[Study stress, burnout and physical complaints among dental students]. / Studiestress, burn-out en lichamelijke klachten bij tandheelkundestudenten.

The study of dentistry is known to cause high levels of psychological stress and physical strain. The aim of the present study was to determine the degree to which dental students experience study stress, burnout and physical complaints. The study showed female students experience higher levels of study stress, on average, than male students. Students' mean level of emotional exhaustion was 'high'. In addition, 90% of the students had suffered from physical complaints in the year preceding the survey. A strong correlation was shown to exist between physical complaints and emotional exhaustion, and in addition, a strong wish for more (pre)clinical teacher support correlated with study stress, burnout and physical complaints. It can be concluded that dental students, on average, experience the study as taxing, feel emotionally exhausted and suffer from many physical complaints. In the dental practice, they will be confronted with many taxing factors. In the dental curriculum, therefore, adequate and frequent attention should be given to learning to cope with stressful situations and to maintain physical well-being.

[Burnout and work stress]. / Burn-out en werkdruk bij tandartsen.

Work stress and burnout among Dutch dentists have been studied in the past; since then, however, considerable changes have taken place in practicing dentistry. The aim of this study was to investigate whether these changes are reflected in reported burnout and stress. Also, the study sought to investigate whether burnout could be associated with making mistakes during treatment or being confronted with a formal complaint. 500 Dutch dentists were randomly selected for an online survey, 105 of whom responded (21%); 50.5% male and 49.5% female. Higher mean scores on emotional exhaustion (EE) and personal accomplishment (PA) were reported, compared to previous results, and to reference scores from the burnout measuring manual, and lower mean scores on depersonalisation (DP) compared to reference scores. No gender differences were found for burnout. Women reported more work stress on Patient Contacts and Considerations about work. The 36 to 45-year-old age group reported higher mean scores on burnout and work stress. Having been confronted with patient complaints was associated with higher scores on DP, while worrying about making mistakes was associated with higher scores on EE and DP. Burnout is a relevant topic for dentists, which appears to be most prominent at middle age. Recognising, and knowing how to deal with, demanding aspects of work is a crucial means to prevent burnout.

[Series: Education and the dentist in 2025. Harmonisation of dental curricula in a European and Dutch perspective]. / Serie: Onderwijs en de tandarts anno 2025. Harmonisatie van de opleidingen tandheelkunde in Europees en Nederlands perspectief.

Coinciding with an increasing tendency of professionals to cross national borders, there is also an increasing need to harmonise curricula. In dentistry in Europe, this tendency is undiminished. By defining international curriculum requirements for dentists, international harmonisation can be strengthened. In the Netherlands, too, harmonisation with European standards has taken place in establishing final achievement levels for dentistry curricula, as defined in a national framework. In a working environment where oral health professionals are confronted with rapid change, for example, in the division of responsibilities, future caregivers should have an optimal educational preparation for their competences, skills and expertise.

[Dentists' judgement of the complaint procedure of the Royal Dutch Dental Association]. / De KNMT-klachtenregeling beoordeeld door tandartsen.

In 2013, to evaluate the functioning of the complaint procedure of the Royal Dutch Dental Association (KNMT), an anonymous, written survey was conducted among 955 dentists and dental specialists, for whom in the period mid-2008 to mid-2013 a complaint was handled. 413 (43%) participated in the study. 51% of them reported that the complaint was successfully mediated by the Regional Mediation Boards and the Specialist Mediation Board and 17% that the patient had withdrawn the complaint. For the remaining 32% the complaint was handled by the Central Complaint Committee, who determined that 13% was (partially) substantiated, 17% was not substantiated and 2% was settled. Generally, 79% of the dentists are (mostly) positive about the procedure of mediation, while 8% are neutral and 13% are dissatisfied about it. With regard to the complaints procedure this was 60%, 11% and 29% respectively. The judgment of the dentists about the Regional Mediation Boards and the Specialist Mediation Board and about the Central Complaints Committee is influenced by the success of the complaints procedure and by the impact of the complaint that was experienced. The emotional support of dentists during the complaints trajectory is one of the points requiring attention.

Dental practitioners and a digital future: an initial exploration of barriers and incentives to adopting digital technologies.

BACKGROUND: Digital technologies are proliferating into dental practices. While their technical attributes have often been studied, it remains unclear why some dentists adopt and use these technologies more than others. AIM To explore the incentives for and barriers against accepting and using digital dental technologies. METHOD: Eleven semi-structured qualitative interviews were conducted with experts in dentistry, dental technology and dental education in the Netherlands. RESULTS: Dentists' acceptance and use of digital technologies are to varying degrees driven by the perceived advantages over analogue methods, perceived influence on treatment quality, dentists' personal and professional orientation, and social influence from peers and external groups. These effects are complemented by personal and dental-practice characteristics. CONCLUSIONS: The findings suggest that there are large differences in motivation to adopt and use digital technologies between early adopters, late adopters and non-adopters, which should be examined in greater detail. We recommend that educators, dentists, and representatives of the dental industry who deal with the diffusion of these technologies take account of dentists' widely different attitudes to digitalisation.

Improvement in patients with a TMD-pain report. A 6-month follow-up study.

UNLABELLED: Even though chronic TMD pain tends to persist in most patients, some chronic patients show improvement. It is largely unknown which factors contribute to the improvement of chronic pain. The aim of this study is to investigate which factors, from a biopsychosocial perspective, help to predict improvement in patients with a report of TMD pain. METHODS: Subjects with a report of TMD pain were recruited in seven TMD clinics. They received a baseline questionnaire which included a wide range of possible predictors for improvement. After 6 months they received a follow-up questionnaire which included a measure to determine which participants were 'improved' or 'not improved'. To study which predictive variables were associated with improvement, multiple regression models were built. RESULTS: From the 129 patients who responded to the baseline questionnaire, 100 patients also filled in the follow-up questionnaire (85% women, mean age (years) ± s.d. = 46·0 ± 13·8). Fifty percentage of these subjects had improved at the 6-month follow-up. Pain duration was the strongest (negative) predictor for 6-month improvement (P = 0·009). Also the number of care providers (P = 0·017) and the degree of hindrance on function (P = 0·045) helped to predict improvement. CONCLUSIONS: The duration of the TMD-pain complaint, the number of care practitioners attended and the degree of hindrance on function (negatively) helped to predict 6-month improvement. No evidence is found to support the role of psychological or social factors on the improvement in patients with a report of TMD pain.

[Professional behaviour in dental education]. / Professioneel gedrag in het tandheelkundeonderwijs.

The professional behaviour of future dentists is an important topic in dental curricula. Aspects of professional behaviour are, among other things: being respectful to patients, putting the interest of the patients first, reliability, integrity, and knowing one's professional limitations and acting according to them when treating patients. Throughout the curriculum students receive feedback on their functioning with regard to professional behaviour and are also examined on those points. At the programme at the Academic Centre for Dentistry Amsterdam, experience has been gained in recent years in addressing and evaluating (un)professional behaviour among students.

Low burnout risk and high engagement levels among oral and maxillofacial surgeons.

Little is known about the well-being of oral and maxillofacial surgeons. The aim of this study was to measure the levels of burnout risk and the demanding work aspects of Dutch oral and maxillofacial surgeons, as well as the levels of positive work engagement and stimulating aspects of the work environment. The Maslach Burnout Inventory, Dutch version (UBOS), and inventories on positive engagement, work demands, and stimulating aspects of work, were sent to all 179 Dutch oral and maxillofacial surgeons currently in clinical practices. With a 70% response, UBOS mean scores on Emotional Exhaustion and Depersonalization appeared lower, and on Personal Accomplishment appeared higher, when compared with relevant reference scores. Engagement scores appeared to be relatively high. Mean scores on the work demands subscales were all well below the scale midpoint, whereas work resources were all well above. Dutch oral and maxillofacial surgeons showed relatively favorable burnout and engagement levels. The aspects of the work environment that best explain differences in burnout are 'Practice demands and organization' and 'Lack of variation and perspective in work'. Differences in engagement are best explained by 'Variety in work' and 'Positive effect upon patients'. It is remarkable that all work demands show relatively low levels and all stimulating work aspects show relatively high levels.

[Burn-out and engagement among oral surgeons]. / Burn-out en bevlogenheid bij kaakchirurgen.

The aim of this study was to measure Dutch oral surgeons' levels of burn-out risk and the contributing role of demanding working conditions. In addition, the extent of work engagement was considered, and which stimulating working conditions contributed to it. All 179 Dutch oral surgeons registered in the Dutch Dental Association's files received a questionnaire by means of which burn-out, work engagement and both demanding and stimulating aspects from the work environment could be measured. Based upon a 70% response, it can be concluded that Dutch oral surgeons have a relatively low risk of burn-out and a high degree of engagement. Demanding working conditions which explain the differences in the risk of burn-out are: 'Pressure of work and clinic organization', and 'Lack of variation and perspective in work'. Differences in enthusiasm were best explained by 'Variety in work', and 'Positive effect upon patients'. It is remarkable that the mean for all demanding aspects of work is relatively low and the mean for all stimulating aspects is relatively high.

[Aging and oral health care in The Netherlands. An explorative study]. / Vergrijzing en mondzorg in Nederland. Een verkenning.

In order to investigate which initiatives are being taken in The Netherlands to anticipate a change in oral health care demands as a result of ageing, 9 experts in the field of oral health care for the elderly were interviewed. The experts were selected because of their varied expertise and involvement in geriatric dentistry. Those interviewed were unanimous in the opinion that the demand for oral health care among the elderly will increase in the years to come. National initiatives to improve oral health care for the elderly appear to be limited. This situation can be changed by getting professional homecare more involved in oral health care for the elderly, and by regular dental checkups, stimulated by more actively operating general dental practitioners. For those in homes for the elderly and nursing homes, there appears to be no national policy with regard to oral health care. Several initiatives have been undertaken to improve dental health care, but those differ from institution to institution. According to the interviewed experts, financing, government prioritization, and health care laws are major bottlenecks on the road to the improvement of oral health care for the elderly.

[Discussing and evaluating professional behaviour. 2. Amsterdam Dental School]. / Bespreken en beoordelen van professioneel gedrag. 2 Academisch Centrum Tandheelkunde Amsterdam.

Since the introduction of the bachelor-master structure five years ago at the Amsterdam Dental School, the evaluation and assessment of professional behaviour has been an examination subject in the bachelor programme. Professional behaviour is understood to be the student's observable behaviour in the educational setting, as distinguished from someone's inner beliefs or convictions. The core of this element in the curriculum is the feedback which the student regularly receives from several teachers concerning their behavior, given whatis expected from a medical professional. The programme's requirement is that a third year student demonstrably has sufficient satisfactory evaluations to earn the necessary study credits.

Using the Maslach Burnout Inventory among dentists: burnout measurement and trends.

OBJECTIVES: To extend our knowledge about the applicability of the Maslach Burnout Inventory (MBI) among dentists and to investigate trends in burnout risk among dental professionals. METHODS: The structure of the MBI is examined among two independent, representative samples of dentists (n = 493 and 497, respectively). Moreover, results are compared to those of other independently-practicing health professionals (i.e., general practitioners and physiotherapists). In addition, the percentage of dentists that are at risk for burnout are compared in samples from 1997, 2000, and 2001. RESULTS: Correlations between the Emotional Exhaustion and Depersonalization subscales among dentists were higher than those found elsewhere. Additionally, a considerable increase in burnout risk was found since 1997. CONCLUSIONS: It was confirmed that the MBI can be considered a suitable instrument for use among dentists. It is argued that certain specific aspects of entrepreneur-like occupations are reflected in deviating responses to the MBI. Given the clear increase in burnout risk found, this topic should remain under investigation among dentists.

Outcome of career expectancies and early professional burnout among newly qualified dentists.

OBJECTIVES: To measure burnout development, outcome of expectations with regard to dental career and feelings of being unprepared for practice among newly graduated general dental practitioners. METHODS: In 1997, 50 dentists were approached to fill in the Maslach Burnout Inventory, Dutch version (UBOS) and some additional variables between six months and one year after graduation at the Academic Centre for Dentistry Amsterdam (ACTA) (76% response). Six years later, in 2003, the same 50 dentists, plus another 60 who had graduated in the same period at ACTA, were approached (78% response). RESULTS: Using Repeated Measures analysis, mean scores of dentists for whom two measurements were available on the three UBOS subscales (N=24) showed no statistically significant changes over six years on Emotional Exhaustion, Depersonalisation, or Personal Accomplishment. The same was true for group means of all in 1997 (N=33) compared with all in 2003 (N=82). However, according to manual criteria, varying percentages (7.2% - 24.4%) of dentists showed an unfavourable level on either one of the UBOS dimensions. Factors most frequently mentioned to be responsible for being unprepared for practice were: law and insurance matters (61.2%), practice organisation (56.6%) and staff management (55.2%). Most frequently reported factors that came out (much) worse than expected were: stressfulness of work (45.1%), and staff management (43.4%). CONCLUSIONS: Burnout appears no threat for the average newly qualified dentist. However, some individuals report alarmingly high burnout scores at an early professional stage. Practice management is the professional aspect about which young professionals worry most. It is recommended that dental schools pay attention to practice management skills and the stressfulness of work in the curriculum. Also, longitudinal monitoring of dental students and newly qualified dentists on burnout development is strongly advocated.

Dental nurses on perceived gender differences in their dentist's communication and interaction style.

OBJECTIVES: To investigate if dental nurses perceive gender differences in the communication and interaction style used by their dentist in general practice. METHODS: Data were collected from 64 Northern Irish dental nurses (70% response), and from 549 Dutch nurses (41% response). Respondents completed the Communication and Working Styles Questionnaire (CWSQ), a self-report questionnaire with 20 items on staff communication and working styles. Using principal component analysis, six distinguishable factors could be extracted: [1] gender-related (four items, Cronbach's alpha = 0.78), [2] friendly relation (four items, alpha = 0.66), [3] teamwork (four items, alpha = 0.44), [4] playfulness (two items, alpha = 0.69), [5] personal attention (three items, alpha = 0.60), and [6] business-like (two items, alpha = 0.32). Factors [3] and [6] were additionally analysed at item level given their low internal consistencies. RESULTS: MANOVA indicated a main effect for dentist's gender [F(6,541) = 4.649, p < 0.001], and for country [F(6,541) = 37.601, p < 0.001] on the communication style scales. No interaction effect of gender with country was found. Nurses working with a male dentist had higher scores for the 'gender-related' communications styles, whereas those working with a female dentist had higher scores for 'friendly-relation' and 'personal attention' communication styles. Dutch nurses had higher scores on 'playfulness', whereas Northern Irish nurses had higher scores on 'friendly relation' and 'personal attention' communication styles. Some additional differences were found at item level. The age of the dental nurse explained some differences in communication and working styles [F(6,541) = 2.341, p = 0.031); younger dental nurses scored significantly higher for 'gender- related' communication and working style. CONCLUSION: Gender of the dentist does influence dental nurses' perceptions of the communication styles used in the primary dental care setting. Dental nurses working with female dentists report a style predominantly characterized by 'friendly-relation' and 'personal attention', whereas those working with a male dentist report 'gender-related' communication and working styles. Given the steadily growing percentage of females entering the dental profession, it is recommended to raise both dentists' and nurses' awareness on gender influences in professional communication by introducing these topics in their respective education.

Job resources in Dutch dental practice.

AIM: To develop an instrument measuring job resources among dentists, and to assess the relative importance of these resources and relate them to job satisfaction. METHODS: 848 Dutch general dental practitioners (GDPs) received a questionnaire to monitor work experiences, including the Dentists' Experienced Job Resources Scale (DEJRS, 46 items, score range: 1 (not satisfying) to 5 (very satisfying), and the Dentist Job Satisfaction Scale (DJSS, 5 items, Cronbach's alpha = 0.85). RESULTS: A total of 497 (58.6%) dentists responded. Factor analysis (PCA) on the DEJRS resulted in 8 factors (Cronbach's alpha: 0.75 > alpha < 0.89), representing distinguishable categories of job resources. In rank order: Immediate Results / Aesthetics (M = 4.04, sd = 0.5); (Long-term) Patient Results (M = 4.03, sd = 0.6); Patient Care (M = 3.90, sd = 0.6); Craftmanship (M = 3.77, sd = 0.7); Idealism / Pride (M = 3.65, sd= 0.6); Entrepreneurship (M = 3.55, sd = 0.9); Material Benefits (M = 3.05, sd = 0.7); and Professional Contacts (M = 3.03, sd = 0.7). MANOVA indicated gender differences on: (Long-term) Patient Results (F(1,548) = 10.428, p = .001), and Patient Care (F(1,548) = 11.036, p < .001). Subscale correlations with the total DEJRS are: 0.57 > r < 0.88. All subscales show a positive correlation with the DJSS. DISCUSSION: The DEJRS is a valuable and psychometrically sound instrument to monitor job resources as experienced by GDPs. Dentists report immediate results and aesthetics, and long-term results of working with patients to be the most rewarding aspects. All job resources showed a positive correlation with job satisfaction. The discussion includes conjecture that stimulating a greater awareness of job resources serves a major role in burnout prevention.

Work stress and burnout among dental hygienists.

OBJECTIVES: The aim of this study was to describe the factors associated with work stress and burnout among dental hygienists. Furthermore, how to deal with work stressors in order to prevent burnout in the dental hygienist work environment will be discussed. METHODS: From a small literature search, only a few empirical studies could be traced that describe work stress or burnout among dental hygienists. RESULTS: Burnout incidence among dental hygienists appears to be relatively favourable, when compared with other professions, according to a 20-year-old study. On the contrary, in a recent study, it was described that one out of eight dental hygienists felt emotionally exhausted from work. Dental hygienists, when compared with other professionals, are relatively negative about the variety of tasks they find in their work. Factors associated with experienced work stress are, according to another study, musculoskeletal pain, combining work and private life, highly efficient organization of work, long working hours, working without assistant, difficult or demanding patients, lack of leisure time, lack of support by practice management and doubts about one's own capabilities. Some factors that may prevent burnout are: recognition of one's own work pressure, learning to unwind, time management and organization of work, realistic career expectancies, social skills, healthy life-style, peer-group contacts and pre-graduate reflection. CONCLUSIONS: There appears to be a lack of recent data on burnout among dental hygienists. Although some knowledge exists on work stressors, a thorough investigation on burnout incidence, risk factors, as well as job resources is needed.

[Career expectations and the type of dentist in the light of burnout]. / Beroepsverwachtingen en type tandarts in het licht van burn-out.

The aim of this study was to measure if dentists with unfulfilled career expectations have higher burnout scores than dentists who succeeded in realising their expectations. Furthermore, the relation between type of dentist and burnout was investigated. It appeared that dentists who experienced reality being worse than expected, showed higher burnout levels, as did dentists putting more interest in life outside practice. It is recommended that attention for realistic career expectations is a regularly recurring topic in dental education. Also, introspection upon the type of dentist one prefers to be is something a professional should not neglect.

[Burnout among dentists: a question of coping]. / Burn-out bij tandartsen: een kwestie van coping?

Work stress and burnout are considered to be serious professional risks in dentistry. This study investigated the relation between a dentist's coping style and burnout level. It was hypothesized that dentists characterized by an active coping style would show relatively low burnout levels, whereas dentists characterized by a passive coping style would show relatively high burnout levels. From a survey among 709 active general dental practitioners, who filled out the Maslach Burnout Inventory and the Utrecht Coping List, this hypothesis was supported. It was concluded that coping style could explain differences in burnout levels to a substantial degree. In the discussion the need for feedback on one's coping style, and the importance of an individual dentist's active attitude towards career planning, among other things, are emphasized.

[Job stress and health in dentists]. / Werkdruk en gezondheid bij tandartsen.

This study aimed at monitoring stressful work factors as indicated by Dutch general dental practitioners. Special attention was given to gender differences. Apart from mental pressure also physical pressure was studied. It appeared that among all dentists patient related aspects were considered stressful, als well as external interference by government, insurance company, etc. Male dentists also felt pressure from a lack of career perspective and dental office management, whereas female dentists felt pressure from unexpected or uncertain professional situations. Dentists appeared to have a good physical health, when compared with Dutch reference scores, although some job specific physical complaints could be detected. In the discussion the importance of early career planning is emphasized.