The strains of a (seemingly) global lockdown are swelling the trove of pressures typically weighing down dentists. These exacerbated conditions are showcasing the unique psychological stresses of dentistry and stirring conversation about the importance of mental well-being among clinicians.

This is a long overdue discussion, according to Dr. Joshua Austin, DDS. “It’s a shame that it took a global pandemic to get people to think about it, because this is not a new problem in dentistry,” he says. The ADA Center for Professional Success says dentists have double the rate of anxiety disorder, depression, and panic attacks compared to the general population… and that’s self-reported numbers. “This has been a problem in dentistry for decades and no one wants to talk about it,” Austin laments.

“I’m not saying everyone needs a therapist. I’m saying every dentist needs a therapist.”

Dr. Austin operates his own practice in San Antonio, Texas and has struggled with the impacts day-to-day dentistry has on his mental health. He’s found ways to prioritize mental well-being and believes his methods can help clinicians fighting similar battles.

Unique Brand of Pressures

By the nature of the business, dentistry can be lonely despite clinicians spending their days surrounded by patients and staff. “The last number I looked at was from 10 years ago that showed 65 percent of dentists were solo practitioners. That number is probably lower now, but there’s a great isolation in being a dentist,” Austin says. All major office decisions are often falling on the lone clinician in the practice, compounding stress. “I’m in a solo practice, it’s just me and three hygienists, two assistants, and two people at the front desk. And there are times where I feel like everything has to go through me. And I’m making all these decisions on a daily basis and every one of those decisions adds another rock to my backpack, and at the end of the day I feel so weighed down,” Austin says with a strained voice.

All quotes from Dr. Austin originated from the above conversation with Ultradent's Hartley Lojik.

The financial pressures of operating a business in normal times are demanding enough and the COVID-19 lockdowns are piling on additional burdens. Practices will now have to budget for PPE and other office upgrades, and that’s outside of the effects spurred by economic downturn.

The potential for failures can weigh heavy on clinicians as well. “Even the most experienced clinicians have failures [ . . . ] we deal with failure on a daily basis, which is really difficult, it’s difficult to keep your self-esteem up high when you see stuff like that,” Austin says, adding that clinicians often find coping mechanisms like compartmentalization to deal with failures.

What Can We Do About It?

Austin advocates for turning down all unnecessary noise, which includes a massive chunk of the dental social media circles, specifically influencers who push a grandiose lifestyle. “They’ll casually mention how much money they produce,” Austin says. “You have these people who drop these kernels of information to make you think they’re these amazing businessmen or amazing clinicians, but there’s really no vetting of any of that. Anybody can go on and say anything. So we end up comparing ourselves to all these people, and trying to keep up with the virtual joneses, and that’s a pathway to self-loathing, depression, and constantly thinking you’re not good enough.”

“Only follow dog accounts.”

“I encourage everyone, for the love of god, take a two-week social media vacation throughout the year,” Austin says emphatically. “It doesn’t have to be two weeks all at one time, you can break it up a week here and a week there.” He recently took a five-month break from Facebook and lauds the benefits it had on his mental well-being. “Not having that constant noise is really enlightening to how much noise it is.” Austin has since removed Facebook from his phone so he can only access it through desktop, which limits temptation to use it. “I’m not saying social media is all bad [ . . . ] I have some great friends that I know from social media. Just limit it, especially for people who have the personality of dentists, especially when you follow a lot of dentist accounts, it just really does a number on your mental psyche.” He has one key tip for Instagram: “Only follow dog accounts.”

Turning down the noise doesn’t end for Austin with limiting social media. He also regularly meditates and schedules mindfulness time every morning after his team’s huddle. “I go back to my office, shut the door, and turn on a guided meditation app for ten minutes,” he says, noting he uses earbuds and an eye mask to aid his process.

Austin is quick to champion the benefits of yoga in the chain of wellness for clinicians, as proper physical condition can help stave off injuries and lingering pain. Research from Harvard University suggests “pain shares some biological mechanisms with anxiety and depression,” and according to ADA numbers, nearly one in three dentists self-report “moderate or severe pain or discomfort in the neck.” 29 percent of those same dentists surveyed also reported pain or discomfort in their lower back. While a variety of exercise and activities can keep the body in proper condition, Austin says yoga fits his needs.

Strategic scheduling has led to improvements in Austin’s mental health. He avoids scheduling post-op appointments to start or end a day to avoid beginning or finishing his day with his mistakes front and center. “I don’t want to start off my day with something that makes me feel bad,” he says.

Asking for help and recognizing that it’s OK not to be OK were both massive steps toward Austin improving mental well-being. “I’m not saying everyone needs a therapist. I’m saying every dentist needs a therapist,” he chuckles. Austin says a therapist should be considered essential staff for a clinician. “Find that right person, have them be part of your team. Look at it like finding your lab tech, like finding your attorney, finding your CPA. It’s part of your team, part of your support team, it’s just mental support and that’s as important as any of those other things.”