Dental hygiene students' mental health: Are we doing enough to address burnout?
The dental staffing shortage is nothing new. It started in 2020, and it doesn’t look like there’s an end in sight. It started with the COVID-19 pandemic, then shifted to taxing workloads and stress, and finally, to burnout as a big reason for the shortage.1 Each community facing a dental staffing shortage may have its own reasons for why there are not enough providers.
No matter the reason, the shortage must be dealt with because without enough clinicians there’s not enough dental care. The Commission of Dental Accreditation hopes to help with this problem by allowing dental and dental hygiene schools to increase their class sizes.2,3 Some believe if there are more graduates, there will ultimately be more workers.
Have we properly addressed burnout?
This does seem like a feasible solution; however, has anyone taken the time to define what it means for a dental professional to be burned out? Have we addressed the elephant in the room? Is burnout allowed to happen only to those who have been in our profession for a long time? If we need new graduates to fill the voids, how can we help them be the best providers possible? Are they ready to work when they graduate or are they already burned out?
Burnout, though not classified as a medical condition, is an overwhelming experience that disrupts one's normal functioning. It can occur at any stage of life and is distinguished from depression by the specific event or trigger that leads to a loss of control. Once the trigger is removed, the burnout tends to subside.4 Symptoms include fatigue, irritability, headaches, and difficulties eating and sleeping. With the growing number of people working remotely, burnout is often linked to poor work-life balance, as individuals may struggle to disconnect from work during their time off.4,5
Even health-care workers, who typically cannot work remotely, are not immune from burnout. They face challenges such as high patient demands, rigid schedules, time constraints, emotional strain, diverse leadership styles, and conflicting priorities, all of which can contribute to burnout. When health-care workers experience burnout, it can have serious implications for patient care as they may not be able to perform at their best.6
Vast numbers of RDHs have felt the physical and mental stresses of our job.7,8 Some blame unsafe work environments, hostile coworkers or bosses, packed schedules, working too many days in a row, difficult patients, and physical constraints for causing them to rethink their careers as dental hygienists.7,8 Dental hygiene (DH) burnout is discussed as a possibility that has contributed to the shortage of providers.1 One argument says that dental professionals have perfectionist personalities, and this increases their risk for burnout.7
Regrettably, many RDHs face high levels of stress even before they complete their education. It’s a widespread issue for DH students to experience various forms of stress, burnout, and mental health challenges.9-14 In recent years, there’s been a growing focus on the mental health of student RDHs, revealing astonishing findings. Many students report feeling significantly stressed and overwhelmed to the extent that it adversely impacts their physical well-being and interpersonal relationships.9-14
The demands of school
The demanding nature of DH school, including patient load, preparation for national and regional boards, coursework deadlines, and accelerated learning, has been identified as the primary contributor to poor mental health among students. The most commonly cited emotions are burnout, exhaustion, depersonalization, excessive stress, anxiety, and depression.9-14 Shockingly, some students have even disclosed thoughts of suicide due to the overwhelming demands of their coursework.12,14
These findings, gathered from DH students across the nation at various stages of their programs, underscore the alarming impact on their well-being. No one should ever feel so isolated that they consider self-harm or believe they have no support. Without addressing the burnout that health-care professionals experience, we cannot expect optimal patient care or academic performance from DH students.
How to reduce burnout among DH students
Many professional resources have suggested ways to reduce burnout and stress.15,16 DH students should spend time with family and friends, eat healthy foods and beverages, get eight to nine hours of sleep a night, avoid being under the influence of any drugs or alcohol, exercise for 30 minutes a day at least three times a week, meditate, keep a journal, and set realistic goals.15,16 DH faculty who display an honest, open, and supportive leadership style should have more successful students than those with an authoritarian leadership style.5
Supportive environments help students feel more open to sharing if they are struggling with their mental health. If a DH student, or any college student for that matter, fails to reach graduation it not only hurts the student, but also the school and the job market. DH faculty who support their students’ mental health will provide a ripple effect without even realizing it.
DH faculty and staff could collaborate on ways their school can help the mental health of their students based on individual needs. When students feel supported, they can be successful. While more research is looking into the mental health of DH students, it would be beneficial to see which specific therapies have the biggest benefits. Perhaps there will be more faculty workshops designed to prioritize DH students’ mental health.
The rigorous demands of DH school can take a toll on students' mental health. It's worth considering whether persistent stress leads to early career burnout later. Implementing improved mental health support and therapies in DH programs could better equip graduates to handle the challenges and fatigue of the profession. By addressing the mental well-being of students now, we can ensure a more resilient and prepared workforce in the future, potentially mitigating the shortage of DH professionals.
References
1.Hill A. The dental hygienist shortage: will dentistry ever look the same? DentistryIQ. August 22, 2023. https://www.dentistryiq.com/practice-management/staffing/article/14297985/the-dental-hygienist-shortage-will-dentistry-ever-look-the-same
2. Old Dominion University approved by CODA to increase dental hygiene class size to 48. Vadental. June 25, 2024. https://www.vadental.org/home/2024/06/25/old-dominion-university-approved-by-coda-to-increase-dental-hygiene-class-size-to-48
3. Solana K. Dental schools and the future supply of dentists. ADANews. September 6, 2023. https://adanews.ada.org/ada-news/2023/september/dental-schools-and-the-future-supply-of-dentists/
4. Boreland A. What is burnout? Cleveland Clinic. February 1, 2022. https://health.clevelandclinic.org/signs-of-burnout
5. Vonderlin R, Schmidt B, Muller G, et al. Health-oriented leadership and mental health from supervisor and employee perspectives: a multilevel and multisource approach. Front Psychol. January 17, 2021. https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2020.614803/full
6. Murthy V. Confronting health worker burnout and well-being. N Engl J Med. 2022;387(7):577-579. doi:10.1056/NEJMp2207252
7. Versaci M. The burden of burnout. ADA News. May 31, 2022. https://adanews.ada.org/new-dentist/2022/may/the-burden-of-burnout/
8. 5 things dental hygienists can do to care for their mental health. Delta Dental. May 11, 2023. https://www1.deltadentalins.com/dentists/fyi-online/2023/dental-hygienists-mental-health.html
9. Deeb GR, Braun S, Carrico C, Kinser P, Laskin D, Golob Deeb J. Burnout, depression and suicidal ideation in dental and dental hygiene students. Eur J Dent Educ. 2018;22(1):e70-e74. doi:10.1111/eje.12259
10. Harris M, Wilson JC, Holmes S, Radford DR. Perceived stress and well-being among dental hygiene and dental therapy students. Br Dent J. 2017;222(2):101-106. doi:10.1038/sj.bdj.2017.76
11. Haslam SK, Munroe A, Hamilton-Hinch B, Torres S, Grant T, Ross N, Gilbert R. Adverse childhood experiences and stress among oral health students: a descriptive correlational study. Can J Dent Hyg. 2023;57(3):149-160.
12. Busch, M. 1 in 10 U.S. dental hygiene students considers suicide. DrBicuspid. November 17, 2022. https://www.drbicuspid.com/dental-hygiene/article/15380189/1-in-10-us-dental-hygiene-students-consider-suicide
13. Vavrosky K. Tips I wish I knew in dental hygiene school. Today’sRDH. September 26, 2023. https://www.todaysrdh.com/tips-i-wish-i-knew-in-hygiene-school/
14. Beck J, Kornegay E, Phillips C, et al. Assessing students’ mental health in two American dental hygiene programs. IJDH. November 16, 2022. https://onlinelibrary.wiley.com/doi/abs/10.1111/idh.12631?msockid=3c2707875e3d646d347d15ef5fb965d2
15. Brennan D. What to know about mental health and college students. WebMD. April 5, 2023. https://www.webmd.com/mental-health/what-to-know-about-mental-health-and-college-students
16. Crystal K, Lane J, Gurenlian J, et al. A 15-minute yoga intervention to reduce entry-level dental hygiene student stress. J ADHA. 2021;95(2):63-70.
