The human factor
Featured Products Promotional FeaturesPosted by: Dental Design 7th September 2021
Typically, when considering implant failure, the academic literature focuses on hard and fast technological and biological factors. Dental implants enjoy an exceptionally high success rate, and rare failures can often be pinned down to such causes. However, there are human elements in play, and as the ancient saying goes, to err is human.
Many dental practitioners are keenly, even painfully, aware of the possibilities for mistakes to occur and the potentially devastating consequences these can have for patient and practitioner. Dentistry is already widely regarded as a stressful calling, and burnout levels are, unfortunately, consistently high. Stress interferes with prefrontal cortex activation, with a deleterious effect on decision making and problem solving.[1] This can create a vicious circle, with stress causing mistakes which in turn create more stress.
Dental care is not about finding the one definitive solution to a problem – each case presents numerous variables and considerations, requiring interpretation and for clinical judgements to be made. This creates potential for clinical decisions to be challenged, most commonly in the event that something does go wrong. Dentists typically work with relative clinical autonomy and are comparatively isolated from professional peers, while simultaneously being highly accountable for individual treatment in a complex and ever-changing regulatory environment. Sanctions for malpractice can be career-ending and personally devastating, and so are a background concern and stressor for many dentists.[2] A recent survey revealed that 77% of UK dental professionals have stress and anxiety over the potential threat of legal action against them.[3]
It is well established that chronic stress reduces performance, disrupts sleep, causes fatigue, increases the risk of making mistakes, and may ultimately lead to “burnout”.[4],[5] In the long-term, stress is a risk factor for psychological and physiological issues including cardiovascular disease.[6] Occupational stresses come in many forms, but cumulatively have similar effects on the individual. Some of these are environmental and somewhat inescapable given the nature of the work. However, a great many potential sources of stress can be modified or approached differently, which can be tremendously helpful.
Training and experience have obvious benefit to reducing stress over carrying out treatments successfully and without incident. To dental professionals at the start of their careers, the prospect of carrying out complex implant surgery may seem quite intimidating. However, with diligent training and experience, most challenging complications can be anticipated and identified during treatment planning.
If you are still feeling a little intimidated, think upon other skills you may have honed over the years. Like any skills, the more you can practice the movements and the sequences, the more automatic they become. For example, the martial artist repeatedly practices simple kicks and punches to make their responses intuitive leaving their mind free to assess other aspects of when faced with confrontation. Driving is similar, at first simply moving a car without stalling requires active thought, though with experience, the driver gains an intuitive awareness of the vehicle’s dimensions and can operate the vehicle without conscious thought (you stop thinking about how to do things like changing gears and simply do them). This frees the driver to better concentrate on reading the road, enabling them to better respond to hazards when they occur. Clinical judgements are not a million miles from this – experience allows a practitioner to rapidly identify key factors that must been taken into account, while less experienced practitioners may find themselves swamped taking stock of all possible factors and worrying that they may have missed something important in the process.1
One factor that has been linked to psychological morbidity and burnout is the inability to access education.5 Finding the time to improve your knowledge and skills is already difficult, so the last thing you want is to feel like you have wasted time on a course that does not meet your expectations.
Ucer Education is at the forefront of postgraduate education in UK implantology, led by Specialist Oral Surgeon and celebrated implant dentist, Professor Cemal Ucer. Ucer Education has taught legions of satisfied dentists in the art of implantology, covering everything from treatment planning to post-operative care, as well as many other facets of dentistry. Ucer Education’s Postgraduate Certificate (PGCert) in Implant Dentistry (EduQual Level 7) – is an excellent opportunity for clinicians looking to advance their knowledge and develop practical skills. The course delves into human factors specific to implant dentistry while also furnishing attendees with hands-on training, including in piezo surgical techniques. It represents terrific value for money, and a great time investment covering advanced diagnostics and treatment planning, restorative, clinical and surgical skills, and much more.
Implant dentistry can be a taxing field, but it is also deeply rewarding. With the right combination of training and outlook, a great deal of stress and mistakes can be avoided, making for a bright outlook for dental practitioners and patients alike.
For more information on the PG Cert in Implant Dentistry from Ucer Education – supported by Geistlich, Megagen, Neoss, Implants and General Medical – please visit www.ucer.education and ucer-clinic.dental or call Prof Ucer on 07767 645331
Email ucer@oral-implants.com
[1] Renouard F., Amalberti R., Renouard E. Are “human factors” the primary cause of complications in the field of implant dentistry? International Journal of Oral & Maxillofacial Implants. 2017; 32(2): 55-61. https://doi.org/10.11607/jomi.2017.2.e July 6, 2021.
[2] Toon M., Collin V., Whitehead P., Reynolds L. An analysis of stress and burnout in UK general dental practitioners: subdimensions and causes. British Dental Journal. 2019; 226: 125-130. https://doi.org/10.1038/sj.bdj.2019.46 July 5, 2021.
[3] Evans S. Fear of being sued causes stress and anxiety in eight out of 10 dentists. Dentistry.co.uk. 2019. https://dentistry.co.uk/2019/04/09/fear-sued-causes-stress-anxiety-eight-10-dentists/ July 6, 2021.
[4] Nollet M., Wisden W., Franks N. Sleep deprivation and stress: a reciprocal relationship. Interface Focus. 2020; 10: 20190092. https://doi.org/10.1098/rsfs.2019.0092 July 6, 2021.
[5] Basu S., Qayyum H., Mason S. Occupational stress in the ED: a systematic literature review. Emergency Medicine Journal. 2016; 0: 1-7. http://dx.doi.org/10.1136/emermed-2016-205827 July 6, 2021.
[6] Dar T., Radfar A., Abohashem S., Pitman R., Tawakol A., Osborne M. Psychosocial stress and cardiovascular disease. Current Treatment Options in Caridovascular Medicine. 2019; 21(5): 23. https://doi.org/10.1007/s11936-019-0724-5 July 6, 2021.
