Mental Health in Dentistry: How Your Mindset Can Impact Your Clinical Performance

Experiencing difficult emotions, such as sadness, anxiety, or stress, is a natural part of the human experience. Mental health can and will affect your clinical performance. 

No one could have predicted the global shutdown of our profession in 2020. It had so many deleterious effects, yet there were bright spots. For one, it allowed us as a profession to shed light on the stigma of mental health in dentistry. Our lives are usually complex and full of challenges, and it is understandable to feel overwhelmed or struggle to cope. 

The Mind / Body Connection

A healthy mind is just as important as a healthy body. Learning how to safeguard our mental health is as vital as learning clinical dentistry.

Why? Because when it comes to the mind-body connection and our physical ability to provide excellent dentistry, dualism does not exist. We can no longer ignore the mind-body connection for ourselves, our patients, our team, and our family. 

Research studies suggest poor mental health, including anxiety, depression, and burnout, is higher among dentists than in the general population. According to a systematic review published in the Journal of Occupational Health in 2018, the prevalence of common mental disorders among dentists ranged from 7% to 65%, with an average of 31%. Another study published in the Journal of the American Dental Association in 2020 found that 59.5% of dentists reported experiencing burnout symptoms. 

The nature of our dental profession, including high practice demands, long working hours, patient expectations, and financial pressures, can contribute to the increased risk of poor mental health among us. Dentists may also experience unique stressors such as musculoskeletal pain, exposure to infectious diseases, and legal and ethical challenges. 

Acknowledging and accepting difficult emotions is an essential part of healing and recovery. It can help us recognize when we need support, reach out for help, and take steps to improve our mental health and well-being. It can also help to reduce the stigma and shame associated with mental health challenges, making it easier for us in dentistry to seek help without fear of judgment or discrimination. 

Mental Health in Dentistry

How are the mind and body connected in providing excellent dentistry?

Research has shown that a negative mindset can affect the visual cortex, the part of the brain that processes visual information. A negative attitude can lead to "emotional gating," suppressing sensory information irrelevant to one's emotional state. 

In other words, when someone is in a negative mindset, their brain may filter out information that contradicts their negative emotions, which can lead to a distorted perception of reality. For example, someone in a negative mindset may be more likely to perceive neutral facial expressions as harmful or threatening. 

A negative mindset can also affect attentional control, which is the ability to focus and direct attention. Negative emotions can impair attentional control, making it more challenging to concentrate and process information. 

So how does a negative mindset impact a dentist's ability to provide high-quality care?

1. Reduced Attention and Focus: Negative emotions can reduce a dentist's attention and focus, leading to mistakes and errors in diagnosis and treatment planning. The dentist may more likely overlook critical details and only partially consider all treatment options. 

2. Decreased Empathy: A negative mindset can reduce a dentist's empathy and compassion for patients, making it more difficult to establish rapport and build trust. Patients may feel less comfortable asking questions or expressing concerns, leading to a breakdown in communication. 

3. Decreased Motivation: Negative emotions can reduce a dentist's motivation and enthusiasm for their work, leading to decreased productivity and poorer quality of care. The dentist may be more likely to rush through procedures or cut corners to get through the day. 

4. Increased Stress: A negative mindset can increase a dentist's stress levels, leading to burnout and decreased job satisfaction. Burnout can lead to reduced engagement and an increased risk of making mistakes. 

A negative mindset can lead to decreased quality of care, decreased patient satisfaction, and reduced job satisfaction. Dentists must prioritize their emotional well-being and seek support if they struggle with negative emotions affecting their ability to provide high-quality care. This may include self-care strategies, seeking professional help, or changing our practice environment or schedule. 

Mental Health Beyond Dentistry

We are not alone; this negativity–clinical connection is not solely reserved for dentists.

A study conducted by Manzini, Vosgerau, and Unnava in 2019 explored the impact of sweet treats (specifically candy) on anchoring bias in medical doctors. 

Anchoring bias is a cognitive bias that occurs when people rely too heavily on the first piece of information they receive when making decisions. In medical decision-making, anchoring bias can lead to diagnostic errors and inappropriate treatments. 

The study involved seventy-three medical doctors from various specialties who were asked to estimate a patient's weight based on a hypothetical scenario. The doctors were randomly assigned to one of three conditions: a candy condition, a control condition, or a no-information condition. 

The doctors received a small packet of candy before making their weight estimate in the candy condition. In the control condition, the doctors received a small box of nuts before making their estimate, and in the no-information condition, the doctors did not receive any additional information. 

The study results showed that the doctors in the candy condition were less susceptible to anchoring bias than those in the control and no-information conditions. The doctors who received candy made more accurate weight estimates than those in the other two conditions. 

The study's authors suggest that the sweet taste of candy may activate a reward system in the brain, leading to a more positive mood and reducing the impact of negative biases such as anchoring. Additionally, receiving a small gift (such as candy) may increase feelings of reciprocity, leading to more careful and thoughtful decision-making. 

The study suggests that small gestures, such as giving medical doctors candy before making decisions, may help reduce cognitive biases and improve decision-making in the medical field. 

So yes, negativity can influence our ability to provide excellent dentistry. However, I am not suggesting that we navigate our day by denying these emotions and always trying to be positive; that is something called toxic positivity.

Toxic Positivity​

Toxic positivity is the concept of overemphasizing or overvaluing positive emotions and experiences to the point of dismissing or invalidating difficult or negative emotions. It involves focusing on positivity at all costs and believing that individuals should always maintain a positive attitude, regardless of their circumstances. 

While positivity can be beneficial in many ways, toxic positivity can negatively affect an individual's mental health and well-being. It can create pressure to hide or suppress difficult emotions, leading to feelings of shame or guilt for not being able to "think positive." It can also make it difficult for individuals to seek support or express their genuine emotions, as they may fear being judged or invalidated. 

Examples of toxic positivity include statements like "just think positive" or "good vibes only." While these statements may be well-intentioned, they can minimize the complexity of an individual's emotions and experiences and may not offer the support and empathy that the individual needs. 

Managing Negative Emotions

It is essential to recognize that difficult emotions are a natural and normal part of the human experience and that feeling sad, anxious, or overwhelmed is sometimes okay. By acknowledging and accepting these emotions and seeking support from loved ones or professionals when needed, dentists can improve their mental health and well-being healthily and sustainably. 

Happiness is a comparative emotion; we can only know happiness by knowing sadness because the two are intertwined and interconnected. Happiness and sadness are opposite emotions in a spectrum of human experience. Without the knowledge of sadness, happiness may not be fully appreciated or understood. 

Sadness and other negative emotions allow individuals to develop a sense of resilience and coping skills to deal with difficult experiences. These experiences can also provide perspective and appreciation for happier moments in life. 

Additionally, happiness and sadness are not mutually exclusive emotions; they often coexist and are interdependent. For example, experiencing sadness can lead to seeking happiness, and sharing happiness can make coping easier when it arises. 

Furthermore, the experience of sadness can also lead to personal growth and self-reflection. By experiencing and processing difficult emotions, dentists can better understand themselves and their needs, improving mental health and well-being. 

Prioritizing Your Mental Health

Prioritize your mental health and seek support when needed. Effective strategies include self-care, mindfulness, seeking professional counseling or therapy, and building a supportive professional network. 

There exists an undeniable impact of a negative mindset on our ability to provide high-quality care, including decreased attention and focus, reduced empathy, decreased motivation, and increased stress levels. It is important to prioritize your emotional well-being to combat these factors.

Mental health in dentistry is real. You are not alone. It is OK not to be OK; we are here to support you.

Martin Mendelson, D.D.S., C.P.C., E.L.I.-M.P., is a member of Spear Resident Faculty.