mental health – Beyond the Bite

Responding to the Mental Health Needs of Dentists

by Florida Dental AssociationMay 25, 2023May 8, 2023Leave a comment

By Alan Budd, DMD

When first-year students at Tufts University School of Dental Medicine feel overwhelmed, they might unwind with a yoga class or meditation session. Dr. Christina DiBona Pastan, an endodontist and director of Mind-Body Wellness at Tufts, has developed a course on wellness that is required of all students. The curriculum focuses on lowering stress to improve students’ overall wellbeing, decreasing burnout and increasing resilience.

Support for a dentist’s health and wellness has come a long way. The first programs formed in the late 1970s consisted of dentists in recovery; think AA for dentists. These groups were a lifeline for dental professionals with substance use. Due to stigma, they were also a wellkept secret. To an extent, they still are. According to the 2021 American Dental Association (ADA) Wellbeing Survey, only 46% of dentists know that their state association has a wellbeing program.¹ The notion that patient care and self-care can coexist continues to escape many of our colleagues.

Front-line worker health suffered terribly during the pandemic. Dentists have had their share of challenges. The percentage of dentists diagnosed with anxiety more than tripled in 2021 compared to 2003, according to the ADA’s 2021 Dentist Health and Wellbeing Survey Report.²

Even before the COVID-19 pandemic, health workers were experiencing alarming levels of burnout – broadly defined as a state of emotional exhaustion, depersonalization and a low sense of personal accomplishment at work. Burnout can also be associated with mental health challenges such as anxiety and depression.³

Anxiety and depression aren’t the only mental health issues. Many are also experiencing notably higher rates of insomnia, anxiety, stress, fatigue, burnout, depression, somatization, obsessive-compulsive symptoms and post-traumatic stress disorder.⁴ More than 50% of public health workers reported symptoms of at least one mental health condition, such as anxiety, depression or increased levels of post-traumatic stress disorder (PTSD).⁵

There has been a notable increase in substance use.^6,7,8,9 Experts say misuse of opioids and stimulants is also on the rise.¹⁰ In response to a CAGE-AID questionnaire, 12% of dentists agreed with one statement, and 11% agreed with two or more. A “yes” answer to even one item indicates a possible substance use disorder and a need for further testing.¹¹

The isolation of private solo practice, access to controlled substances, denial of a problem because of higher education, and enabling coworkers may be partly to blame for difficulty identifying ill or impaired dentists. Direct observation is vital to detecting diversion and may be the only way to identify an impaired colleague.12

These findings and some high-profile suicides among leaders of organized dentistry have spurred the ADA and ADA Council on Dental Practice to take action on supporting the wellness of dentists:

The House passed Res. 95H-2021, Prioritizing the Mental Health of Dentists, which stipulated that the ADA, in conjunction with mental health consultants, analyze the availability of resources to support the mental health of dentists.¹³ The ADA is an active contributor to the National Academy of Medicine’s Action Collaborative on Clinician Wellbeing and Resilience.¹⁴ This program was launched in 2017 to improve baseline understanding of challenges to clinician wellbeing, raise the visibility of clinician stress and burnout and elevate evidence-based, multidisciplinary solutions.¹⁵ “The stressors of the dental profession begin with dental students in their first year of dental school. At Tufts, we teach our students practical applications of mindbody practices in the academic and clinical settings and we are seeing the benefits in them personally and professionally. Stress management resilience building skills are essential for overall wellbeing and also contribute to developing grounded professionals enabled to deliver mindful and compassionate patient care,” according to Christina DiBona Pastan, DMD, Director of Mind-Body Wellness Office of Student Services.

The ADA is training the first cohort of dental professionals called to serve on its new initiative, the Wellness Ambassador Program, in which volunteers will work to ensure that peer dentists struggling with health obstacles are aware of support services. Chief among the ambassadors’ messaging is that members and nonmembers can download the ADA Dentist Well Being Program Directory at bit.ly/3YZWdEZ for free through the ADA store to find their state program director’s contact information, with all calls or emails kept strictly confidential.¹⁶

The National Council of Dentist Health Programs is a national member organization of state dentist wellness programs (DHP) established in 2022. State member programs provide a confidential, therapeutic alternative to discipline and have the support of organized dentistry in their state, often through legislation, exceptions to mandated reporting, or other safe haven provisions. In addition to working with participants, DHPs provide education, outreach and advocacy to their communities to support dentist health and wellbeing.

If you or a dental colleague are experiencing substance use or other mental health crises, we encourage you to contact the ADA Dentist Wellbeing Advisory Committee. All calls are confidential.

References Available Upon Request

Mental Health Awareness Month – Great Time for Dentists to Prioritize Self-Care

by Florida Dental AssociationMay 4, 2023May 1, 2023Leave a comment

By Bobi Seredich, Founder of the Southwest Institute for Emotional Intelligence

Since May is Mental Health Awareness Month, it is a great time to reflect on how you are managing the pressures of being a dentist or working in the dental profession. In my years of coaching leaders, I’ve noticed that their key to success is more about attitude than time. The most successful leaders and dentists take time for self-care while balancing stress.

Your ability to change your mindset and attitude has much to do with self-care. Whether you’re up or down in life or rich or poor, you can change your situation for the better. Remember that you can’t change much if you’re depleted of energy, self-worth or rest. Feeling unhealthy, unhappy or lacking mental focus won’t help either. It is crucial to constantly work on yourself — by doing so, you’ll be able to bring your best self forward to help and serve others effectively. Executives and leaders prioritizing self-care are happier, more productive and more engaged. One CEO said it best in a Harvard Business Review article: “Self-care is no longer a luxury; it’s part of the job.”

Why do some dentists ignore self-care?

If self-care is so important, why do some dentists turn a blind eye? Below are a few reasons:

They think it’s a luxury.
They think it’s a sign of weakness.
Dentistry is demanding mentally and physically daily, and many dentists don’t have the time for it.

Carving time out of a busy schedule can be challenging, but too many leaders are stressed and burnt out. When this happens, there’s a release of the stress hormone that puts your body into fight or flight mode. The emotional part of our brain, the amygdala, kicks in and diverts the oxygen and blood flow away from our thinking brain called the prefrontal cortex (which is responsible for logic, reasoning, problem-solving and willpower). Taking time out of your day to practice self-care might be a little uncomfortable initially, but I promise you it’ll be worth it. https://vimeo.com/754350986

How to practice self-care

If you want to be innovative and creative and solve challenges causing pressure, you need to take breaks and manage your energy and stress. It’s important to disengage to re-engage more effectively. Even short breaks improve your level of productivity and focus.

According to an article on leadership best practices, it stated:

“Specifically, a healthy diet has been linked to better moods, higher energy levels and lower levels of depression. Aerobic exercise increases blood flow, boosting both learning and memory. Getting good sleep has been linked to increased focus, improved cognitive function (including creativity and innovation), greater capacity for learning and improved empathy.” Adam Grant researched the topic of self-care in his book, Give & Take, and he shares how selflessness at work leads to exhaustion — and ends up hurting the very people you want to help. There’s a time when giving and generosity can go wrong.

Grant talks about teachers as a great example. Most teachers are givers, as Grant stated in an Inc. magazine article:

“We love teachers who are selfless, but [the research shows that] the most selfless teachers ended up being the least engaged in the classroom and their students did the worst on standardized achievement tests.”

The selfless teachers put everything into teaching and didn’t allow extra time for themselves or their families. Other teachers were givers but took time for their families and themselves — they didn’t give all of their time to students. Grant shared, “They felt less altruistic, but they actually helped more. Their giving was energizing instead of exhausting.”

The “less altruistic” teachers decided to do things differently and did the following: focused on the team; took time to sleep, eat well and exercise; worked on their strengths and delegated responsibilities that were not their area of expertise; hired great team players.

Here are some quick self-care tips and tricks:

Revamp your workspace. Check out these popular Marie Kondo videos on how to simplify your setup.
Clean out your mind. The things from your past that are holding you back may originate from your family and your judgment around others. Let go or find a way to confront it, learn from it and then let it go. Learn from your past mistakes, while remembering that you don’t have to keep reliving them. If you’re looking for a great read around this topic, check out The Work by Byron Katie.
Take time for just you. Having space from your partner, family and work is re-energizing. Work on your strengths and focus on what brings you joy.
Prioritize wellness. Remember to rest, exercise and have a healthy diet.
Hire a coach or trainer to support your overall health and wellness. The Millennial Dentist believes in investing in yourself and hiring someone to help you reach your health and fitness goals. We offer several coaching and leadership programs on improving emotional intelligence and managing stress. Here is a link to our public online leadership training courses. We are offering a 15% discount for all Florida Dental Association Members (see details below).

How do you do things that are good for you when you don’t feel like it? Set a schedule. Be flexible with your time. Make time for short meditations or workouts. Go for a walk. Take time for appreciation as a bare minimum.

When a dentist or leader practices self-care and values it, his or her team will follow, creating a more engaged culture. Join me in prioritizing better self-care. Have fun with it and enjoy what you’re doing in life. I just redid my office space and removed a lot of clutter, and it feels fantastic. I’ve started Pilates and yoga again and committed to walking my dogs and meditating more. Now, when I start my workday, I feel more productive and focused.