It may seem strange to non-dentists that dentistry and general practice in particular can be a lonely place. And it's not just small or single-handed practices. It's well documented that even individuals working in busy multi-surgery practices can experience isolation. So why is this the case and what can we all do to protect ourselves from the long-term mental health effects it can cause?
What are the factors increasing loneliness and isolation in general practice?
The jump between the supportive environment of dental school and general practice is enormous. Foundation and Vocational Training practices still provide a buffer through mentorship and support, but once we move into becoming self-employed associates, opportunities for in-house support and coaching can greatly reduce.
The jump between the supportive environment of dental school and general practice is enormous."
Having a busy diary often means you are working all day in a surgery alone with your nurse. Plus note writing can often eat into your lunch time, reducing the chance for interacting with colleagues. For some, the need to reach contractual targets can influence the annual leave we choose to take and/or increase our working hours, having a negative impact on work/life balance.
Unlike many other sectors where legislation and compliance are overseen at organisational level, as a self-employed associate the onus is on the individual.
Practitioners, especially in their early years, feel pressure to appear calm, confident and reassuring"
This also applies to patient complaints where the performing dentist and not the business is liable. Gallagher et al produced a qualitative study in 2021 which demonstrated that NHS associates felt more vulnerable and unprotected than their salaried colleagues.
Added to this, practitioners, especially in their early years, feel pressure to appear calm, confident and reassuring to often anxious patients when their own self-belief or confidence levels are not as high as they would wish.
What are the long-term effects of loneliness and isolation in dentistry?
The truth is, it's hard to measure the effects of long-term stress. Loneliness and isolation can be significant causes of stress in individuals. But the effects of stress on dentists are complex and multifactorial. Some of these stresses are within the individual's control and others, such as regulations, are not. Individuals coping mechanisms and personal resilience also vary greatly. Stress and burnout are at greater levels amongst dentists than within the general population and, as further highlighted by COVID, has become a pressing issue for the profession.
Stress and burnout are at greater levels amongst dentists than within the general population"
What is well documented in the general population is how isolation and loneliness have a disastrous effect on our mental wellbeing. They can increase incidences of depression, anxiety and dramatically reduce our productivity.
Sometimes we may not even realise the detrimental effects our working conditions can have on our personal health. We can feel that we should be coping better because 'everyone else is in the same boat' and therefore don't seek help and support as early as we should.
Positive steps we can take
- Acknowledge as GDPs we work in a very challenging environment and that it is not uncommon to experience symptoms related to loneliness and isolation
- Prioritise your own wellbeing. There are lots of resources out there to help reduce stress and increase resilience in dentistry
- Stay social - A big part of reducing isolation is having a supportive network you can access, both through family and friends and professionally. Being part of a group of likeminded dentists can be a great way to support and encourage each other
- Know where to seek professional support.
For me, one of the most useful things is being part of a collective. I'm part of a brilliant profession but belonging to the BDA throughout my career has made me feel like I'm not alone.