Dentistry can be a rewarding profession when treatment goes according to plan and patients are happy. Unfortunately there are times when it can also be difficult, and all dental professionals will go through times of stress during their working life. Some may cope better than others, but even the hardiest individuals can struggle to cope if they are subjected to a particularly stressful experience, or a prolonged period of stress.

The majority of problems encountered in day-to-day practising life will be resolved successfully, but some may become compounded and escalate, increasing the likelihood of an adverse impact on physical and mental health. Since starting my role as a dento-legal adviser, part of which involves supporting members facing difficulties, I was profoundly affected by how stressful some dento-legal problems can be for the person involved, and how it can have a huge impact on their work, private lives and health.

GDC fitness to practise investigations, complaints and other complex difficulties faced by dental professionals can be particularly stressful when they have the potential to adversely impact that person's career and livelihood. Some of these processes can be long, and mean that members often suffer prolonged times of stress which can impact on the physical and mental health.

Although trying to continue to work during these investigations can be a distraction from the process itself, it can also be very difficult because a dento-legal problem can have an adverse effect on confidence and health. If you do face these challenges, and think you may be suffering adversely from the stress caused, it is important to seek advice at the earliest stage possible. Doing so may allow any help given by the bodies providing support to be more effective, and potentially reduce the risk of the difficulties you face being compounded, with resultant further stresses.

One for all, all for one

In addition to seeking assistance and support with their own personal difficulties, it is important for dental professionals to be able to identify others who are in need of help, and encourage them to seek help and guidance if needed.

Most dental professionals are in frequent contact with other members of their practice team, but it is important to remember that those in small or isolated practices in the same area may also experience difficulties from time to time. Any changes in the behaviour of those in small practices, such as reports by patients of frequent absence, may be a sign that something is amiss. If you think it's appropriate, make contact to ask after the well-being of such colleagues, who may be otherwise isolated.

The most obvious of these concerns would be the knowledge that a practitioner is undergoing a GDC investigation, dealing with complaints or dealing with a legal claim, but unusual behaviour of a professional may also warrant further enquiry.

Sources of stress

Stress can arise from a variety of sources including difficulties in a person’s private life, difficulties in the workplace from either an employer or employee perspective, workload, or an adverse incident. One difficulty with a dental professional experiencing times of greater than normal stress, is that it may adversely affect the quality of care that professional provides, which may ultimately compound the difficulties that professional faces.

There have been a number of studies highlighting the stressful nature of general dental practice and some potentially worrying associations with stress when working as a GDP (for example, as published in the BDJ in 2004 and 2016 and in Dentistry magazine in 2012). The job itself can be stressful enough on its own, but when the commonly occurring stresses are magnified by external factors, such as a complaint or disciplinary investigation, the situation can quickly become more severe.

Where to turn

There are many aspects of a dental professional's working life that may give rise to times of higher than normal stress levels, which in turn may start to affect wellbeing. These are not all specific to dentistry, but the Health and Safety Executive offers an excellent resource with web links, information and assistance on the commonly occurring work related stress issues.

There are also a variety of dentist specific health support programs, with one of the longest-running being the Dentists' Health Support Trust. The charity is delivered by coordinators with expertise in dealing with addiction, mental illness, and fitness to practise concerns affecting dentists, and it facilitates interventions, diagnosis, treatment, support, rehabilitation, recovery and reintegration.

The programme provides a number of activities including responding to inquiries, assessments and treatment pathways followed by ongoing monitoring and support. One of the key aspects of the support is that it is extended to families and colleagues of the dental professional in difficulty. An individual's case is managed and coordinated with liaison between health and other professionals involved in the dental professional's treatment and support. The advice and support is free, depending mainly on donations.

Another similar organisation is the British Doctors and Dentists group. Formed originally for doctors who were attempting to recover from alcohol dependency and other substance abuse, it was later extended to involve dentists, with the aim of providing a meeting place for doctors and dentists to share their problems.

If group meetings aren't suitable for you or the individual concerned, a more personal individual counselling service can be provided by contacting your general medical practitioner for advice. The Samaritans can also offer face-to-face meetings with an individual encountering difficulties so they can discuss their concerns, but if preferred, they also offer support by email and telephone.

The GDC has worked in partnership with the Samaritans to train staff involved in the fitness to practise process to ensure they have the skills to help recognise where an individual may need additional support. Their website provides contact links for registrants to the Samaritans.