Mental Health in Dentistry

Following mental health awareness week, I teamed up with ‘@Dentistsofinsta’ and www.carioustees.com to discuss some of the current issues in dentistry and their possible impact on the mental health of the profession.

Having lost a childhood friend to suicide 3 years ago, mental health is something which I spend a lot of time considering and I find it both upsetting and frustrating that so many people are suffering in silence, without seeking help, or without feeling as though there is a light at the end of the tunnel.

Why is this the case in Dentistry?

In a world more connected than ever before, why do we feel as though we need to fight these battles alone? With medicine the most advanced it has been, at times I feel desperate for a miracle cure for those suffering. In my opinion, mental health conditions (any level of severity) are illnesses as much as any other and we should be appropriately empathetic, sympathetic and supportive to those struggling.

For a long time, I have been a firm believer that social media is a very dangerous tool. Whilst it is a fantastic platform for connecting people, for business and for creativity, it can be toxic.

It is rare I see a dental professional post about where something has gone wrong. Even rarer I see someone with a high public profile post these things, even though it certainly happens - it happens to all of us.

Personally, I understand why this is the case. The internet is for everyone to see. The media, patients, colleagues and yes, the GDC. Although posting pictures publicly of things that haven’t quite gone to plan, such as a perforation during endodontic treatment, may reassure other dental colleagues that these things ‘happen to everyone’ and ‘no-one is perfect’, it could equally cause problems of a different kind.

Headlines such as ‘PATIENT LEAVES DENTIST WITH TOOTH RIPPED OUT FOLLOWING NEEDLE TEARING THROUGH TOOTH’ and the like, could soon be gracing the covers of our newspapers and patients could easily see these common complications (not necessarily negligence/errors) of treatment as a reason to avoid seeking appropriate dental care. After all, who would choose to see a dentist who was advertising their failures more than their triumphs?

Striking a Balance With Social Media

In general, (and I think this is probably a shared opinion of many), social media platforms such as Instagram and Facebook are highlight reels of our life. We post when we are having a good time, we post when we look and feel good, we post when we are with friends or family. There are some accounts that strive to be ‘real’ and post the downs as well as the ups in life.

However, in general we only see the best, and it can be almost impossible to not compare ourselves to others whether that be their achievements, financial success, material belongings, relationships or lifestyle.

What Does The Evidence Say?

In 2004, the World Health Organisation (WHO) estimated that up to 50% of people with severe mental health problems in developed countries such as the UK receive no treatment. Shockingly 43.3% of adults think they have had a diagnosable mental health condition at some point in their life, with 51.2% of these being women.

The AMPS (2014) showed that a fifth of adults had thought of taking their own life at some point in their lives, with a higher rate of 22.4% women compared to 18.7% of men. These statistics came as a surprise to me, not just the number of adults suffering, but the number not seeking help.

I am very fortunate that I was raised in an environment where it was normal, in fact, I was encouraged, to talk about my feelings and share any concerns I had. It is something which my family and I joke about now, as I do tend to overshare and ‘babble’ on! However, not everyone was or is in the same position as me and opening up about distressing feelings isn’t easy for everyone.

Take Time For Yourself

As healthcare professionals we spend our days concerning ourselves with the health and wellbeing of others. We work through lunch to get someone we have never met before out of discomfort or pain. We stay late to check our labwork for the day ahead to be sure appointments run smoothly, not just for us, but for our patients. We invest in courses, to become the best possible communicators, clinicians, artists, that we can be.

But in all of this, where do we ensure we are taking care of, or at least being aware of, our own discomfort? We may consider investing in our dentistry is an investment in ourselves, but how often do we invest TIME in ourselves. TIME to relax, TIME to breathe, TIME to do things we truly enjoy without feeling guilty?

Social Media - Two Sides Of The Coin

I recently attended a conference, at which myself and a colleague were discussing the concept of ‘course addiction’. Every time I attend a course I feel inspired. I feel like I’ve improved as a dentist, even if I’ve been sat in a chair all day and haven’t laid eyes on a patient. I talk to inspiring people, I consume copious amounts of caffeine and I leave on a high, wondering what or when the next course I attend will be.

In the past, courses were to improve specifically on areas where we felt we were lacking. In my opinion, partly due to social media, courses have almost become a status symbol.

Through social media we see certain courses and training academies over and over again, and I can’t be the only one who gets a feeling of FOMO? (For those who aren’t aware, FOMO is a ‘fear of missing out’, often experienced by dental students revising for exams as their non-dental house mates go out clubbing having finished term…).

It is so easy to feel as though you aren’t doing enough, are falling behind, or somehow don’t know the ‘secret’ that everyone else does, by attending a particular course or study day that has become popular.

We need to understand that we can’t do everything. We can’t please everyone. We can’t be the best at everything. In my opinion the key is to avoid comparison, carve your own path, your own way.

Wise Words - Probably From a Dentist...

I wish I could remember who said to me that; ‘to worry only means to suffer twice’. I try extremely hard to implement this in my day to day life. With an increasingly litigious society, many dentists spend their days feeling as though they are walking on egg shells.

The recently published 2018 NHS confidence monitor by Practice Plan revealed that out of 86% of NHS dentists who said they did not see themselves as an NHS dentist in 5 years, 24% of these were planning a career change.3 Out of the same cohort of NHS dentists, only 9% felt happy they were able to carry out their work without feeling overly stressed (81% were either unhappy or very unhappy).

Having sat on the Young Dentist Insights Panel to discuss these results, there seemed to be a consensus amongst us that we believe dentists often have a persistent, underlying anxiety that they will be sued, investigated or struck off, without doing anything negligent or perhaps even anything wrong at all.

We need to support each other, ask how our colleagues are. Groups such as Dentinal Tubules (www.dentinaltubules.com) form a great support network to discuss concerns (either personal or practical) and having a group of like-minded peers to run things by can really help alleviate some of our stresses.

Where Does The Dental Community Go From Here?

Whilst I don’t think I hold the answers to everything, I truly believe that by working together to support, encourage and lift each other, posting on social media with some attention to what we are saying and the message we are giving, investing time in ourselves and doing the things we love whilst enjoying the journey (which is not a race!), we can help each other move in the right direction towards a happier, healthier mindset and life.

There are some wonderful mental health charities currently working to improve access to mental health services and to reduce the stigma associated with mental health conditions.

I have listed below some useful numbers and contacts for anyone struggling, if you are having a difficult time, PLEASE speak to someone, and PLEASE reach out.

Childline 0800 1111 Mind 0300 123 3393 www.mind.org

Nightline (night-time listening service run by students for students), details available from your student union Samaritans 116123 Email Jo@samaritans.org

Anorexia and Bulimia Care 03000 11 12 13

Campaign against living miserably (CALM) for men, 0800 58 58 58, 5pm to midnight every day

Maytree, A sanctuary for the suicidal 020 7263 7070 (North London)

Papyrus prevention of young suicide 0800 068 41

USA National suicide prevention hotline 1-800-273-8255

1 – Demyttenaere et al, 2004. Prevalence, severity and unmet need for treatment of mental health disorders in the World Health Organization World Mental Health Surveys. JAMA. 292(21). 2581-2590

2 – McManus et al, 2016. Suicidal thoughts, suicide attempts, and self-harm. In S. McManus, P. Bebbington, R. Jenkins & T. Brugha (Eds.), Mental health and wellbeing in England: Adult Psychiatric Morbidity Survey 2014. Leeds: NHS Digital.

3 – 2018 NHS Confidence Monitor Survey, Practice Plan. Available at www.nhsdentistryinsights.co.uk