da Silva Moro J, Soares J P, Massignan C et al. Burnout syndrome amongst dentists: a systematic review and meta-analysis. J Evid Based Dent Pract 2022; DOI: 10.1016/j-jebdp.2022.101724. MacAulay R, Morash S, Kenwell S K, Haslam S K. Burnout in oral health students: a scoping review. J Dent Educ 2022; DOI: 10.1002/jdd.13143.

Low self-esteem? Overwhelmed? You may not be alone

Burnout syndrome is characterised by emotional exhaustion (loss of energy, lack of enthusiasm, increased tension, frequent headaches - EE), depersonalisation (irritability, emotional insensitivity to colleagues and patients - DP) and reduced personal accomplishment (low personal esteem, the tendency to self-deprecation at work or overwhelmed by academic expectations - PA). Dentists are at high risk and the consequences can be cognitive impairment, attention deficit and insomnia. Clinical errors may be frequent, negatively impacting patient care and safety. Symptoms of EE are considered the first stage of the syndrome, which may be triggered by increased workload.

Moro et al. found 37 relevant papers relating to burnout amongst dentists, mostly emanating from the Americas. Within a range of 4% to 32%, the overall prevalence of burnout syndrome in dentists was found to be 13% (lower than that found in doctors and paediatric nurses.) Measures of EE, DP and PA varied widely between studies. Strategies suggested to alleviate EE particularly include leisure activities, relaxation and emotion management.

MacAulay et al. found 18 relevant papers, almost half of which emanated from Europe, four from Asia and the Middle East, and the remainder from the Americas and Africa. Prevalence of burnout in dental students was found to vary between 7% and 70%. Those in the penultimate year of study, when clinical experiences are often added to academic requirements, and those with limited social support living away from home, were found to be more prone to burnout. Women reported higher scores for EE than men. The importance of early recognition of the signs of burnout is highlighted. Suggested preventive strategies include, again, leisure activities, relaxation and stress management. A suggested curriculum change was to improve student communication skills in preparation for patient contact. It has also been suggested that the earlier in the course patient contact occurs, providing an early sense of accomplishment, the potential effects of burnout may be decreased.

As in most reviews, the authors of both reviews highlight the lack of homogeneity between the many studies, making the drawing of definitive conclusions difficult. However, burnout syndrome is clearly a potential problem for both undergraduates and graduates of dentistry, with serious consequences for clinicians and patients. Early recognition of the symptoms by educators and fellow team members is a first step to reducing those consequences. Strategies should aim to reduce EE and improve stress management techniques.