Designing a Predoctoral Dental Curriculum To Help With Therapy Issues such as Stress Management and Suicide Prevention

An interesting article titled “Tackling Stress Management, Addiction, and Suicide Prevention in a Predoctoral Dental Curriculum” by Brondani et al. appears in the Journal of Dental Education, vol. 78, no. 9, pp. 1286-1293, September, 2014. The article discusses many issues commonly dealt with in therapy such as stress management, addiction, and suicide prevention being incorporated into a predoctoral dental curriculum.

The article discusses how a lot of research has been conducted over the years regarding ways for health professionals to cope with depression and stress. In such works, dentists have been singed out as among the most likely to experience severe stress, depression, and substance abuse. The article mentions how dentists are considered to have some of the highest rates of deliberate self-harm such as suicide among all health professionals. Reasons for suicide can often be a consequence of an diagnosed mental illness or an untreated depression as a result of the inability to cope with life stressors. Suffering from depression can lead to self-medication or substance abuse in an attempt to alleviate any suffering. This is because depression is characterized by symptoms such as sadness, decreased energy, and loss of interest or pleasure in activities previously enjoyable. The article goes into some details of the undergraduate curriculum in the University of British Columbia (UBC) Faculty of Dentistry to help prepare future dentists for the issues discussed above.

The article goes into detail of the UBC Professionalism and Community Service (PACS) module which is a four-year longitudinal learning experience. One of the assessments used throughout the PACS module involves personal reflections where students are encouraged to reflect on a continuous basis throughout the four years of the program. In the article excerpts from some of the self-reflections are provided to help illustrate how students consider stress management, addiction, and suicide to the practice of dentistry.

In the program, an afternoon is spent on stress management and suicide prevention. First students are given two articles to help cope with stress management, Alexander’s “Stress-Related Suicide by Dentists and Other Health Care Workers: Fact or Folklore?” and Rankin and Harris’s “Comparison of Stress and Coping in Male and Female Dentists” prior to a three hour session. The first part of the three hour session is where someone comes in for fifty minutes to give some practical steps to cope with difficult situations along with some coping mechanisms. Next a 15 minute video is shown of a testimonial from a dentist who attempted suicide at the peak of his career after decades of private practice. Next a second 15 minute video is shown of a female partner of a successful dentist who committed suicide in front of her years ago. This is followed by an hour and a half of in class discussion where it is emphazied about the importance of a safe environment to allow for the discussion of sensitive issues faced by dentists. Further students are made aware of the resources available to them such as support groups and counseling services. In the program, another afternoon is spent on addiction and substance abuse. First students roleplay seven ethical scenarios including one scenario where an alcoholic dentist attends a lunch party. Next, the abuse of alcohol by dentists is explored using a small group format.

The program has been designed to educate and train dentists with high conduct and ethics and who are able to minimize occupational hazards related to the practice of dentistry. The authors state

“…we believe that to meet the purpose of a dental professional in society, it is necessary to identify coping skills, develop stress management strategies, and recognize signs of burnout syndrome if we are to graduate individuals who are able to promote the oral health of the community while balancing their own lives successfully.”

The authors hope the program can allow for students to increase their awareness about the stress of being a dentist and be able to balance the demands of practice with their own personal lives. While the authors did not explore any of the stressors not related to the practice of dentistry, they recognize that such exploration is necessary to help reduce suicide in dentistry and lead to a balanced practice of dentistry. While not explicitly mentioned in the article one item to note is that perhaps such awareness of issues can lead future dentists to have more successful marriages. Therefore, it may be beneficial for these students in an intimate relationship to also think about potential premarital counseling if they have not yet married. As explored in another article titled Divorce and Dentistry: Repairing Broken Relationships dentists have a lower rate of divorce when compared to many other professions but it still is something to be mindful of. Therefore, I think that if these students explore counseling services and not just for the stress of being a dentist but also for stressors in their personal lives this can allow for an all around better dentist with positive relationships in their home and work lives.