The human factor – reducing stress in implant dentistry

stressCemal Ucer delves into reducing stress and mistakes in implant dentistry.

Typically, when considering implant failure, the academic literature focuses on hard and fast technological and biological factors.

Dental implants enjoy an exceptionally high success rate. You can often pin rare failures down to such causes. However, there are human elements in play, and as the ancient saying goes, to err is human.

Many dental practitioners are keenly, even painfully, aware of the possibilities for mistakes to occur and the potentially devastating consequences these can have for patient and practitioner.

Dentistry is already widely regarded as a stressful calling. Burnout levels are, unfortunately, consistently high.

Stress interferes with prefrontal cortex activation. This has a deleterious effect on decision making and problem solving (Renouard, Amalberti and Renouard, 2017). This can create a vicious circle, with stress causing mistakes that in turn create more stress.

Judgement call

Dental care is not about finding the one definitive solution to a problem. Each case presents numerous variables and considerations. These require interpretation and clinical judgements.

This creates potential for clinical decisions to be challenged, most commonly in the event that something does go wrong.

Dentists typically work with relative clinical autonomy and are comparatively isolated from professional peers, while simultaneously being highly accountable for individual treatment in a complex and ever-changing regulatory environment.

Sanctions for malpractice can be career-ending and personally devastating. This can be a background concern and stressor for many dentists (Toon et al, 2019).

A recent survey by Dental Protection revealed that 77% of UK dental professionals have stress and anxiety over the potential threat of legal action against them.

It is well established that chronic stress reduces performance, disrupts sleep, causes fatigue, increases the risk of making mistakes, and may ultimately lead to ‘burnout’ (Nollet, Wisden and Franks, 2020; Basu, Qayyum and Mason, 2017).

In the long-term, stress is a risk factor for psychological and physiological issues, including cardiovascular disease (Dar et al, 2019).

Occupational stresses come in many forms, but cumulatively have similar effects on the individual. Some of these are environmental and somewhat inescapable given the nature of the work.

However, a great many potential sources of stress can be modified or approached differently, which can be tremendously helpful.

Stress reduction

Training and experience have obvious benefit to reducing stress over carrying out treatments successfully and without incident.

To dental professionals at the start of their careers, the prospect of carrying out complex implant surgery may seem quite intimidating. However, with diligent training and experience, you can anticipate most challenging complications and identify during treatment planning.

If you are still feeling a little intimidated, think upon other skills you may have honed over the years. Like any skills, the more you can practise the movements and the sequences, the more automatic they become.

For example, the martial artist repeatedly practises simple kicks and punches to make their responses intuitive. This leaves their mind free to assess other aspects of when faced with confrontation.

Driving is similar; at first, simply moving a car without stalling requires active thought. With experience, the driver gains an intuitive awareness of the vehicle’s dimensions. They can operate the vehicle without conscious thought (you stop thinking about how to do things like changing gears and simply do them). This frees the driver to better concentrate on reading the road. It enables them to better respond to hazards when they occur.

Clinical judgements are not a million miles from this. Experience allows a practitioner to rapidly identify key factors that must been taken into account, while less experienced practitioners may find themselves swamped taking stock of all possible factors and worrying that they may have missed something important in the process (Renouard, Amalberti and Renouard, 2017).

Improving knowledge

One factor linked to psychological morbidity and burnout is the inability to access education (Basu, Qayyum and Mason, 2016).

Finding the time to improve your knowledge and skills is already difficult. The last thing you want is to feel like you have wasted time on a course that does not meet your expectations.

Ucer Education is at the forefront of postgraduate education in UK implantology, and has taught legions of satisfied dentists in the art of implantology, covering everything from treatment planning to postoperative care, as well as many other facets of dentistry.

Ucer Education’s Postgraduate Certificate in implant dentistry is an excellent opportunity for clinicians looking to advance their knowledge and develop practical skills. The course delves into human factors specific to implant dentistry. It also furnishes attendees with hands-on training, including in piezo surgical techniques.

It represents value for money, and a great time investment covering advanced diagnostics and treatment planning, restorative, clinical and surgical skills, and much more.

Implant dentistry can be a taxing field, but it is also deeply rewarding. With the right combination of training and outlook, you can avoid a great deal of stress and mistakes. This makes for a bright outlook for dental practitioners and patients alike.  


Renouard F, Amalberti R, Renouard E (2017) Are ‘human factors’ the primary cause of complications in the field of implant dentistry? International Journal of Oral & Maxillofacial Implants 32(2): 55-61

Toon M, Collin V, Whitehead P, Reynolds L (2019) An analysis of stress and burnout in UK general dental practitioners: subdimensions and causes. British Dental Journal 226: 125-130

Nollet M, Wisden W, Franks N (2020) Sleep deprivation and stress: a reciprocal relationship. Interface Focus 10: 20190092

Basu S, Qayyum H, Mason S (2017) Occupational stress in the ED: a systematic literature review. Emergency Medicine Journal 34: 441-447

Dar T, Radfar A, Abohashem S, Pitman R, Tawakol A, Osborne M (2019) Psychosocial stress and cardiovascular disease. Current Treatment Options in Caridovascular Medicine 21(5): 23

This article first appeared in Dentistry magazine. You can read the latest issue here.

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