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South African Dental Journal

versão On-line ISSN 0375-1562
versão impressa ISSN 0011-8516

S. Afr. dent. j. vol.75 no.1 Johannesburg Fev. 2020




Managing mental health wellness



Pusetso D Moipolai

President, SADA




The beginning of a new decade is on us and we need to take lessons from the previous decade if we are to move the profession forward. One of the key issues from the recent decade that was forefront in the healthcare profession and in society at large is mental health wellness. Locally, we have not been excluded from the ravages of this phenomenon, with the untimely passing of the then dean of UCT's Faculty of Health Sciences - the world renowned Prof Bongani Mayosi, may his soul rest in peace.

It is well established that dentistry is a stressful profession,1 including the demanding route to attaining that professional qualification.2 It has been reported that dentists experience more stressful conditions than all other professionals.3 The stress is attributable to a variety of factors including the nature of the profession, the working conditions in the dental surgery4 and the academic requirements of dental school programmes.5 Some of the factors identified as major stressors, contributing nearly 50% of the stress, include the fragility of the patient-dentist relationship, patient scheduling, time spent for treatment provision, HR issues, financial obligations, technical problems and job satisfaction.6 The stressors faced by health professionals may not only affect their own mental and physical health, but may adversely affect the quality of care provided to patients. The dramatic changes (technologically and regulatory) which are taking place in the profession, and at a phenomenal pace, make it important that we recognise the impact on the mental wellbeing of ourselves and our colleagues. It is indeed difficult being a dentist or dental student!

With the changing local healthcare regulatory landscape, it may not be remiss to postulate that this potentially may have adverse effects on the professionals and the quality of service provided. The national public service is already under immense pressures to provide quality oral healthcare, in the face of considerable limitations and challenges in the provision of basic preventive and restorative oral healthcare. The critical question to ask at this juncture, is how is the envisioned NHI going to address the current deficiencies that are burdening the profession - without adding to an already stressful environment? The uncertainty amongst oral health practitioners around the implementation of the NHI regarding its impact on the provision of oral health, cannot be underestimated as a potential major stressor.

SADA has been working very hard on these matters. The Association organised a profession-wide NHI Task Team that included all associations in the oral health space. The resulting document adopted by all was sent to the Department of Health as well as the War Room on NHI chaired by Dr Olive Shisana. The Association has provided input on the NHI green paper and the Bill. We have also identified able members of the profession whom have been nominated to sit on various committees of the NHI. SADA remains closely involved and is giving input to the relevant bodies as they work on the implementation of the NHI.

Added to this scenario are the reported challenges that plague the HPCSA, resulting in President Ramaphosa having had to order a probe into the Council by the State's Special Investigation Unit. This turn of events can also not be seen as providing any sense of comfort to the profession! The level of confidence in which the Statutory Body is held by its membership is at an all-time low. Without an alternative to the HPCSA to protect the profession, members are left in a vulnerable state with respect to being supported in the provision of their respective services.

The above picture speaks to a chronic systemic problem which fundamentally impacts not only on individual professionals, but also on the working environment. Many of the interventions advocated previously to assist healthcare professionals have targeted individuals, rather than the system. Organisational or structural change is needed to improve working conditions and environments to effect more long-lasting positive outcomes.

As a profession, it is incumbent on all of us to raise awareness of the effects of mental health for the survival of our profession and to ensure that our members are supported in preventing and managing the ill effects of this condition.



1. Cooper CL, Watts T, Kelly K. Job satisfaction, mental health and job stressors among General Dental Practitioners in the UK. Br Dent J. 1987; 24: 77-88.         [ Links ]

2. Bhayat A, Madiba TK. The self-perceived sources of stress among dental students at a South African dental school and their methods of coping. SADJ. 2017; 72: 6-10.         [ Links ]

3. Bourassa M and Baylard JF. Stress situations in dental practice. Can Dent J. 1994; 60: 65-71.         [ Links ]

4. Smith A, Johal S, Wadsworth E, Davey Smith G, Peters P. The Bristol Stress and Health at Work Study. Health and Safety Executive, 2000. Contract Research Report 265/2000.         [ Links ]

5. Westerman GH, Grandy TG, Ocanto RA and Erskine CG. Perceived sources of stress in the dental school environment. J Dent Educ. 1993; 57: 225-31.         [ Links ]

6. Naidoo S. Managing stress in the dental environment. SADJ. 2015; 70: 388-9.         [ Links ]

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