuring they practice good oral hygiene by brushing their teeth for two minutes twice a day and cleaning between their teeth daily.

What is the #1 cause of stress? ›

Work stress tops the list, according to surveys. Forty percent of U.S. workers admit to experiencing office stress, and one-quarter say work is the biggest source of stress in their lives.

What causes the most stress? ›

Stress is up.

Most Americans are suffering from moderate to high stress, with 44 percent reporting that their stress levels have increased over the past five years. Concerns about money, work and the economy top the list of most frequently cited sources of stress.

What are the signs of stress? ›

Physical symptoms of stress include:
  • Aches and pains.
  • Chest pain or a feeling like your heart is racing.
  • Exhaustion or trouble sleeping.
  • Headaches, dizziness or shaking.
  • High blood pressure.
  • Muscle tension or jaw clenching.
  • Stomach or digestive problems.
  • Trouble having sex.
Jan 28, 2021

What is toxic stress? ›

Toxic stress response:

This is the body's response to lasting and serious stress, without enough support from a caregiver. When a child doesn't get the help he needs, his body can't turn off the stress response normally. This lasting stress can harm a child's body and brain and can cause lifelong health problems.

What are the four factors of stress? ›

Stress factors broadly fall into four types or categories: physical stress, psychological stress, psychosocial stress, and psycho-spiritual stress.

What are the most common types of stress? ›

Common types of stress
  • emotional distress.
  • muscle tension.
  • headache, back pain, or jaw ache.
  • stomach upset.
  • rapid heartbeat.
  • raised blood pressure.

What are 10 examples of stress? ›

Life events
  • Death of a loved one.
  • Losing a job.
  • Illness.
  • Starting university.
  • Work promotion.
  • Birth of a child.
  • Marriage.
  • Winning the lottery.

What are 10 causes of stress? ›

Top 10 Causes Of Stress And How To Beat Them
  • Not having enough time. ...
  • Unhealthy lifestyle. ...
  • Taking on too much. ...
  • Conflicts in the workplace or at home. ...
  • Inability to accept things as they are. ...
  • Failure to take time out and relax. ...
  • Non-work-related issues. ...
  • Failure to see the humour in situations.

What stressors do dentists face? ›

In addition to heart-related problems, dentists are also 2.5 times more likely to experience mental health issues such as anxiety, breakdowns, depression, and more, according to Oral Health Group. Each of these health concerns make it increasingly important to create strategies to decrease their impact.

Is being a dental student stressful? ›

Recent studies have shown that studying dentistry can be extremely stressful for dentistry students who need to acquire diverse proficiencies such as theoretical knowledge, clinical skills, and interpersonal communication skills.

Why is dentistry so difficult? ›

Dentistry is very physically demanding, although many people would probably not think so. Doing precise and tedious work in a tiny area with your hands and having your eyes focused on a small area through loupes for long periods of time are reasons why dentistry is demanding physically.

What is the overwhelming fear of dentist? ›

What is dentophobia? People with dentophobia, also called odontophobia, have a fear of dentists. Someone with dentophobia may have extreme anxiety at the thought of going to the dentist or while in the dentist's office.

Is being a dentist hard on your body? ›

A lot of dentists have back and neck issues.

I was sitting in one position working on her for hours. I've also seen patients who had decay on every single tooth and needed root canals on most of them. Those procedures can be very taxing on your body too. Now, I do yoga for my back, and that's helping.

Are dentists happy with their careers? ›

A recent survey found that only two out of every five dentists are satisfied with their careers. Dentists are well paid, but the profession comes at the cost of a long education and generally high student debt.

Is dentistry harder than med school? ›

Both schools have the same levels of difficulty when it comes to courses and disciplines. The dental school offers practical courses much earlier into the schooling. Medical school offers only classroom learning during the first 2 years.

Why do most people not go to the dentist? ›

Many people are anxious and afraid to see the dentist. They don't like the sounds and smells in the dental office. They worry about pain from having their teeth cleaned. They stress about problems the dentist may find during the oral exam.

What are the hardest dentistry subjects? ›

Some of the hardest classes at dental school include oral surgery, periodontics, and prosthodontics, classes that require– once again– both a firm medical background knowledge and excellent motor skills.

Is it harder to become a dentist or pharmacist? ›

Unlike pharmacy school, dental school is becoming slightly more competitive with time, not less. The average dental school matriculant has a GPA of 3.5, and a composite DAT score up to 20, which is around the 75th percentile. Of all the students that apply to dental school, approximately 50% matriculate.

How do I calm my anxiety at the dentist? ›

How to manage dental anxiety or phobia
  1. deep breathing.
  2. meditation.
  3. distraction (such as listening to music or the use of devices)
  4. guided imagery.
  5. progressive muscle relaxation.
  6. agreeing with your dentist on a signal to stop during the treatment for a break (such as raising your left pointer finger or hand)

Is Xanax good for dental anxiety? ›

Also called pill sedation, oral sedation is a type of sedation dentistry that uses prescription medication to help patients relax before and during their dental exams. The medication used for oral sedation is usually a type of benzodiazepine such as Valium, Xanax, or Halcion.

Is it normal to cry at the dentist? ›

Crying or feeling the desire to cry is extremely common when you are experiencing high levels of anxiety. Pay attention to your emotions when you are thinking about a visit to the dental office.


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