By Gerard Scannell, DDS

We may not enjoy discussing stress in our lives, but it’s often helpful to know we’re not alone in our struggles. Dental school can be a very stressful environment for students. Here are the factors that are currently stressing my classmates and me out the most, and you may find they aren’t so different from what practicing dentists are experiencing.

Licensure Exam

A major stressor specific to dental students is the clinical licensure exam. Currently, fourth-year students are trying to find patients with ideal lesions that they can use for the exam. Most of you have experienced this process. I assisted a student who scheduled a patient to see whether a certain carious lesion would be acceptable for the exam. We evaluated a radiographic lesion on tooth No. 10 that appeared to be penetrating at least halfway through the enamel, possibly extending to the dentinoenamel junction.

Considering the patient’s age, this Class III lesion could have been this tiny for many years, and treating it just for an exam may not be the best option for this patient.

The exam also presents ethical stressors. Most students search for patients with carious lesions small enough for licensure exams, but these may be lesions for which many dentists would take a conservative, more preventive approach. This aspect of patient selection walks the ethical line that many of us vow not to cross by encouraging us to drill and restore areas where licensed dentists may not.

In addition, students must worry about the patient actually showing up on exam day so they don’t lose the significant money they paid to take the exam. It is a common stress for dental students that can be improved, and students are advocating for alternative pathways to obtain their dental license in a more ethical process.

Day-to-Day Stressors

Simply passing classes and absorbing the necessary information is another stress. When I polled my classmates for this column, some of them mentioned they’re worried they won’t learn enough before graduating. The potential to fail and have to repeat a course is also stress-inducing, partly because repeating courses or even an entire semester involves accruing even more debt from student loans.

This fear of failure puts students under constant stress during their time in school.

Another major source of stress is patient attendance. In dental school, students are dependent on patients showing up in order to graduate, and we know this will be a career-long struggle — it is certainly also an issue for practicing dentists, whose finances depend on patient care. This stressor ties in with a common trait of dentists — the desire to have some degree of control over the environment — but we all know we can’t completely control our patients. We can encourage and educate all we want, but their actions are out of our control, and that can be stressful. The reality is that our patients are trying to incorporate oral healthcare with everything else in their lives. Acknowledging that patients also struggle could help students and dentists alike minimize the stress of canceled appointments.

Finding the Perfect Balance

The most common stress for my classmates and me is balancing professional and personal lives. Some of us have more to balance than others. My classmate’s wife and two children live five hours away from our dental school. He drives home on weekends when he can to see them, but he still also has school to worry about. Not being physically present to help with difficulties at home when he’s at school is a great source of stress for him.

Personally, what adds to my stress is expecting to be able to balance everything perfectly, which isn’t a realistic goal. Balancing academics; patients; extracurricular activities; personal relationships; and spiritual, physical and mental well-being is what I strive for, and keeping these things balanced also decreases my overall stress. However, accepting nothing less than a perfect balance among all of these variables is unrealistic — understanding it’s not always going to be perfect also helps me.

What I have learned from practicing dentists is that stressful issues don’t disappear once we graduate — in fact, many of them become harder. Becoming a dentist only adds more factors to juggle, and we must continue to work to balance them.

Many of you know dental students who are facing the same issues you dealt with in school. Reach out to them, and lend them a helping hand. Understand that their experience may be different from what your journey was like. Offer them the help you got as a student or that you wish you had received. Dentistry can be stressful, but — as most of us know — it can be even more rewarding.

This column was originally published in the April 2020 issue of AGD Impact. Dr. Scannell is now a general dentist in St. Petersburg, Florida.