Stress and coping strategies in pediatric dental residents.

PURPOSE/OBJECTIVES: This study examines the amount and sources of stress, as well as coping strategies, exercise, and alcohol use, among pediatric dental residents in the United States. METHODS: One hundred fifty pediatric dental residents (n = 76 postgraduate year [PGY] 1; n = 74 PGY2) in 2-year residency programs responded to an anonymous survey that included demographic questions, the Perceived Stress Scale (PSS), Graduate Dental Environment Stress Scale (GDES), Tactics For Coping With Stress Inventory, and questions about alcohol consumption and exercise. RESULTS: Stress scores were moderate (mean PSS = 16.7 ± 7.1; GDES = 61.7 ± 16.0). The largest sources of stress were research requirements, program/clinic issues, and finances. There were no significant differences in amount and sources of stress between PGY1 and PGY2 residents (P ≥ 0.10). Residents from western programs (based on AAPD districts) reported less stress than those in other areas (PSS, P = 0.04; GDES, P = 0.09). Number of negative coping tactics used was positively correlated (PPS, P < 0.0001; GDES, P = 0.0004), while number of positive coping tactics was negatively correlated (PSS, P < 0.0001; GDES, P = 0.0008) with stress scores. Younger residents (< 30yrs) used more coping tactics than older residents (P = 0.0002). Hospital-based residents used more negative coping tactics than those in university-based and combined programs (P = 0.05). Residents exercising > 150 min/wk had lower PSS (P = 0.03) and GDES (P = 0.09) scores. Alcohol consumption was unrelated to stress scores. CONCLUSION(S): Amount and sources of stress do not differ by residency year. Residents utilizing positive coping strategies and exercising had lower stress than those using negative coping strategies. Pediatric dental residency programs should educate and encourage residents to use positive coping strategies and exercise.

A longitudinal study of stress in first-year dental students.

This study examines the association of stress with performance and health in first-year dental students and changes in the amount and sources of stress over one year. Students at four U.S. dental schools completed the Dental Environment Stress (DES) scale, Perceived Stress Scale (PSS), stress rating, and demographic questions at the start of their first year of school (baseline), 11.7 weeks, and one year later when first-year GPA, illnesses, health ratings, and symptom frequency were also assessed. Overall, 296 (186 men, 110 women) responded at baseline and after one year; 205 responded all three times. Stress scores were negatively correlated with GPA (DES, p=.006; PSS, p=.04; stress rating, p=.002) and with physical and emotional health ratings (p's< or =.002), but positively associated with illness (p<.05), symptoms (p<.0001), and symptom frequency (p's<.05). Stress was higher after one year (p's<.001) and varied by school (p<.0001). Women (p<.01), younger (p<.003), and single students (p<.03) had higher stress at baseline, but after one year, there were no differences by gender, age, or marital status. Ratings for items on the Dental Environment Stress scale related to schoolwork were high at baseline and increased further by one year (p's< or =.0001); items related to school atmosphere had low ratings initially with large increases over time (p's<.0001). In conclusion, stress increases over time in first-year dental students and is related to detrimental effects on performance and health. Variation between schools may reflect different teaching methods. Changes in sources of stress may reflect the different contributions of anticipatory and situational stress over time. First-year dental students may benefit from stress reduction programs.

The effect of condyle fossa relationships on head posture.

Although it is commonly accepted that there is an interrelationship between the temporomandibular joint (TMJ) and head posture, few, if any, previous studies have quantified this effect. The purpose of this study is to quantify the effect of a change in the condyle fossa relationship of symptomatic temporomandibular joints on head posture. Charts of 51 patients (N=10 men and N=41 women) with symptomatic TMJ pathology were reviewed. The condyle fossa relationships were measured pre- and posttreatment using sagittal corrected hypocycloidal tomography. The amount of slant between the shoulder and external auditory meatus (EAM) was measured in pre- and posttreatment photographs as an indicator of forward head posture; less slant indicates better posture. Subjects ranged in age from 13-74 years (mean=43.1) and had been treated for an average of 5 months. Comparisons with pre-treatment measures showed that after treatment, the amount of retrodiskal space was significantly increased by an average of 1.67 mm on the left side (t=-10.11, p<0.0001) and 1.92 mm on the right (t=-9.62, p<0.0001). Comparisons also showed that after treatment, the amount of slant between the shoulder and EAM decreased by 4.43 inches on average which was also significant (t=13.08, p<0.0001). Improvement in the condyle fossa relationship was related to decreased forward head posture. This suggests that optimizing mandibular condyle position should be considered in the management of forward head posture (adaptive posture).