Dental Environment Stress Research Articles

Successful treatment of a Himalayan cat with feline orofacial pain syndrome

AbstractFeline orofacial pain syndrome is a neuropathic pain disorder in cats, characterised by oral discomfort and tongue self‐mutilation. The pathogenesis of feline orofacial pain syndrome remains unclear, but trigger factors such as dental disease and environmental stress have been described. Feline orofacial pain syndrome is a diagnosis of exclusion, and suggested treatment includes administration of non‐steroidal anti‐inflammatory agents, opioids and adjuvant drugs for analgesia. This case report describes a 4‐year‐old female Himalayan cat with anorexia, ranula and unilateral lesions of the tongue. Clinical signs ranged from pawing at the mouth to tongue self‐mutilation during severe pain attacks. Although no dental disease was present, a dominant and suppressive partner cat may have had a stressful influence. First‐line treatment with non‐steroidal anti‐inflammatory drugs and opioids could not prevent further pain attacks. Successful treatment was achieved with administration of pregabalin and minimisation of potential stress factors. No clinical signs of pain were observed in a follow‐up period of 2 years.

The Impact of COVID-19 Fatigue and Pandemic Burnout alongside Academic Stress on the Gingival Health of Dental Students

Abstract Objectives Stress has delirious effects on gingival health. Dental students experience higher levels of academic stress during their education that requires clinical and patient management skills. Coronavirus disease 2019 (COVID-19) fatigue is a type of chronic stress that has put the population under high stress for an extended period of time. This study aimed to assess the impact of pandemic burnout and fatigue on the gingival health of academically stressed dental students. Materials and Methods This study compared junior (n = 20) and senior (n = 20) year dental students undergoing their final year exams. Gingival health was assessed by plaque index (PI), gingival index (GI), and modified papillary bleeding index (MPBI). Academic stress was measured by the dental environmental stress questionnaire, while COVID-19 burnout was judged by COVID-19 student stress questionnaire (CSSQ). Statistical Analysis Quantitative data were expressed as mean, standard deviation and median Student's t-test was used to compare two categories for normally distributed quantitative variables, while significance of the obtained results was judged at the 5% level. Results Gingival health evaluation revealed no significant differences in GI and PI; however, MPBI in juniors was more significant (p = < 0.001). Academic stress was significantly higher among seniors (p = 0.001); nevertheless, CSSQ showed low levels of stress toward the pandemic with no significant differences. Conclusion Gingival diseases are multifactorial in nature; stress is a biologically influencing factor as well. Despite the evidence of high academic stresses among dental students, the impact of COVID-19 fatigue on gingival health was inconclusive and slight differences were found between junior and senior-year dental students.

Academic Stress contributes to Temporomandibular Joint Disorders (TMDs) among Dental Students of the Universiti Teknologi MARA Malaysia, not the Social Stress: An Institutional Study

Objectives: The objectives of this study were to determine the prevalence of TMD in dental students in Universiti Teknologi MARA, and to identify risk factors that may contribute (social vs academic) to TMD in dental students. Methods: In a cross-sectional study, 202 dental undergraduate students, aged 19 to 25 years from year 1 to year 5 were recruited in our study. The respondents have undergone an assessment using a Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and Dental Environment Stress (DES) questionnaires. TMD was diagnosed by using RDC/TMD axis I and II. The DES questionnaire was based on five-point Likert scale, from a range of not pertinent to very stressful. Stress scores were measured from seven stressor domains. Statistical analysis was performed using Fisher-exact test using SPSS 20.0. Significance level was set at P≤0.05. Result: 13.3% of the students were diagnosed with TMD, The higher prevalence of TMD was detected among female students. Present study demonstrated that academic stress is significantly higher than social stress among all dental students. Among the domains in the academic stress, performance pressure found to be the highest to effect the students. Conclusion: The significant association between TMD and academic stress observed in our present study warrants further investigation to examine the underlying molecular mechanism of academic stress in TMD initiation and progression.

Perceived stress among dental students and the role of parental influence in career decision-making.

The current study aimed to assess perceived stress levels among dental students at Riyadh, Saudi Arabia, and to explore the influence of parental roles in their decision to pursue dentistry as a potential source of social stress. This cross-sectional study employed the validated Dental Environmental Stress (DES) Scale to evaluate perceived stress, and incorporated additional questions to fulfill the research aim. We approached all undergraduate dental students at King Saud University, both male and female, across all academic years, using online channels (such as emails, WhatsApp, Twitter, etc.) and hard copy distribution. Data collected were analyzed using SPSS version 20, utilizing descriptive and correlation statistics. A total of 326 students participated in the study, with an even distribution of male and female students. Female students reported higher levels of stress compared to their male counterparts across most DES domains. A notable correlation emerged between mean DES scores in certain domains and influence of parents in the decision to pursue dentistry. Our findings indicate that female dental students experience higher stress levels than males in all examined areas, barring social stressors. Furthermore, the study underscores the significant impact of parental involvement in choosing dentistry as a career on students' stress level.

Stress experienced by dental students performing clinical training in different dental disciplines: a cross-sectional study.

To assess the stress level, the impact of stress factors, and discrepancies between fourth- and fifth-year undergraduate clinical students at the University of Jordan. A cross-sectional study was conducted in the academic year 2022/2023. The study group included fourth- and fifth-year dental students at the University of Jordan (n = 382) who were asked to voluntarily fill in an online dental environment stress (DES) questionnaire. Analysis was conducted using Mann-Whitney U test, independent t-test, χ2 test, and Spearman ρ rank correlations. Statistical significance was inferred when P < .05. Fourth-year students reported higher levels of nervousness before treating patients for the first time. Fifth-year students faced more difficulty, higher stress, and/or fear regarding the amount of assigned work, provided treatment, completed requirements, failing the course, time to finish assignments, patient comprehensive care, and financial expenses of the course. Comparison between groups revealed that the fifth-year students scored higher levels of stress on the total DES score and all partial DES scores. Furthermore, the total DES questionnaire scores were significantly correlated with grade point average (GPA) among the total study sample and the prosthodontics clinical course marks among the fourth-year students' group. The stress level among students in clinical courses was influenced by their academic performance, gender, year level, and the type and time needed for the provided treatment. Completing course requirements was among the most commonly faced stressors. Future research endeavors might be considered to study each clinical factor, its impact on students' stress level, and how to manage and positively improve these factors.

The Relationship between Stress and Preclinical Dental Students' Performance: A Longitudinal Study.

The aim of this study was to evaluate the changing levels of stress among dental students during 8 months of a basic manual skills course in the preclinical year and to examine the association between stress and dental performance. A longitudinal study was conducted in the 2023 academic year in a total of 58 (male = 17 and female = 41; mean age = 26.43, range 22-33) undergraduate dental students at Tel Aviv University of dentistry during their fourth year of study. Depression Anxiety Stress Scale (DASS-21) and Dental Environment Stress (DES) questionnaires were used to assess the psychological well-being and the severity of DASS symptoms experienced by the students. The students' dental performances were assessed using two manual tests on plastic teeth. The questionnaires and the manual tests were used at three periods of time, T0, T1, and T2. Wilcoxon signed-rank tests were performed to compare the DASS scores and DES stressors of dental students between T0, T1, and T2. Kendall's nonparametric correlations were calculated to investigate the relationships of DES stressors and depression, anxiety, and stress scores with manual performance. The perception of high stress by dental students is due to the stressful education process of the preclinical year. There is an inverse correlation between the lower level of anxiety and the increase level of dental performance with 74% of the variance in dental performance explained by the anxiety score. Work-related stressors such as manual skills might reduce dental performance in contrast to non-work-related factors such as financial obligations, personal issues, and family factors, which might increase student dental performance.

Dental and endodontic-related stress amongst undergraduate students before and during the COVID-19 pandemic: A mixed-methods study.

To determine and explain the principal sources of stress among preclinical and clinical dental undergraduate students with a particular focus on the stressors linked to endodontics. A mixed-methods study, with an explanatory sequential design, was employed. Volunteer students of second, third and fourth years were asked to complete both the Dental Environment Stress (DES) questionnaire and a bespoke questionnaire for endodontic-related stress assessment, which had 21 questions in common with the DES. The results were analysed by Kruskal-Wallis and Marginal Homogeneity tests. In the second part of the study, a qualitative phase was conducted through focus group interviews of students from each academic year included in the study. Interviews were analysed by inductive content analysis. The DES questionnaire determined that for all years the most stressful domains were 'performance pressure', 'workload' and 'clinical training'. According to the endodontic stress questionnaire, the most stressful domains were 'self-efficacy beliefs', 'endodontic clinical training' and 'faculty and administration' in early years, while they were 'endodontic patient treatment', 'performance pressure in endodontics' and 'clinical training' in later years. Comparing questions common to both questionnaires revealed that the stress score was lower for the endodontic stress questionnaire than in the DES questionnaire for 17 questions, being significantly lower for 13 questions (p < 0.05) and significantly higher for no question. The qualitative study showed that students' dental and endodontic-related stress was linked to different domains: patient, clinical procedure, organization, staff, academic education, evaluation and COVID-19-related issues. Qualitative aspects highlighted the important role that patients and COVID-19 have played in student stress. However, they suggested a possible explanation for the lower endodontic stress observed in this dental university hospital, which was based on: the nature of the teaching in endodontics, the consensus between endodontic supervisors, the use of a logical, progressive procedure and the considerable experience that students gain over the years. Students considered endodontics stressful; however, education can play a central role in reducing stress, particularly during the early parts of the undergraduate course.

Assessment of Perceived Stress and Stress Predictors Among Dental Students: An Institutional- Based Study

Background: Stress is one of the most prevalent psychological conditions globally. However, healthcare students are at an increased risk of psy-chological distress as compared to the normal population. Medical/Dental training is considered a stressful experience for students as they face a wide range of challenges related to their lengthy curriculums, patient care, and pursuit of academic excellence. Purpose: To assess the prevalence of perceived stress levels and associ-ated risk factors among undergraduate dental students Methods: This cross-sectional study was conducted among 230 under-graduate dental students to assess their perceived stress using the Modi-fied version of the Dental Environment Stress questionnaire. Data were analyzed using SPSS 22. Descriptive statistics and chi-square tests were used. P&lt;0.05 was considered significant. Results: Most dental students reported mild stress related to most of the academic and clinical components in the questionnaire. However, a higher percentage of pre-clinical students reported moderate and severe stress (37.5% &amp; 14.1% respectively) as compared to clinical year students (6.8% and 1.5% respectively) with p&gt;0.05. The major risk factors causing stress were competitiveness among peers, the pressure of the assessments, and the inability to balance the clinical and academic workload. Conclusion: Undergraduate dental students were found to be under stress due to a range of factors. The faculties need to identify and alleviate such stress among students through support systems.

Dental Environment Stress Among Iraqi Students: A Qualitative Study

Objective: To determine the degree of psychological stress in undergraduate dental students &amp; explore related gender variation. Methods: 100 5th-year dental students at Al-Rafidain University College (RUC), Iraq, participated in the study by completing The Modified Dental Environment Stress Questionnaire (DES). Results: The primary sources of stress were found to be Completing the clinical requirement, the Atmosphere created by the clinical supervisors, Full working day, Patients being late or not showing up for their appointments, Difficulty in learning precision manual skills required for clinical and laboratory work, examination, and grades &amp; fear of unemployment. The highest score source was (patients being late or not showing), followed by (examination and grades). Regarding gender differences, the (Full working day) was the highest stressor item for the male student’s team, while female students chose (Atmosphere created by clinical supervisors) as their top stressor. Conclusion: The highest perceived sources of stress reported by students should be further explored by longitudinal studies, and strategies to minimize the resulting stress should be developed and implemented since psychological stress in study years of dentistry predicts occupational stress later.

The Impact of the SARS-CoV-2 Pandemic on Stress and Anxiety of Dental Students.

To investigate the impact of the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) pandemic on stress and anxiety of preclinical and clinical dental students. Dental students (participants) in their clinical course (CC; n = 64) or preclinical course (PCC; n = 53) were included in the study. The subjective perceived levels of stress and anxiety were evaluated using the Dental Environment Stress (DES) questionnaire and the Depression, Anxiety and Stress Scales (DASS) questionnaire. Cortisol levels were measured in saliva samples collected from participants. Knowledge of the pandemic was evaluated using a 100-mm visual analog scale. All data were collected twice: once during the university holidays and once during term time. Results from DES, DASS, and salivary cortisol tests were compared between baseline and follow-up using descriptive and bivariate statistics. Multivariate linear regression models were computed with DES, DASS, and cortisol values as dependent variables to analyze possible influencing factors. Participants showed medium levels of stress and anxiety at baseline and follow-up. The DASS score in the "anxiety" subdomain was significantly higher in the PCC group than in the CC group at baseline (p < 0.001) and increased during term time. DASS scores in the "stress" subdomain also increased during term time. However, both subdomain scores were lower than the cutoff value for a psychological disorder. The mean total DES scores were 615.9 ± 97.7 in the CC group and 580.40 ± 98.9 in the PCC group. These scores indicated medium stress levels and were not significantly different between the groups, nor did they change during the study period. Mean saliva cortisol levels were higher in the CC group (9.2 ± 5.2) than in the PCC group (4.9 ± 2.2) at baseline (p < 0.001) but converged by follow-up. Multivariate regression models showed that intraindividual perception of stress at baseline was consistently the most important aspect for changes in stress and anxiety levels during term time. The SARS-CoV-2 pandemic affected stress and anxiety levels in some participants, but this was not ubiquitous. Intraindividual differences in stress perception seem to be more relevant than course affiliation (preclinical or clinical) or the SARS-CoV-2 pandemic to stress and anxiety levels in dental students.

Emotional Intelligence, Depression, Stress and Anxiety Amongst Undergraduate Dental Students During the COVID-19 Pandemic.

Objectives: This study aimed to measure depression, anxiety and stress (DAS) among undergraduate dental students during the COVID-19 pandemic, identify key contributing factors of stress and explore the association of emotional intelligence to DAS. Methods: A multi-centre, cross-sectional study was conducted across four universities in Malaysia. The study administered a questionnaire consisting of the validated Depression Anxiety Stress Scale (DASS), Dental Environment Stress (DES), Emotional Intelligence Scale (EI) and 10 statements assessing COVID-19 specific potential stressor factors. Results: Participants included 791 students across four universities. Abnormal levels of DAS were identified in 60.6%, 66.8% and 42.6% of the study participants, respectively. "Pressure of performance," "Faculty administration" and "Self-efficacy belief" were the highest rated stressors. On-time graduation was the main COVID-19 specific stressor factor. EI was negatively correlated with DAS scores (p < 0.001). Conclusion: The levels of DAS during COVID-19 pandemic in this population is high. However, participants with higher EI presented with lower DAS suggesting that EI may be a form of coping resource and should be enhanced in this population.

Impact of resilience and environmental stress on burnout of students in public and private dental schools in Western Saudi Arabia.

Dental students' burnout has been repeatedly reported in the literature; however, there is little information about the contributing factors in different contexts and settings. This study aimed to investigate the correlation between burnout among undergraduate dental students and sociodemographic (specifically gender), psychological (resilience), and structural factors (dental environment stress). An online cross-sectional survey questionnaire was distributed among a convenience sample of 500 undergraduate Saudi dental students. The survey included questions about sociodemographic factors (gender, level of education, academic achievement, type of school [public or private], and living arrangements). The study also included items that allowed assessment of students' burnout using the Maslach Burnout Inventory (MBI) and assessment of student environmental stress and resilience using the Dental Environment Stress Scale (DESS) and the Brief Resilience Scale (BRS). Descriptive statistics, univariate, and linear regression analyses were performed. The response rate was 67% (male = 119, female = 216). Univariable analysis showed that gender, level of education, and DESS and BRS scores correlated significantly (P <.05) with MBI scores. Adjusted multiple linear regression lends further support to that the MBI scores negatively correlated with the BRS score but positively correlated with the DESS score (β = -0.29, P <.001; β = 0.44, P <.001, respectively). Within the limitations of this study, the findings demonstrated that increases in resilience correlated significantly with decreases in burnout and increases in environmental stress correlated significantly with increases in burnout among dental students. However, gender had no influence on burnout.

Psychosocial Impact, Perceived Stress Levels and their Learning Effect among the Undergraduate Dental Students during the Transition from Preclinicals to Clinicals: A Questionnaire-based Cross-sectional Study

Introduction: Dentistry is known as the most challenging and stressful profession. Dental education enhances students’ ability to provide high-caliber work in the clinical field. To fulfill this criterion, students are required to develop professional conduct, competencies, and psychological and cognitive abilities in due course of time. The shift from preclinical to clinical is considered one of the most crucial stages for dental undergraduates. During this period, individuals often experience unique emotional and social challenges, leading to stress, anxiety, and depression. Aim: The aim of this study is to assess the perceived stress levels, psychosocial impacts, as well as depression and anxiety levels among dental undergraduates during their transition from preclinical (2nd year) to clinical (3rd year) practice. Materials and Methods: A cross-sectional questionnairebased study was conducted among second and third-year dental undergraduates from different dental colleges in South India from February 2022 to June 2022. Two questionnaires, the Dental Environmental Stress (DES) scale (25 items) and the Depression Anxiety Stress Scale (DASS) (21 items), were utilised to measure stress, depression, and anxiety levels. The questionnaire was designed using Google Forms and distributed via WhatsApp. The snowball sampling technique was used, and data from 489 self-selected participants were collected and sent for statistical analysis. Descriptive statistics (mean, 95% Confidence Interval [CI]) were used to identify major stressors and their perceived magnitude. The responses were recorded on a 4-point Likert scale. Results: This study included a total population of 489 participants, with 360 (73.6%) females and 129 (26.3%) males, respectively. According to the DES results, the educational environment and clinical domain were the most stressed domains, with mean values of 1.7859±0.47929 and 1.7639±0.43729, respectively. The top five stressors identified were lack of relaxation time, fear of failure, financial burden, assigned work, and examinations/ grades. The DASS results revealed the highest prevalence of stress (15.22±5.92), followed by anxiety (13.39±6.01) and depression (12.60±8.66). Conclusion: The results of this study indicate that dental undergraduates experience higher levels of perceived stress, psychosocial effects, depression, and anxiety during the transition from preclinical (2nd year) to clinical (3rd year) practice. Structured student support systems, such as counselling programmes and effective communication skills, can help create an environment that reduces stress and enhances student well-being.

Investigating the Relationship Between Academic Burnout and Dental Environment Stress Among Dental Students

Investigating the Relationship Between Academic Burnout and Dental Environment Stress Among Dental Students

Association between dental environment stress and sense of coherence in dental students: a cross-sectional study.

The aim of this study was to explore associated variables with sense of coherence (SOC), and dental environment stress (DES) in a sample of dental students. All undergraduate (n = 474) and graduate (n = 105) dental students enrolled in the first semester of 2020 at a public university in southern Brazil were invited to participate. Data collection was performed by an online questionnaire, which included information related to sociodemographic and educational characteristics, biopsychosocial factors, aspects related to feelings experienced in the COVID-19 pandemic, and the SOC scale. The study outcome (DES) was measured by a validated tool. Linear regression analyses were performed to identify the associations between the outcome and all independent variables. A total of 408 students were included (response rate: 70.5%). The overall mean score of the DES scale was 73.95 (SD: 24.13). Students with higher SOC scores were observed to have significantly lower DES scores (βGRADUATE: -0.376; 95%: -0.482 to -0.271; βUNDERGRADUATE: -0.478; 95%:-0.658 to -0.297). Female undergraduate students (β: 11.788; 95%CI: 7.161-16.415) had higher DES scores compared with undergraduate male students. In addition, the presence of anxiety symptoms when providing dental care to patients with symptoms or suspected COVID-19 infection was associated with higher DES scores (β: 10.460; 95%CI: 5.644-15.277) among undergraduate dental students. The level of stress was higher in non-white undergraduate students than white (β: 8.912; 95%CI: 3.581-14.244). Among both undergraduate and graduate dental students, higher SOC scores were associated with lower DES.

Stress among Students’ of Dental College in Nepal

INTRODUCTION: Dentistry is a most stressful profession in the medical field. During the practicum period, most of the dental students feel stressed from internal and external environmental stressors. Therefore, this study was designed to assess the stress among dental students, this will provide applicable insights for further improvement. MATERIALS AND METHODS: A descriptive, cross-sectional research design was used with an online Structure questionnaire to assess stress among the students of dental colleges of Nepal by using dental environmental stress (DES) questionnaire, which was developed by Garbee et al. Probability Proportionate to the size sampling technique was used to collect the sample. The organized data will be entered by using IBM Statistical Package for Social Science (SPSS) version 20.0. The data will be further analyzed by using descriptive statistics (frequency, percentage, mean, median and standard deviation) and inferential statistics. RESULTS: Out of 756 students, 58.7% of the respondents were equal to or greater than 22 years of age. The median age was 22 years. Among them, 78.7% were female. Stress-related to domain, Professional and carrier-related stressor had higher, followed by academic performance and Clinic patient-related stress is mean percentage was 70.43, 69.17 and 61.09, respectively. About 50.3% had moderate levels and 15.3% of respondents had a severe level of stress. There was statically association between stress level with age (p=0.01), first choice of study (p=0.026), academic year (p=&lt;0.001) and current residence (p=&lt;0.001). CONCLUSIONS: Professional and carrier-related stressor, academic-related and patient-related stressors are higher in dental students. Severe Levels of stress increased over the academic year and peaked in 5th year. Stress affects student academic as well as professional carrier in the future so minimize the stressor by the institutional level.

Perception of Stress and Professional Burnout among Dental students during clinical years

Background: Dentistry is associated with numerous stressors and dental students encounter a lot of stress during their undergraduate studies. This study was conducted with the objectives to know the understanding of stress and factors among the clinical dental students. Aim: To determine the perception of stress and professional burnout and determine the possible factors of it among dental students at College of Dentistry Sharif Medical and Dental College Lahore. Methodology: A cross sectional study was carried out in May 2021 on 3rd and final year BDS students from Sharif Medical and Dental College Lahore by using modified dental environmental stress questionnaire. SPSS vn 23.0 was used. Results: Male students are mostly affected by rules and regulations (36%) and lack of time to do schoolwork (36%) whereas female students are mostly affected by fear of failing exam (65%) whereas female students are mostly affected by fear of failing exam (65%). Whereas a highly significant association is seen between fear of failing exam and gender i.e.,&lt;0.0001 for the major cause of causing stress. Conclusion: The result of this study shows that dental students of clinical years do suffer from stress. Syllabus and examination pattern should be amended to decrease stress as well as faculty attitude should be more supportive. Counselling sessions should be arranged for student’s better performance. Keywords: Stress, Burnout, Clinical dental students

Perceived stress and career planning awareness of Japanese and Taiwanese undergraduate dental hygiene students

Background/purposeDental hygiene students' stress might be rising with increasing undergraduate study content and expansions in dental hygienists' roles and expectations as society changes. This study explored Japanese and Taiwanese dental hygiene students’ perceptions of stress and their idea of career planning. Materials and methodsParticipants were second- to fourth-year students in the 2020 academic year at Tokyo Medical and Dental University (TMDU; n = 60) and Taipei Medical University (TMU; n = 62). An anonymous questionnaire was distributed, which included questions on demographic information and career planning, as well as the Perceived Stress Scale-10 (PSS-10) and modified Dental Environment Stress questionnaire (DES). ResultsThe response rates were 100.0% (TMDU) and 96.8% (TMU). The number of participants who chose dental hygiene as the first program choice (P < 0.001) and wished to work as dental hygienists after graduation (P = 0.018) in TMDU was significantly higher than in TMU. There was no significant difference between the two schools’ stress levels in both PSS-10 and DES-26. The factors influencing students who wished to work as dental hygienists after graduation were “clinical year or not” (P = 0.007) in TMDU, and the DES factor included items related to lack of confidence in becoming a successful and competent dental hygienist, expectations, and fear of the future (P = 0.033) in TMU. ConclusionBoth schools’ students experienced moderate or relatively low levels of stress. TMDU students had higher stress related to academic studies, while TMU students had slightly higher stress related to future anxiety.

Adapting the German version of the dental environment stress questionnaire.

To develop a German version of the Dental Environment Stress (DES) questionnaire, and to evaluate its reliability and validity. The original English DES questionnaire was translated into German using a forward-backward translation process. To evaluate construct stability, a subgroup of dental students (n=43) completed the DES twice (interval: 1week). To evaluate how the DES responds to anticipated changes in stress, all dental students' (n=64) DES scores and saliva cortisol levels administered from a clinical study were compared between holiday and term time. Furthermore, the Depression, Anxiety and Stress Scale (DASS) and a stress self-assessment were used to determine the validity of the DES. Reliability analyses were calculated using Kendall's tau correlations. To estimate reliability strength, correlation coefficients and intraclass correlations (ICCs) were used. Regarding construct stability, 24 of 25 DES items had at least moderate correlations, and most items showed strong correlations. Correlations for the seven subdomains were good (range: 0.778-1.000). The same was true for the total DES score (ICC: 0.944). Correlations for response to term-time stress were weaker and more varied. Validity analyses revealed fair correlations between the DES and students' self-assessment (Pearson's r=.592) and DASS score (Pearson's r=.392), suggesting satisfactory validity. Stress levels were quite similar between baseline and follow-up. The German DES is a reliable tool for evaluating stress in dental students. Because it can be used to identify individual stressors in various categories, it might enable the detection of specific stress situations in educational situations and facilitate solutions (adjustment of curricula, tailored consulting services).

PERCEIVED SOURCES OF STRESS AMONG UNDERGRADUATE DENTAL STUDENTS IN INDIA – A CROSS SECTIONAL SURVEY

Objective: To investigate the perceived sources of stress, the role of parents, socio-cultural background and the learning environment on the stress levels of the students studying dentistry in Bapuji Dental College, Davanagere, India.Methods: In this cross sectional survey 320 dental students were invited to participate, and 284 responded, resulting in a response rate of 88%. A self administered 42 close ended Dental Environment Stress (DES) questionnaire was used to assess various sources of stress.Results: The sample consisted of the subjects in the age range of 17-28 years, 59.5% of the students joined dentistry as their self choice followed by 9.5% due to parental choice and 31% as they had no other option. Analysis of Variance (ANOVA) revealed perceived sources of stress between classes and across all classes: final year students ranked high (3.32±0.87) due to examinations and grades. Difficulty in learning precision manual skills for doing clinical and laboratory work resulted in highest stress among the first years (2.45±0.83). Working on patients with dirty mouth resulted high amount of stress in final year students (2.84±0.95).Conclusion: The increased amount of stress among dental students highlights the importance of periodic interaction between the students, college faculty and educational psychologists to maximize performance of the students and minimize stress.