Don’t leave it too late and make sure you get help if you need it, Alun Rees says.

Dentistry is tough, with unique pressures.

All professions expect knowledge and skills, but dentists do intricate, exacting work in one of the most sensitive areas of the body with conscious patients.

Add to the mix the increasing burden of compliance and legislation, then throw in the pressure of running or being part of a small business where time is money.

The resulting stress and its consequences are widespread and can affect all team members.

Performance

In many dental businesses there still exists a macho culture where speed of work and high ‘grossers’ are lauded.

It is little surprise that with an NHS system that is built around delivering UDAs like so many widgets on a production line, often in practices that are owned by faceless venture capitalists, the ‘performers’ can feel unappreciated.

Increasing stress and subsequent burnout are on the rise.

Dissatisfaction and unhappiness, not only with the NHS system and the drop in income, but also with the threat of the possibility of a career ending complaint, have made many look beyond their chosen calling.

What do we mean by sick?

‘Suffering from ill health; mental, spiritual or psychological disturbance; disgusted or weary and not in working order.’

Some people can deal with this; they are able to roll with the punches, adapt to the changes and live their lives.

However, it is clear that more and more dentists, young and old, are being negatively affected by internal and external pressures.

Who’s more susceptible?

It was always believed that practice owners were more susceptible to stress because of the pressure that came from running a business.

However it is clear that associates have problems for different reasons.

Not only the old ‘favourites’; pressure of time and patient expectations – now we must include the conflicts of having little or no say in decision making, materials, laboratories or policies.

For many there is no release from the day-to-day stressors and the demands outstrip the resources they have to deal with them.

Stress becomes distress and leads to burnout with a decrease in performance leading to physical and mental problems.

Burnout brings emotional exhaustion, depersonalisation and reduced personal accomplishment.

Often their performance will suffer clinically and output falls.

They seem to be working harder but accomplish little.

Sometimes problems manifest themselves in unhealthy displacement activities including the use of alcohol, drugs, gambling and overspending on credit cards.

Is it a real problem?

Repeated research by the BDA and others leave us in no doubt that stress and burnout are major problems in UK dentistry amongst all team members.

How to deal with the problem?

Firstly, you have to come to accept that: ‘It’s OK to say that you’re not OK’.

The role of a successful clinician means that you tend to take in a lot of other people’s emotions, fears and problems.

Dealing with the problem can be difficult; if you feel that someone on the team is not OK then ask them, listen to them, do not judge but encourage them to get professional help.

A practice owner has many pressures and acknowledging that they are sick in any way is hard; sometimes it is their colleagues who have to broach the subject.

Prevention is key.

Support

Dentistry can be a very lonely existence; make sure you have a good circuit of supportive friends, both within and beyond the profession, who you can trust, who will not judge you and who will support you through the difficult times – and we all have difficult times.

Take time away from dentistry, indulge in your hobbies and turn off.

Have regard for your nutrition, take regular exercise and get sufficient rest.

Learn to know yourself and where your limits lie.

We are all different; we each have a varied response to individual stressors with unique levels of resilience.

Clinically – beware of perfectionism and reduce your exposure to people who are stressors.

Mentally wipe your feet on leaving the surgery, avoid taking work home – you’ll be too tired to do it effectively and this will lead to more frustration.

If you have had a crisis take stock and reassess your life.

Ask yourself what you can change and what you cannot and then make the changes.

Unfortunately most people only make change when the pain of doing nothing exceeds the pain of doing something.

You only have one life, enjoy it, all of it, don’t suffer in solitary silence, there is help.