By 10 July, 2018 August 3rd, 2018 Members

Here are some inane ramblings from someone who doesn’t know his arse from a hole in the ground :)

Some recent research has shone some fresh light on what causes depression and anxiety in western civilisation. Whilst there is still significant scientific evidence that abnormal brain chemistry and childhood trauma are significant driving factors, the level of control an individual has in his her life also seems to be significant (there are plenty of other factors of course).

So let us relate that to the world of dentistry. It is safe to argue that dentistry can be stressful. But why? Why do some people enjoy certain aspects that others hate? Why do some people cringe at the thought of an extraction whilst others revel in it? I think some of it is down to our perception of the control we have over a situation. Here are some scenarios i want you to mull over and ask yourself “How would this make me feel if it happened?”

1) You have a patient in the chair for the extraction of a LR6. The rad looks like an easy extraction, but thirty minutes in and the thing just won’t budge. Your next patient is a toothache that has been squeezed in, and your arm is already burning.

2) You have just finished instrumenting an UR4 for RCT and irrigate with hypochlorite. The patient suddenly reports a severe pain in the area.

3) You have a difficult patient in the chair who you are prepping the UR7. There is not much left of the tooth and you have taken off 1.5mm from the occlusal surface. The patient bites together and you notice that the 1.5mm disappears. You have failed to notice that this tooth was the first point of contact in RCP.

4) You are doing what should be a straightforward prep. But despite your best efforts, you are on your fourth impression.

5) You fitted 6 veneers a few days earlier for a private patient. She was very demanding, and you had gone through several re-try’s to get things perfect. Your receptionist walks in to say the patient has walked into reception and insists on seeing you NOW. The receptionist says there are daggers in the patient’s eyes.

Some of you won’t understand what the problem is and in your opinion sh*t happens and you get on with it. Others will probably be having palpitations just reading through that list. How many of you gaze in dread at that small sliver of white space in your daybook because you just **KNOW** the reception team are going to slot some random having trouble in there?

A lack of control is a big factor in anxiety and depression. Businesses that have stakeholder employees (who have a say in the running and who share in the profits of the business) usually report increased happiness in the workplace because the employees have more control. The majority of your will be associates, revelling in the illusion of your self-employed status. But all of us will have varying issues with control.

So if you are suffering from work-related anxiety and depression (that is not related to childhood trauma or chemical imbalance) it may be worth investigating if you feel a lack of control is an issue. I am not a counsellor, so can only talk from my own experience. The stressful situations in my career were almost always due to a lack of control. Sometimes it was even the perceived lack of control, the little movies played in our heads that envision situations of doom that invariably never happened.

The other issue is the lack of support on the NHS. In 1996 I attempted to extract a LL8 and failed miserably. But I was able to phone the local max fax who saw the patient that day. 20 years on, such a scenario is impossible. The fear of failure, the fear of “what might happen” and the fear of rejection are sending many of us to an early grave.

And the first part of the battle against it is to realise it is actually happening. Then we can work on getting our control back.

Dr Stephen Hudson BDS, MSc, PGD Med law, PGC Dental Law & Ethics