Self-Perceived Sources of Stress and Burnout Determinants in Dentistry - A Systematic Review
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Burnout Syndrome
Coping Strategies
Job Satisfaction

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Avramova, N. (2023). Self-Perceived Sources of Stress and Burnout Determinants in Dentistry - A Systematic Review. Galician Medical Journal, 30(1), E202317.


Introduction. In recent decades, under the influence of various factors, there has been a serious increase in psycho-emotional tension and stress. Furthermore, considering unprecedented times of global pandemic threat, stress levels can rise significantly. Dental profession is physically and mentally stressful as dentists encounter a number of occupational hazards of a biological, chemical, physical, and psycho-emotional nature.

Objective. The current review paper aimed to answer the question: what are the most important stressors and burnout determinants in daily dental practice?

Materials and Methods. The Web of Science Core Collection database was searched for according to the PRISMA guidelines in September 2022. Empirical studies - observational, experimental, cross-sectional, and longitudinal studies published in English were considered for inclusion.

Results. The initial search yielded 355 articles. Eighteen studies met inclusion criteria and were considered for the final analysis. Two articles reported identical data; therefore, they were not included in the current report. Finally, this review presented 16 reports with a total of 8, 824 subjects.

Conclusions. Both long-term and short-term stress can cause negative effects on practitioner’s physical, mental, and emotional functioning. As healthcare providers, dentists should be aware of these risk factors, as well as they need to be sufficiently motivated to know the risks and inconveniences of their profession, learning effective strategies how to deal with adverse conditions, factors, and relationships. Providing information on this issue will contribute to increasing dentists’ awareness and improving their personal and professional performance.
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Rohan M. What are the Branches of Dentistry? [Internet]. Life Persona. 2022 [cited 1 Sep 2022]. Available from:

Katrova L. Social status of dentists and social perspectives for the dental profession. Sofia: Leading Technology in Dentistry Publishing; 1998. 290 p.

Bonev B, Avramova N, Yaneva K, Filchev D. Dental caries and associated socio-demographic factors in adult people in Bulgaria. Balkan Journal of Dental Medicine. 2015;19(2):33–37. Available from:

Spanemberg JC, Cardoso JA, Slob EMGB, López-López J. Quality of life related to oral health and its impact in adults. Journal of Stomatology, Oral and Maxillofacial Surgery. 2019 Jun;120(3):234–239. Available from:

Petrova G. Stress and consequences of stress [Internet]. Psihichno Zdrave. 2020 [cited 1 Sep 2022]. Available from:

Avramova N. Theoretical aspects of stress: a review article. Journal of Medical and Dental Science Research. 2020;7(8):11–17.

Johns R, Jepsen D. Sources of occupational stress in NSW and ACT dentists. Australian Dental Journal. 2015;60(2):182–189. Available from:

Puriene A, Janulyte V, Musteikyte M, Bendinskaite R. General health of dentists. Literature review. Stomatologija, Baltic Dental and Maxillofacial Journal. 2007;9(1):10–20. Available from:

Avramova N. Medico-psychological problems in dental practice and their impact on the personality and professional activity of the dentist. Sofia:Direct Services Ltd Publ.; 2021. 218p.

Neuman H. Occupational hazards in dentistry. The journal of the Israel Dental Association (1993). 2011;28(3):72. Available from:

Vodanović M, Galić I, Kelmendi J, Chalas R. Occupational health hazards in contemporary dentistry – a review. Rad 530. Medical Sciences. 2017;530(44):25–41. Available from:

Shaik MA, Mohammed NS. Occupational Hazards in Modern Dentistry. International Journal of Experimental Dental Science. 2013;2(1):33–40. Available from:

Szymańska J. Occupational hazards of dentistry. Annals of agricultural and environmental medicine. 1999;6(1):13–19. Available from:

Fraga J. Why the WHO's decision to redefine burnout is important [Internet]. Health Line. 2019 [cited 1 Sep 2022]. Available from:

Raman P. Burn out among dentist's post Covid-19 pandemic. Acta Scientific Clinical Case Reports. 2021;2(2):01–2. Available from:

Piko BF. Burnout, role conflict, job satisfaction and psychosocial health among Hungarian health care staff: a questionnaire survey. International Journal of Nursing Studies. 2006 Mar;43(3):311–318. Available from:

Della Valle E, De Pascale G, Cuccaro A, Di Mare M, Padovano L, Carbone U, et al. Burnout: rising interest phenomenon in stressful workplace. Annali di Igiene: Medicina Preventiva e di Comunita. 2006;18(2):171–177. Available from:

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. Available from:

Moher D. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. Annals of Internal Medicine. 2009;151(4):264–269. Available from:

Higgins JPT, Savović J, Page MJ, Elbers RG, Sterne JAC. Chapter 8: Assessing risk of bias in a randomized trial. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA, editors. Cochrane Handbook for Systematic Reviews of Interventions version 6.3. Cochrane. 2022. Available from:

Ahmed N, Abbasi MS, Zuberi F, Qamar W, Halim MSB, Maqsood A, et al. Artificial Intelligence Techniques: Analysis, Application, and Outcome in Dentistry—A Systematic Review. Grassia V, editor. BioMed Research International. 2021;2021:9751564. Available from:

Visser MR, Smets EM, Oort FJ, De Haes HC. Stress, satisfaction and burnout among Dutch medical specialists. Canadian Medical Association journal. 2003;168(3):271–275. Available from:

Al-Rawi NH, Uthman AT, Saeed M, Abdulkareem AA, Al Bayati S, Al Nuaimi A. Depression, anxiety and stress among dentists during COVID-19 lockdown. The Open Dentistry Journal. 2022;16:e187421062202242. Available from:

Song K-W, Kim H-K. Job stress and its related factors among Korean dentists: an online survey study. International Dental Journal. 2019 Dec;69(6):436–444. Available from:

Denton DA, Newton JT, Bower EJ. Occupational burnout and work engagement: a national survey of dentists in the United Kingdom. British Dental Journal. 2008;205(7):E13. Available from:

Freeman R. Barriers to accessing dental care: dental health professional factors. British Dental Journal. 1999 Aug;187(4):197–200. Available from:

Holt VP, Ladwa R. Mentoring. A quality assurance tool for dentists part 6: outcomes: patient care, professional development and personal growth authentic happiness for dentists. Primary Dental Care. 2010;os17(1):15–20. Available from:

Puriene A, Aleksejuniene J, Petrauskiene J, Balciuniene I, Janulyte V. Self-perceived mental health and job satisfaction among Lithuanian dentists. Industrial Health. 2008;46(3):247–252. Available from:

Brake HT, Bouman A-M, Gorter R, Hoogstraten J, Eijkman M. Professional burnout and work engagement among dentists. European Journal of Oral Sciences. 2007 Jun;115(3):180–185. Available from:

Collin V, Toon M, O’Selmo E, Reynolds L, Whitehead P. A survey of stress, burnout and well-being in UK dentists. British Dental Journal. 2019;226(1):40–49. Available from:

Antoniadou M. Estimation of factors affecting burnout in Greek dentists before and during the COVID-19 pandemic. Dentistry Journal. 2022;10(6):108. Available from:

Özarslan M, Caliskan S. Attitudes and predictive factors of psychological distress and occupational burnout among dentists during COVID-19 pandemic in Turkey. Current Psychology. 2021;40(7):3113–3124. Available from:

Liu Y, Song Y, Jiang Y, Guo C, Zhou Y, Li T, et al. Burnout and its association with competence among dental interns in China. Frontiers in Psychology. 2022;13:832606. Available from:

Gómez-Polo C, Casado AMM, Montero J. Burnout syndrome in dentists: work-related factors. Journal of Dentistry. 2022;121:104143. Available from:

Molina-Hernández J, Fernández-Estevan L, Montero J, González-García L. Work environment, job satisfaction and burnout among Spanish dentists: a cross-sectional study. BMC Oral Health. 2021;21:156. Available from:

Nangle MR, Henry JD, von Hippel C, Kjelsaas K. An empirical study of how emotion dysregulation and social cognition relate to occupational burnout in dentistry. British Dental Journal. 2019;227(4):285–290. Available from:

Gómez-Polo C, Martín Casado AM, Castaño A, Montero J. Epidemiological study on burnout in Spanish dentists: underlying psychological factors. International Journal of Environmental Research and Public Health. 2021;18(24):13418. Available from:

Noori F, Kazemeini S-K, Owlia F. Determination of professional job burnout and temperament (Mizaj) from the viewpoint of Traditional Persian Medicine and work-related variables among Iranian dentists: a cross-sectional study. BMC Psychology. 2022;10:94. Available from:

Alqahtani N, Aljajji S, Alshalan N, Aljabaa A, Aldosari M, Albarakati S. Occupational stress among orthodontists in Saudi Arabia. Journal of International Society of Preventive and Community Dentistry. 2020;10(3):350–358. Available from:

Miron C, Colosi HA. Work stress, health behaviours and coping strategies of dentists from Cluj-Napoca, Romania. International Dental Journal. 2018;68(3):152–161. Available from:

Mujić Jahić I, Bukejlović J, Alić-Drina S, Nakaš E. Assessment of stress among doctors of dental medicine. Acta Stomatologica Croatica. 2019;53(4):354–362. Available from:

Siddiqui MK, Taqi M, Naqvi S, Raza SA, Bawany H, Hasan Z. Levels of perceived stress according to professional standings among dental surgeons of Karachi: a descriptive study. BMC Oral Health. 2022;22:243. Available from:

Khoo E, Saeed SG, Chiu H-Y, Quach V, Janal M, Stewart K. Stress and anxiety in orthodontic residents during the coronavirus disease 2019 pandemic. American Journal of Orthodontics and Dentofacial Orthopedics. 2022;162(1):e35–e43. Available from:

De Sio S, Traversini V, Rinaldo F, Colasanti V, Buomprisco G, Perri R, et al. Ergonomic risk and preventive measures of musculoskeletal disorders in the dentistry environment: an umbrella review. PeerJ. 2018;6:e4154. Available from:

Lingam A, Ramaswami E, Nimma V, Jakhete A, Contractor I, Kadam S. Assessment of occupational hazards among dentists practicing in Mumbai. Journal of Family Medicine and Primary Care. 2020;9(4):2016–2021. Available from:

Yolov T, Yaneva K. Social medicine, medical ethics, and dental public health. Sofia:Simelpress Publ.; 2011. 252 p.

Osborne D, Croucher R. Levels of burnout in general dental practitioners in the south-east of England. British Dental Journal. 1994;177(10):372–377. Available from:

Gorter RC, Albrecht G, Hoogstraten J, Eijkman MAJ. Professional burnout among Dutch dentists. Community Dentistry and Oral Epidemiology. 1999;27(2):109–116. Available from:

Alemany-Martínez A, Berini-Aytés L, Gay-Escoda C. The burnout syndrome and associated personality disturbances. The study in three graduate programs in Dentistry at the University of Barcelona. Med Oral Patol Oral Cir Bucal. 2008;13(7):E444-E450. Available from:

Brake H te, Bloemendal E, Hoogstraten J. Gender differences in burnout among Dutch dentists. Community Dentistry and Oral Epidemiology. 2003;31(5):321–327. Available from:

Jugale PV. Burnout and work engagement among dental practitioners in Bangalore city: a cross-sectional study. Journal of Clinical and Diagnostic Research. 2016;10(2):ZC63-ZC67. Available from:

Freudenberger HJ, Richelson G. Burn out: the high cost of success - and how to cope with it. USA:Doubleday & Co., Inc.; 1980. 214p.

Wasoski RL. Stress, professional burnout and dentistry. Journal - Oklahoma Dental Association. 1995;86(2):28–30. Available from:

Avramova N. Dentists' job satisfaction. Dissertation [PhD Thesis in Bulgarian]. Sofia:Medical University; 2014. 154 p. Available from:

Kay EJ, Lowe JC. A survey of stress levels, self-perceived health and health-related behaviours of UK dental practitioners in 2005. British Dental Journal. 2008;204(11):E19. Available from:

Croucher R, Osborne D, Marcenes W, Sheiham A. Burnout and issues of the work environment reported by general dental practitioners in the United Kingdom. Community Dental Health. 1998;15(1):40–43. Available from:

Gorter RC, Storm MK, te Brake JHM, Kersten HW, Eijkman MAJ. Outcome of career expectancies and early professional burnout among newly qualified dentists. International Dental Journal. 2007;57(4):279–285. Available from:

Manolova M, Panayotov I, Stefanova V, Markova K, Vladimirov S. Stress - an obstacle to or a stimulus for a success. Dental Review. 2007;89:183–187.

Gorter RC, Albrecht G, Hoogstraten J, Eijkman MAJ. Work place characteristics, work stress and burnout among Dutch dentists. European Journal of Oral Sciences. 1998;106(6):999–1005. Available from:

Sancho FM, Ruiz CN. Risk of suicide amongst dentists: myth or reality?. International Dental Journal. 2010;60(6):411–418. Available from:

Jones LM, Cotter R, Birch KM. A review of occupationally-linked suicide for dentists. The New Zealand Dental Journal. 2016;112(2):39–46. Available from:

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