A Comparative Investigation of Undergraduate Dental Student Stress in the Management of Deep and Moderate Carious Lesions.

Abstract

Aim: The primary objective of this clinical study was to analyse, through physiological and psychological parameters, undergraduate dental student stress during the management of deep compared with moderate carious lesions. Additional objectives aimed to compare student confidence, anxiety and satisfaction during deep and moderate caries management and their perception of the quality of teaching they received regarding these treatments.

Methodology: In this crossover study, 35 clinical students treated deep and moderate caries on permanent vital teeth in adult patients with no history of spontaneous pain. The STAI-State (STAI-S) anxiety questionnaire was completed preoperatively. Stress-VAS (visual analogic scale) and confidence-VAS scores were collected during the preoperative (before anaesthesia), perioperative (end of caries excavation) and postoperative (after patient left) phases of both caries management. Cardiovascular parameters (blood pressure and heart rate) were collected during the same stages. A satisfaction-VAS was completed postoperatively. The effects of the depth of the caries, time and student demographics on preoperative anxiety (STAI-S), pre-, peri- and postoperative stress, confidence, blood pressure and heart rate, as well as postoperative satisfaction, were assessed using Mixed ANOVA with multiple pairwise comparisons. The statistical analysis was performed with IBM SPSS. A questionnaire assessing teaching adequacy was completed after each treatment.

Results: The treatment of deep caries led to a significantly higher level of stress and a significantly lower level of confidence among students than the treatment of moderate caries, pre-, per- and post-operatively (p ≤ 0.05). Student preoperative anxiety was significantly higher in cases of deep caries, and their post-operative satisfaction was significantly lower. However, there was no significant difference between the two groups in terms of cardiovascular parameters at any stage. There was no influence of the student year of study on the parameters examined; however, gender influenced confidence at all times combined, as well as preoperative stress, with females less confident and more stressed than males. The median level of perceived teaching 'adequacy' was higher for moderate caries than for deep caries.

Conclusions: Within the limits of this study, the management of deep carious lesions is associated with a higher level of stress among students compared with moderate caries.