I want to start by applauding dentistry. In the span of less than three years, the dental field has made an intentional effort to start the conversation on the importance of mental health in dentistry. I am finally seeing articles and research studies showing the reality of stress, burnout, and just the lack of general mental well-being in the dental field. We even have societies, groups, organizations etc. providing lectures, courses, and support groups specifically targeting the mental health of dentists. As I’m sure most of you know by now, the American Dental Association started their Wellness Committee and Program in 2022, and since, many state dental organizations have followed suit (although it is important to note that they are not affiliated with or supported by the ADA Wellness Program). I might even venture to say that some (even if just a tiny bit) of the stigma around mental health or the lack thereof has softened. We are starting to acknowledge that dentists aren’t perfect, and even more importantly, we don’t want to be. Dentistry has finally started to jump on the mental health bandwagon, and personally, I think that’s exciting!

Dr. Noelle Schwarz gives new ways to look at your mental health journey.
Figure 1: Dr. Noelle Schwarz gives new ways to look at your mental health journey.

Mental Health Resources for Dentists

There are also things happening behind the scenes. For example, the California Dental Association has a wellness program that includes five phone numbers you can call for confidential 24/7 support. Those numbers connect you directly to a fellow dentist who is volunteering their time because they genuinely care. These five callers are dedicated to finding the caller the help he or she needs. Consider the tremendous level of care these dentists must have had to sign up for such an intensive volunteer job when there are over 31,000 dentists in California1. I know that one of my local dental societies has started a small support group for dentists that meets once a month. I can only imagine how much more dentists are doing to support one another that I don’t know about.

Many more mental health resources are available now than before.
Figure 2: Many more mental health resources are available now than before.

The Mental Health Journey

At this point, mid 2023, I would like to take a moment to take a step back, examine what we have, and consider what we need to move forward. I want to note that nothing I write in this article is an exhaustive list. There are so many fantastic minds in this field with so many incredible ideas, and for that I am grateful. There will undoubtedly be so much they can add to this topic. From the articles I have read in Spear Digest alone, we know dentists experience high stress levels and we have a comprehensive list of the primary causes of stress and anxiety in dentistry2,3. We know the importance of mental wellness in dentistry i.e., “Why it Matters”4. And we’ve been given great lists of stress management and self-care techniques2,3,4.

The goal then is to do that list of stress management, self-care so we have good mental well-being. So, have you meditated today? Worked out? Done yoga? Are you on one of the specific but countless healthy diets? Did you write in your gratitude journal this morning or last night? No? Why not? While we might not be consciously thinking about it in this way, my guess is that most of us would agree with Dr. Pooja Lakshmin, “If you think of self-care as a goal, it becomes another task to check off the list.” I do not know about you, but my list is long enough, and there isn’t enough time in the day as it is. I physically can’t add another activity no matter how “healthy” it may be.

 

Self-Care in Setting Boundaries

Lakshmin, the author of Real Self-Care5, talks about the fact that we don’t need “self-care”, we need boundaries. Those lists of self-care and stress management techniques that we find everywhere are in truth just Band-Aids. Lakshmin argues that when caregivers are not being taken care of by the system, it is the system that’s broken – not the caregiver, and real wellness comes from demanding change from the systems5. Our “system” is the perfectionist culture of dentistry, dental schools, dental organizations, etc., the constant grind and hustle that we’ve normalized, the inevitable burnout that starts in dental school before we are even licensed dentists. We as dentists have created and maintained the system that is breaking us, and if we continue to engage in this culture of perfectionism, shaming (ourselves and each-other), and refusing to set boundaries, we are perpetuating the system that destroys our wellness.

A new way to think about self-care.
Figure 3: A new way to think about self-care.

How do we change a system with such an ingrained culture as ours? We stop following and engaging in it. We stop competing. We stop berating and blaming ourselves. We fully internalize that not only is it ok to not be perfect, but also, perfectionism in humans does not exist. We will never be perfect, and our dentistry will never be perfect either. We remember that we are humans first and dentists second. We recognize that dentistry is a job/career. It is how we make money. Yes, we may be passionate about it. We may love every aspect of it. But at the end of the day, dentistry is not our identity. We will all retire someday, and then, who are we? What are you interested in besides dentistry? What makes you, you? Do you know what your values are? Truly, I encourage you to sit down and write out your top five values in life. Self-care is knowing your values and making decisions that are in line with those values. It is setting boundaries based on those values. Living a life in line with our values, which is what leads to mental well-being.

Going against the system is not easy, but it also doesn’t have to be a grand gesture of protest. It is one tiny decision at a time to choose yourself and YOUR values over the values of this system, this culture that we have created. Mental health in dentistry isn’t a problem to solve, and mental well-being isn’t a goal. It is our precious inner beings that we must cherish and protect. It is self-compassion and self-love. And it all starts with knowing your values and setting your boundaries.


Noelle Schwarz, D.D.S., AMFT, APCC (Supervised by Christina Weiss, LMFT (Lic. 100485)) is a dentist turned psychotherapist at Weiss Psychological Center in California.

https://weisspsychologicalcenter.com

https://www.drnoelleschwarz.com

 

References:

  1. NIH. 2019. Active dentists, by state: United States, selected years 2001–2019. Health, United States. [online] https://nih.gov. Available at: https://www.ncbi.nlm.nih.gov/books/NBK569311/table/ch3.tab42/
  2. Bloom, C. 2022. Stress and dentistry: How to reduce and manage stress. [online] https://speareducation.com. Available at: https://www.speareducation.com/spear-review/2022/10/stress-and-dentistry-how-to-reduce-manage-stress
  3. Mendelson, M. 2021. Mental self-care: A path to finding peace in your practice. [online] https://speareducation.com. Available at: https://www.speareducation.com/spear-review/2021/04/mental-self-care-a-path-to-finding-peace-in-your-practice
  4. Wright, A. 2021. Checking in on your mental health: Why it matters now more than ever. [online] https://speareducation.com. Available at: https://www.speareducation.com/spear-review/2021/06/checking-in-on-your-mental-health
  5. Lakshmin, P. 2023. Real self-care: A transformative program for redefining wellness (crystals, cleanses, and bubble baths not included). Penguin Life.

 


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