Crikey, I hadn't even reclined the chair and the patient started crying. A year previously I might have put it down to an extreme phobia or shame, or perhaps that they had Googled me just before their appointment and now realised they had drawn the short straw. But it happens often enough nowadays that the job has become a little different. Operative dentistry is becoming adjunctive to other concerns.

We are grateful to be back at work and practising dentistry, solving problems that were delayed by or which occurred during mandatory lockdowns. Ending dental pain, even by smoothing the sharp edge of a broken tooth, provides an immeasurable improvement to the quality of life for our patients and the job satisfaction to practitioners.

But there is another type of pain that many clinicians are not schooled to address. One that indeed has serious consequences for physical wellbeing. Perhaps it's no coincidence that mental health rhymes with dental health, the two being so emphatically entwined that we ignore the former's impact on the latter at our peril.

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For a long time, mental health was probably seen as an issue about dementia or the chronically depressed. They were the patients who begrudgingly listed a buffet of antidepressants on their medical history forms. They were a minority group given cursory consideration just long enough for us to finish burnishing the amalgam or curing the composite.

It's not a millennial issue or even a modern one. The global pandemic of 2020 has brought many problems into the spotlight but amongst the most pressing is the tsunami of anxiety and fear that so many patients are suffering in its wake.

We are perhaps all finding that more of our appointment times are spent listening to and absorbing the anguish that our patients have been feeling. While dental professionals are fortunate enough to work in an industry that is largely immune to recessions and pandemics, some of our patients have lost their jobs or businesses, ejected from their careers with a box of bills and debt. Or worse still, they have lost a loved one. And these problems, amongst many others, have served to concentrate and amplify their existing anxieties, a reservoir of torment now overflowing into the open and into your chair. And, of course, our spittoons, now deemed terra prohibita, can't collect the spillage.

More patients, perfectly happy and secure in days past, and used to their annual routine of a dental exam and hygienist debridement, are now choked by the clutches of clinical depression. Checking the medical history reveals a cocktail of anxiolytics and hypnotics. The weekly units of alcohol have increased too. Intra-orally, the linea alba on the cheek mucosa reveal their parafunctional activity, as indeed do the tension headaches in the temporalis muscles, radiating through the sternocleidomastoids and into the upper back. The TMJ clicks now, a companion to the rigidity of the medial pterygoids and the fractured cusps next to their MOD amalgams. Sorry folks, I don't think a soft bite guard is going to be enough.

A few extra minutes to talk and listen can potentially heal more than a rebuilt cusp.

They're eating a lot more comfort food now too: the weight gain from all the extra chocolate and sleepless nights a secondary concern to the pitting on their molars from acidic soft drinks and the interdental caries from grazing on confection. Their diet is suffering a lack of interest and the well-nourished machine that used to be their body is starting to fail. The consequent hormonal imbalances, greater inflammation and eventual effects of both may not be under our direct remit but it will come back to bite us eventually, and not merely as an occupational hazard.

Of the many hats we wear in this profession, be it artist, engineer, or even actor, the most increasingly appropriate would seem to be that of counsellor. Empathy is arguably the most useful and effective tool we can use. We don't have to offer solutions. Beyond the education of life itself we're probably not trained for that and our indemnity providers would balk at us bearing that responsibility. Patients lie back in your chair in an undeniably intimate setting, their contact with friends and family mercilessly severed by pandemic privations. They need to talk to someone. They need to vent. They need you to listen.

Perhaps, rather unfortunately, we're better equipped to treat the symptoms rather than the causes. After all, we can't end the pandemic or recover lost jobs or resurrect the dead. But maybe, just maybe, we can mitigate the middle-man, the ever-reliable mental courier that intercepts the problems, converts them into stress and delivers that to the patient in a neat little package free of charge.

You can undoubtedly do amazing things with your tweezers and a flat plastic. But a few extra minutes factored into your appointment time to talk and listen to your patients can potentially heal more than a rebuilt cusp. The inestimable relief from unburdening a full plate of sorrow to a willing audience may not have a listed fee on your menu of services. But believe it or not, like it or not, we're in the busines of making people feel better too. And the success of any business largely depends on the emotional reaction of the client that is served by it.

Now more than ever we all need a little extra reassurance and a reason to be hopeful. We all need to know that someone cares and is willing to understand. It's surely the very least we can do for our patients.

Thank you so much for your attention.