In dentistry, the moment we walk through the doors to our office, the next eight to nine hours are no longer about us. We prioritize patients by assessing, educating, and keeping them physically and emotionally comfortable to the best of our abilities. A lot of ourselves is shared with those who enter our operatory, and they share a lot of themselves with us. Becoming a shoulder to lean on, we share vacation stories, celebrate the news of a new pregnancy, and eventually tear up when we learn of the passing of a beloved patient.
Depending on the type of office, you may also see patients in different stages of life, such as the widow coming in for the first time without their partner or the three-year-old afraid of coming in for the first time. Or you might have the child with ADHD who is sharing their favorite video game scene as they go into the intricate details of how to strategically win a game you didn’t even know existed until that moment. All the while, you’re already ten minutes behind.
When I decided to apply to the dental hygiene program, I didn’t realize how much this profession would require of me. I wasn’t aware that I’d be a source of comfort, a cheerleader, a confidant, a teacher, and a best friend – all in one hour – in addition to being a clinician. Then add the office responsibilities themselves, and our days are easily filled with tasks and patient care from start to finish. On top of our work duties, we continue to work in our personal lives, but now it’s in the form of family care, whether that be parents, siblings, children, or pets. It all requires a piece of us throughout our days.
I’ve felt the give-and-take of this profession’s requirements – that complete depletion at the end of the day. I then go home only to continue with that proverbial tank now on fumes until my head hits the pillow, resting only my body, not my soul. It’s unsustainable and can lead to compassion fatigue and burnout.1
Compassion Fatigue and Burnout
Compassion fatigue often precedes burnout. It occurs when a healthcare provider is no longer able to feel empathy or bear the emotional burden of our patients, typically due to inadequate self-care that fails to refresh or refuel. Risk factors include excessive empathy and cumulative work-related stress, depression, anxiety, and anger.1 When unresolved, burnout may follow, which can be detrimental to ourselves and, in turn, lead to compromised patient care. Burnout can be dangerous not only for career longevity but also for our patients.1,2
Is burnout ever avoidable? Yes and no. It is something many of us will likely encounter at some point in our professional lives. For example, a study focusing on hygienists in California found that nearly one-third of the sample population had experienced burnout.2 However, the degree to which it impacts us can be in our control. It’s up to us individually to take care of our needs to sustain the long-term career satisfaction we desire to have. We need to be able to recognize burnout risk factors and indicators and take proactive steps to protect ourselves from them.
Initial indicators of burnout typically include physical and emotional exhaustion, which can lead to feelings of detachment or disengagement and to being overwhelmed by work demands. Negative feelings and perceptions about patients (depersonalization), our job performance (reduced personal accomplishments), and self-confidence may follow.2,3 It’s no shock that some of these indicators are very similar to symptoms of depression, as they can significantly impact our mental health.2,4
Feeling overwhelmed by work demands can lead to dreading workdays, which is also an indication of burnout.3,5 Risk factors from our work environment that can lead to burnout include:
- Work overload and time constraints: This includes having excessively accelerated patient schedules, shorter appointment times, or long working hours, leading to job demands that feel impossible to meet.
- Lack of support and appreciation: When we feel a lack of respect from the dentist, management, or team members, or feel that we are under-appreciated and not valued, it can create a negative work environment.1,2,5
- Production over patient care: An office culture that prioritizes production goals over the patient’s actual needs can create increased pressure and compromise our patient-centered commitment to care.1
- Operational issues: Insufficient staff, a poor work-life balance, a lack of leadership, and a lack of communication or support from management may lead to job dissatisfaction and eventual burnout.5
Extinguishing Burnout
The steps to extinguishing burnout likely look different for each of us because our situations and needs are not the same. However, the first step is recognizing it, and then identifying the key contributing factors. From there, it may require more than one approach that focuses on both personal restoration and work environment factors.
For example, if your key burnout factors stem from your work environment, communicating your concerns to the dentist, management, and/or the office manager, and advocating for change may be necessary. If no change is possible, it may be time to re-evaluate your fit at that office and look for a more supportive work environment. A supportive work environment includes positive attributes such as a collaborative relationship with the doctor, a shared patient-centered commitment to care, and the opportunity to practice to the full extent of your education and scope of practice in your state.5
In addition to work environment factors, it’s also imperative to take care of ourselves and find ways to cope that build us up. While the path to building up and restoring ourselves is unique, finding moments of restoration is just as important as our dedication to our patients. Prioritize self-care and set aside time for yourself and activities that restore you. Focusing on your own health, such as physical exercise, nutrition, and relaxation, is a preventive stress management strategy that can help increase self-esteem. In turn, positive self-esteem and knowing how to relax can help reduce emotional pressure, enabling better coping in stressful situations.2
Self-care further extends to seeking help when you need it. Don’t disregard burnout and the overlap between burnout and psychological stress. If symptoms of depression, anxiety, or severe stress are present, seek professional help for the appropriate diagnosis and management.3,4
In Closing
How do we fix burnout? That’s the catch – one answer can’t apply to everyone because our needs are unique. While likely similar, our professional goals are not the same, and someone else’s solution or resources may not apply to your situation. However, the recipe will have the same base, which is to first recognize and identify the key factors contributing to burnout. Once you’ve isolated them, you can determine which steps to take next. This won’t solve challenging days or challenging personalities, but it’s designed to help us find ways to protect and restore ourselves so we can keep showing up for our patients and ourselves.
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References
- Knutt, A., Boyd, L.D., Adams, J., Vineyard, J. Compassion Satisfaction, Compassion Fatigue, and Burnout among Dental Hygienists in the United States. J Dent Hyg. 2022; 96(1): 34-42. https://jdh.adha.org/content/96/1/34
- Bercasio, L.V., Rowe, D.J., Yansane, A.I. Factors Associated with Burnout among Dental Hygienists in California. J Dent Hyg. 2020; 94(6): 40-48. https://jdh.adha.org/content/94/6/40
- Llodra, E. How to Cope with Burnout as a Dentist. Journal of the Colorado Dental Association. 2022; 101(3): 17-18. https://cdaonline.org/news/latest-news/how-to-cope-with-burnout-as-a-dentist/
- Hopcraft, M.S., McGrath, R., Stormon, N., et al. Australian Dental Practitioners Experience of Burnout. J Public Health Dent. 2023; 83(4): 397-407. https://onlinelibrary.wiley.com/doi/10.1111/jphd.12594
- Patel, B.M., Boyd, L.D., Vineyard, J., LaSpina, L. Job Satisfaction, Burnout, and Intention to Leave among Dental Hygienists in Clinical Practice. J Dent Hyg. 2021; 95(2): 28-35. https://jdh.adha.org/content/95/2/28
