Burnout Among Dental Professionals: Causes, Implications, and Solutions

Burnout, by definition, is “exhaustion of physical or emotional strength or motivation usually as a result of prolonged stress or frustration.” Sound familiar? If you’re a dental professional, it likely does. We know the harsh realities of burnout all too well. Statistically, healthcare professionals suffer more from occupational burnout than in other industries. Why is that? We’ll get there if you don’t already know. While we’re at it, we’ll talk about the symptoms of burnout, the implications of burnout on your dental practice, and what you can do to help prevent burnout for yourself and your team.

If you are one of the lucky dental professionals who have never experienced burnout nor seen what it looks like on your staff or coworkers, you may ask, “How big of a deal is this?” According to a Deloitte survey of 1,000 full-time US professionals, 77 percent of participants reported experiencing burnout in their current position at least once. More than half of those participants reported experiencing burnout on more than one occasion. Although 87 percent of those surveyed revealed a passion for their work, 64 percent of those folks also disclosed that they are often stressed at work. This unfortunately proves that even highly engaged employees can feel the crushing effects of work stressors. A gallop study of 7,500 full-time workers found that approximately two-thirds experience burnout on the job, with 34 percent of those respondents feeling the effects of burnout “very often” or “always.”

So, how do you know if you are experiencing burnout? The research of psychologist Christina Maslach identifies three primary symptoms of occupational burnout: exhaustion, cynicism, and inefficacy, with exhaustion being the cornerstone of these symptoms. Physical, emotional, and mental exhaustion erode a person’s ability to be effective at work and to have a positive attitude about it. Physical symptoms of exhaustion can include pain and gastrointestinal issues. Because the pain we suffer from the mechanics of our profession isn’t enough.

I’m sure everyone reading this has some frame of reference with which to understand the concept of exhaustion. But what about cynicism? Have your work stressors turned you into a cynic? Are you losing engagement in your work? Do you feel detached from your coworkers or negatively about your work environment? Cynicism can be just as much a cause of burnout as a symptom. With so much overlap in the factors that cause each, it’s a symbiotic relationship.

And then we have our friend, inefficacy. This one is a bit of a quagmire because it is a symptom of burnout, but it can also be an implication of said burnout, or even a cause. Mind blown yet? Inefficient. Inadequate. Incompetent. These words can be an enormous blow to a person’s ego. But when you are experiencing burnout, it can become challenging to be productive, successful, creative, or effective in your work or even your home life. When you are overworked and undervalued, it can lead to exhaustion and cynicism, which in turn, can render you ineffective. Vicious cycle, no?

OK, so what causes burnout? And why is it so prevalent in dentistry? The causes of burnout are vast and varied and include the perception of unfair treatment at work (including favoritism, bias, compensation, bullying by a coworker, etc), lack of managerial support, unclear expectations, and insufficient time to complete tasks. The current market finds many businesses, including dental offices, grossly understaffed. This leads to employees working more hours and picking up more slack throughout the day to ensure that all patients and team members are taken care of.

Then there are the causes unique to healthcare and dentistry specifically. Our patients are our only source of income, yet they are also one of our most significant stressors. They are often needy, anxious, difficult to work on, talkative, late for their appointment, and distracted by their phone - in short - energy vampires. We suffer from alarming rates of musculoskeletal pain as a result of our primary duties. Imposter syndrome is prevalent in our field as well. But perhaps the most interesting finding relates to perfectionism - a trait that is so prevalent among dental professionals and something we often take pride in; something that makes us really good at our jobs. I’ve often poked fun at myself for being “a little bit OCD” when it comes to my job as a dental hygienist. Every time I make the joke, my fellow dental professional will retort, “You’re in the right profession!” or something equally cliche. The truth is that I’m as “a little bit” OCD as my dentist boss is “a little bit” colorblind. The man basically doesn’t know what a rainbow is.

A study of three classes of graduating dentists from the University of Barcelona noted that 75% of the students presented with an obsessive-compulsive personality. In another study conducted by C. Lloyd and L.A. Musser, experts in the field of psychiatry, medical and dental students were observed for specific traits such as narcissism and obsessive-compulsive disorder. Their research identified dental students as being “more obsessive-compulsive in degree and number of symptoms, more codependent, 50% less likely to seek help” when compared to their medical student cohorts. The dental students were also found to be more competitive and isolating. Sounding familiar? Additionally, the study revealed that dental students exhibited a moderately higher number of symptoms of anxiety and depression and a considerably higher number of symptoms of obsessive-compulsive disorder and interpersonal sensitivity when compared to the general population. It should come as no surprise that these traits have been identified as making a person more vulnerable to burnout.

It’s clear that burnout is pervasive and that we are prone to it as dental professionals. Why does it matter, though? Can’t we just keep “watching” the problem like some dentists “watch” decay turn into those treatment? Remember those Deloitte and Gallup studies from earlier? Ninety-one percent of Deloitte participants said that their work quality is negatively impacted when they are under high levels of stress or frustration. The Gallup study revealed that employees who often suffer from burnout are 63% more likely to miss work and 23 percent more likely to end up in the emergency room. Here’s the kicker: Burned-out employees are 260 percent more likely to leave their jobs. Even if they stay, the level of care they provide is likely subpar, and their patients and teammates suffer as well. A teammate picking up the slack for a burned-out employee runs the risk of burning out as well. And so the cycle continues.

The good news (finally, right?) is that burnout can be prevented. There are things that a clinician can do for themselves to help make them resilient against burnout; then there are things that an organization can do to minimize the risks for their staff. Let’s start with ourselves. The aptly named “self-care” is buzzy. But in my experience, there’s usually good reason for buzz behind something (hello, Taylor Swift). Self-care can be as basic as good nutrition, exercise, sleep hygiene, and social connection or as “extra” as meditating, journaling, and enjoying nature. All these things help keep our physical and emotional energy, focus, and mood high and our anxiety, stress, and risk of burnout low. Outside of work, try not to involve yourself with tasks, people, and situations that aren’t necessary and that put you in a bad mood. Instead, take on more of those things that do the opposite. Make your time away from work as restful and rejuvenating as possible. Keep your mood tank full to meet the demands of your time at work.

When you’re at work, learn to set boundaries for yourself, and don’t be afraid to say “no” when it’s appropriate, to shield yourself from becoming overworked. Build positive, supportive relationships with your teammates. The power of going through something together is often overlooked. If you are feeling ineffective, seek professional development, reach out to a mentor, or volunteer. Of course, sometimes a clinician does all these things and still gets burned out because of the things that are out of their control.

If an office sees signs of burnout among the staff, they should ask themselves, “Are we supporting and listening to our team?” Employees are 70 percent less likely to burnout if they feel supported by their manager and 62 percent less likely if they agree that their manager is always willing to listen when it comes to work-related problems. Additionally, an employer can prevent burnout by setting clear expectations for their staff and providing feedback concerning job performance. Other factors are out of everyone’s control when it comes to dentistry. For instance, employees are 43 percent less likely to burn out when they have autonomy when deciding what tasks to do and when to do them. They are also 70 percent less likely if they feel they often or always have enough time to complete their work. The nature of our work dictates what we do and when each day. And the notion of having enough time for each of our patients is slipping further and further away. Another reason dental professionals are prone to burnout and another reason to pay close attention to the things we can control.

We’ll never see a 100 percent drop in burnout rates. The workplace is too unpredictable; our teams, full of extraordinary humans, are too human. Since patients don’t seem keen on a machine heading towards their mouths with sharp instruments, we’ll have to stay vigilant in protecting ourselves and our teams against burnout. We should also keep in mind that millennials in these studies were more likely to suffer from burnout than those in more seasoned generations and more likely to leave their jobs because of it. While I’m at it, I’ll add that millennials crave more feedback at work - only 17 percent of millennials surveyed felt that they receive “routine or meaningful” feedback from their manager. They are the future of our workforce, so we have to do better, or we’ll all burn out!

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References

Gallup, Inc. “Employee Burnout, Part 1: The 5 Main Causes.” Gallup.com, 12 July 2018, 

            www.gallup.com/workplace/237059/employee-burnout-part-main-causes.aspx. 

Gallup, Inc. “Employee Burnout, Part 2: What Managers Can Do.” Gallup.com, 16 July 

            2018, www.gallup.com/workplace/237119/employee-burnout-part-2- 

            managers.aspx.

Lloyd, C., and L. A. Musser. “Psychiatric Symptoms in Dental Students.” The Journal of 

            Nervous and Mental Disease, vol. 177, no. 2, 1 Feb. 1989, pp. 61–69, 

            pubmed.ncbi.nlm.nih.gov/2915217/, https://doi.org/10.1097/00005053-198902000-00001. 

Pendell, Ryan. “Millennials Are Burning Out.” Gallup.com, Gallup, 19 July 2018, 

            www.gallup.com/workplace/237377/millennials-burning.aspx.

Valcour, Monique. “4 Steps to Beating Burnout.” Harvard Business Review, 27 Aug. 2021, 

            hbr.org/2016/11/beating-burnout.

“Workplace Burnout Survey | Deloitte US.” Deloitte United States, 

            www2.deloitte.com/us/en/pages/about-deloitte/articles/burnout-survey.html.

“Depression: What Is Burnout?” www.ncbi.nlm.nih.gov, Institute for Quality and Efficiency in 

            Health Care (IQWiG), 18 June 2020, www.ncbi.nlm.nih.gov/books/NBK279286.