Feeling the Strain

The COVID-19 pandemic has brought its fair share of stress to the dental profession over the last two years. Throughout the pandemic, clinical psychologist Alex Hof has presented webinars and workshops to ADAWA members, advising on coping with the stresses and strains of COVID-19.

Practice Management

As Western Australia’s rate of community infection continues to rise, Alex is again on hand to offer advice and support to dental practitioners in the State. She notes that dentists are under particular financial pressure, as dentistry does not lend itself easily to telehealth. 

“One of the fundamental principles in psychology is that all of us find uncertainty challenging, even those of us that thrive on change,” Alex says. “The reality is, we all have our limits. 

“When you have uncertainty, when you feel like you have very little control over key aspects of your life, then your level of psychological distress is likely to escalate, not because you are weak but because you are human.”

Taking control

In uncertain situations, Alex suggests accomplishing small tasks.  

“If you’re good at playing the card game bridge, join an online group and play. If you’re good at making a particular meal, then make it.

“Try to think about little projects around the house that you can do and get a sense of achievement from getting things done. It might be weeding the rose garden, cleaning the pantry, painting the spare room. Take pride in what you have achieved, lean back, have a cup of tea and think ‘I did that’. It really helps get back that sense of being in control.

“Every time you turn on the radio or open a newspaper there is doom and gloom over COVID and this can get to you,” she adds. “So being consciously aware of those things you can do and can control is important.”

Go back to basics

“Try to get a bit of exercise in, even if it is just walking the dog,” she says. “Get out into nature once a week. Catch up with friends that make you laugh.”

Don’t judge your emotions

Be aware that individual stress signs can be physical, behavioural, cognitive or emotional. “It’s important not to judge your emotions and think you should be coping better. Some people may look like calm swans – but beneath the water you have no idea how much their legs are thrashing around,” Alex says. 

“It’s also important to recognise that a problem shared is a problem halved; it sounds simplistic, but it’s true. Talking with a friend, finding those people who are good listeners and having a chat can make such a difference.”

If you’re concerned about a colleague

It’s always best to say something rather than nothing. “A useful strategy is to comment on the difference you’ve noticed in them,” she says. “Don't jump to a conclusion but say something like, ‘Are you OK? You've been a bit quiet all morning,’ or ‘Are you OK? It’s not like you to snap at the reception staff.’ 

“Reflect to them what you have observed. There can be all sorts of reasons for a change in a person's behaviour. If they say everything is OK but your gut feeling is that it’s not, then you can say, ‘OK but I'm here if you need anything,’

“And if, in the following days, the person's behaviour continues to concern you, you can ask again, but gently, and again tell them what you have observed,” she adds. “And then just be available.”

Impact on the dental community

Chair of ADAWA Infection Control Committee, Dr Peter Duke, says the professional and personal lives of dentists have been significantly reshaped during this rapidly changing and challenging time.

“Working conditions, financial pressures as well as altered interactions with patients and colleagues caused by the pandemic have directly affected the mental health of many dentists and their team members,” he says.

“Due to the chronic duration and widespread repercussions of the COVID-19 pandemic, COVID-19 stress and burnout has put additional pressure on everyone in the community, including the dental community.

“As dental professionals we recognise the importance of mental health and wellbeing for our patients. However, we may not always recognise or prioritise our own mental health needs. 

“Research has shown that even in pre COVID-19 times, occupational stress was common amongst the dental profession and was a key driver of burnout and mental ill health. These problems can affect individuals at any stage of their career. There has traditionally been a reluctance amongst the dental profession to speak about personal problems, including mental ill health, and seek support. This can be driven by concerns about confidentiality, embarrassment, and the impact of health disclosures for professional registration.”

Self-care Toolbox

(Reprinted from ‘Breaking down the barriers’ in the July 2019 edition of the Western Articulator)

Executive director of the Samaritans, Zrinka Highfield, believes that dentists – just like other members of the community – should prioritise self-care, building resilience and seeking help when you are struggling.

1. Be kind to yourself. 

Practice self-compassion. In life there are things we can’t change but many things we can change. Beating yourself up over things, especially those you can’t change, will just make you feel worse. It is not your fault you are feeling this way.

2. Be mindful.

Being present in the moment can help you become aware and manage overwhelming thoughts and feelings.

3. Do something you enjoy. 

Have some “me” time. It can be as simple as listening to your favourite music, going for a walk or seeing a movie. We live in a world that seems to value long working hours and everything else that comes with it. We hardly have time to enjoy life, connect with friends/family and do things that bring us joy. Put aside some time every week to do something you enjoy. Rebalance the scales in favour of your own wellbeing.

4. Try not to judge your emotions. 

There is no right or wrong in emotions – it’s ok to feel what you are feeling in this moment. Aim to move toward accepting the presence of your emotions.

5. Avoid unhealthy habits. 

Try not to rely on smoking, drinking and caffeine to help you cope. Men are more prone to this behaviour than women. It’s only a temporary crutch that can make you feel worse long-term and won’t solve your problem.

6. Remember that you are never alone. 

You don’t have to suffer in silence. Talking to a friend/family member can help you feel listened to and supported. By acknowledging your feelings out loud can help. Maybe you would rather talk to someone anonymously and in that case, you can reach out to a helpline.

7. Seek help. 

Sometimes you may need that extra bit of help and that is ok. Your GP can be a great source of help.

More information

There is COVID-19 specific support advice for healthcare workers. beyondblue.org.au/impacts-on-my-work/Essential-services/on-the-frontline-how-healthcare-workers-can-support-themselves-and-each-other 

Dental Practitioner Support: dpsupport.org.au/workplace/burnoutthinkmentalhealthwa.com.au/mental-health-and-covid-19/

This UK resource also offers good advice: supportfordentalteams.org

Black Dog Institute’s The Essential Network for Health Professionals (TEN) blackdoginstitute.org.au/the-essential-network/

More than half of dentists say stress is affecting their practice. Br Dent J. 2019; 226: 7. https://doi.org/10.1038/sj.bdj.2019.18 

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