Amy Mesilio Peralta explores why self-care in dentistry isn’t a luxury but crucial for practitioner wellbeing and optimal patient care.
It can be so easy to glorify burnout or being overwhelmingly busy, but burnout is real and not glorious at all. It leaves you feeling exhausted, both mentally and physically, lazy, apathetic, uninspired and low.
I believe it is fundamental for us healthcare professionals to take the time to glorify finding the correct work-life balance that energises us. It is pertinent that we glorify creating boundaries that serve us in ways our emotional and mental wellbeing will be positively impacted in the future.
Glorify prioritising rest, recovery and health. Healthcare professionals should realise that, while it is perfectly admirable to be passionate about their career, we must remember we are a person before we are an employee.
What is professional burnout?
Professional burnout is a state of emotional, physical and mental exhaustion resulting from prolonged or excessive work-related stress. It is characterised by feeling drained, detached from work and experiencing reduced professional efficacy. While not a medical diagnosis, the World Health Organization (WHO) defines burnout as an occupational phenomenon.
In relation to the aforementioned, self-care refers to activities that restore and increase physical, mental and emotional wellbeing. Engaging in self-care habits, whether this be at work or in social scenarios, is important for combating symptoms that can lead to depression and anxiety.
Formulating these routines in your everyday life means we get to thrive in all aspect of our lives, not just work, such as our relationships, mental health, physical health and more, leading to a happier, healthier life.
The demands of the dental practice
Dentistry is a physically and emotionally demanding profession with prolonged hours, high levels of concentration, physical strain, and the pressure of perfectionism can take a toll on us. Over time, the accumulation of these factors, with the combination of neglect towards practitioner self-care awareness will, in no doubt, yield undesired mental and physical symptoms.
A study carried out in October 2021 by the Faculty of Dentistry Journal found that burnout is so common in our profession that we are likely to experience it at least once in our careers, revealing that more than 84% of dentists and 26% of dental auxiliaries experience burnout in a working year. This is not aimed at any given control group, male or female, young or elderly. It can, and it will, affect any practitioner at a point in their career.
Healthcare professionals should realise that, while it is perfectly admirable to be passionate about their career, we must remember we are a person before we are an employee
Research shows that clinician wellbeing is directly tied to clinical decision-making, patient communication, and overall treatment outcomes.
As stated above, one of the characteristics that define the phenomenon of burnout is reduced professional efficacy. When interpreted into our industry this could have consequences like decreased quality of work, loss of confidence in one’s abilities, irritability towards patients and poor physical maladies and more.
Stress and cortisol
Stress is a natural psychological and physical response to the everyday demands of life. It is a mechanism designed to protect us when we experience certain situations. When we perceive a threat, our brain’s amygdala produces hormones such as cortisol and neurochemicals that activate the body’s ‘flight or fight’ response. This equips us to deal with the threat by increasing our heart rate, raising our blood pressure and increasing our energy levels. In small doses and under the correct circumstances, stress can be positive.
Excessive or chronic stress doesn’t allow the body to recover after this response. Burnout is a severe form of chronic stress, which causes a key hormone, cortisol, to surge in our body, playing a critical role in our health. Cortisol regulates vital functions, such as sleep, digestion and your immune system, which are essential for an improved quality of life.
Every dental practitioner has experienced stress which, in my opinion, can be a result of their own shortcoming, and this arises out of not establishing adequate professional boundaries, along with unrealistic expectations.
Oblivious to pressure
Let us reflect on how this could be possible, as many practitioners may be oblivious to the pressure and burden we create for ourselves. Remember the day where you were working nine to five, fully booked, overrunning because a patient arrived fifteen minutes late to their appointment, but you agreed to see them anyway? You also agreed to perform a small direct restoration on another patient who was just in for their biannual check-up appointment, even though you only had ten minutes left of that appointment.
You further agreed to see an emergency patient who possibly could have waited for the early appointment tomorrow morning, but instead you decided to treat them during your lunch break, which then meant that, instead of being able to have a nutritious lunch with thirty minutes to yourself to unwind and relax, you ended up having to eat whatever was in the kitchen in under three minutes.
This results in working late, feeling drained and super low on energy with no motivation or time to go to the gym because of family commitments. Does this sound familiar?
With no doubt, patient satisfaction and practice demands would be at a peak and flourishing. Hey, you may even get employee of the month, but at what cost? How would we, as the operator and practitioner, feel mentally and physically having days like this, weeks on end. Exhausted? Depleted? Vulnerable? This is only to name but a few.
One critical element that is often overlooked in dentistry, is the wellbeing of the practitioner themselves. The importance of self-care in dentistry cannot be overstated – not only for the health of the dental professional, but also for the quality of care delivered to patients.
A professional responsibility
As healthcare professionals, we all know that it is better to prevent a condition than to cure it. Given that with todays’ hectic life pressures, it may be impossible to avoid stress from patients, social media, workplace stresses, family obligations and comparison to other dental practitioners. For that reason, I believe we have two remedies: minimise it or, once absorbed, dissipate it.
While negative stigmas still besiege views of mental health, it is possible that many professionals may villainise ‘me-time’. This leads them to experience negative emotions such as work guilt or feeling fruitless when not in a productive atmosphere or flow. Self-care is not indulgence – it’s a professional responsibility. Just as we advise patients to maintain good oral hygiene to prevent disease, we practitioners must cultivate our own mental, emotional and physical health to prevent burnout and ensure long-term effectiveness in practice.
Prioritising a good nights sleep, setting personal boundaries, and making sure to care for yourself will add merit to any dental treatment you perform. In fact, your patients will have a much better experience when you are in a positive mood with a positive momentum, because you’ve managed to eat and sleep to optimisation. Rather than running on your fourth coffee before 10am.
Common sense methods for dealing with stress that we all know about and probably do not do enough of are regular exercise or sports, adequate sleep, meditation, breath work, journaling, taking regular breaks from work to recharge and more.
Self-care hacks
Let us dive a little deeper into the science and discover methods to drive and empower us to overcome cortisol, practice self-care and optimise patient care as practitioners.
As humans, we are incredibly designed to be able to hack our hormones and reduce stress while increasing our levels of happiness at the same time. We have a substantial ability to impact our own motivation and relaxation each day. Luckily for us, our brain chemicals respond immediately, considering they are instantaneously aligned with our behaviours.
Burnout leads to a lack a of action and motivation, which could be a lack of dopamine. One way healthcare professionals can cultivate a self-care practice to increase our dopamine levels is going for a walk. For further results, if one did this in the morning just for ten minutes before work, you will automatically cope with stress and high pressure demands in difficult situations for that day, resulting in performing better dentistry.
Did you know waiting fifteen minutes every morning before checking your phone will increase motivation and wellbeing? In addition, doing something effortful, such as turning your shower cold for one minute will also drive dopamine. Let us glorify taking action when we wake, whether it be waiting fifteen minutes before checking our phones or parking a little further down the road to be able to walk ten minutes to work.
Burnout also results in a feeling of detachment at work. The feeling of detachment can lead to anxiety and depression. Oxytocin and cortisol levels cannot be high at the exact same time.
Calm and collected
So how can we practice self-care and hack oxytocin? Having a warm bath after a long stressful day or creating an appropriate work life balance, where you get to spend quality time with family and loved ones, will deepen your connection and increase oxytocin. This will allow yourself to engage more with patients, fostering better trust and patient compliance.
Burnout can leave us feeling exhausted. Serotonin is our mood regulator and stabilises our energy levels. The key to serotonin is that 90% of this hormone is made in our gut. Gut health, exercise and nutrition have one of the biggest effects on our mental health. Packing a healthy nutritious lunch can have a bigger impact on your energy levels and mood than you may think. For chronic burnout, keto foods energise the brain. Improved energy levels and a better mood will also create a calm and reassuring environment for patients.
Endorphins help us cope with stress by dissipating cortisol. Having low endorphin functions can make us irritable and agitated. When dealing with over fifteen patients a day, this may not work in our favour. A calm and collected practitioner is needed for such a high demand job. This is why it is pertinent that stress is removed physically from our bodies. Physical exertion and any movement is the best choice to help dispel cortisol from our bodies and prepare us for the next day. Stretching is also a great way to exert our bodies without the need for strenuous exercise.
The ripple effect on patient care
To conclude, as practitioners, one of the greatest things we can give our patients is our best selves. I think it is important to realise that cultivating compassion and awareness for ourselves is so much more than self-care, it is the foundation for how we engage with the world. The inner state from which we move from has an impact on our life.
A calm mind takes thoughtful action. Practitioners who prioritise their own wellbeing are more present, empathetic and attentive with their patients. This means they are better able to communicate clearly and compassionately by making accurate clinical decisions, while fostering trust and patient compliance. Ultimately, this renders improved patient satisfaction, adherence to treatment plans and admirable clinical outcomes.
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