Mental Health and Well-Being of Undergraduate Dental Students: A Systematic Review


  • Noraini Abu Bakar Department of Orthodontics, Kulliyyah of Dentistry, International Islamic University Malaysia, Pahang, Malaysia.
  • Shea Lee Lim Kulliyyah of Nursing, International Islamic University Malaysia, Pahang, Malaysia.
  • Nadzirah Ahmad Basri Department of Psychiatry, Kulliyyah of Medicine, International Islamic University Malaysia, Pahang, Malaysia.
  • Salizar Mohamed Ludin Department of Critical Care Nursing, Kulliyyah of Nursing, International Islamic University Malaysia, Pahang, Malaysia.



dental students, mental well-being, depression, anxiety, stress


Mental well-being is the very foundation for emotions, cognition and communication. Mental well-being and mental illness are correlated entities and thus mental well-being should be addressed holistically. Psychological stress, especially chronic stress, can impact one’s health and mental well-being. Dentistry in particular is often said to be highly stressful. This paper aimed to discuss the available literature on mental well-being amongst dental undergraduate students including the prevalence of depression, anxiety, stress, sources of stress, coping strategies and intervention programs. Evidence from this review showed that dental students often had high levels of stress, and also a high prevalence of depression and anxiety which contributed to lower mental well-being in this population.  The main sources of stress were mostly academic and clinical factors. Dental students had different coping mechanisms. Social support was found to be a significant factor when coping with stress. Initiatives to bring about improvement of mental well-being and to help students manage stress also showed promising results. Although many studies examined mental health among dental students, most of the studies are cross-sectional in design and were mainly focused on assessing students according to the symptoms they display, e.g. depressed or non-depressed, with very few studies giving focus on the mental well-being of the students. Very little attention was given to students who are 'well' but at risk of developing poor mental well-being. Thus, it is recommended that further research focuses on mental well-being and early intervention measures so as to prevent possible mental health deteriorations.


World Health Organisation. Promoting mental health?: concepts, emerging evidence, practice. France; 2005.

Keyes CLM. Mental illness and/or mental health? Investigating axioms of the complete state model of health. J Consult Clin Psychol. 2005;73(3):539–48.

Institute for Public Health (IPH). National Health and Morbidity Survey 2015 (NHMS 2015). Vol. II: Non-Communicable Diseases, Risk Factors & Other Health Problems. Ministry of Health Malaysia; 2015.

Collin V, Toon M, O’selmo E, Reynolds L, Whitehead P. A survey of stress, burnout and well-being in UK dentists. Br Dent J. 2019;226(1):40–9.

Myers HL, Myers LB. “It’s difficult being a dentist”: Stress and health in the general dental practitioner. British Dental Journal. 2004.

Puriene A, Aleksejuniene J, Petrauskiene J, Balciuniene I, Janulyte V. Self-perceived mental health and job satisfaction among Lithuanian dentists. Ind Health. 2008;46(3):247–52.

Kay EJ, Lowe JC. A survey of stress levels, self-perceived health and health-related behaviours of UK dental practitioners in 2005. Br Dent J. 2008;204(11):622–3.

b-Murat N, Mason L, Kadir RA, Yusoff N. Self-perceived mental well-being amongst Malaysian dentists. Int J Occup Saf Ergon. 2018;24(2):233–9.

Harnois G, Gabriel P. Mental Health and Work?: Impact, issues and good practices. World Health Organization and International Labour Organization. 2000.

Marin MF, Lord C, Andrews J, Juster RP, Sindi S, Arsenault-Lapierre G, et al. Chronic stress, cognitive functioning and mental health. Neurobiol Learn Mem [Internet]. 2011;96(4):583–95.

Chisholm D, Layard R, Patel V, Saxena S. Mental Illness and Unhappiness. Cent Econ Performance, LSE, CEP Discuss Pap 2013 [Internet]. 2013;(7620).

Alfaris E, Irfan F, Qureshi R, Naeem N, Alshomrani A, Ponnamperuma G, et al. Health professions’ students have an alarming prevalence of depressive symptoms: Exploration of the associated factors. BMC Med Educ [Internet]. 2016;16(1):1–8.

Knipe D, Maughan C, Gilbert J, Dymock D, Moran P, Gunnell D. Mental health in medical, dentistry and veterinary students: cross-sectional online survey. BJPsych Open. 2018;4(6):441–6.

Deeb GR, Braun S, Carrico C, Kinser P, Laskin D, Golob Deeb J. Burnout, depression and suicidal ideation in dental and dental hygiene students. Eur J Dent Educ. 2018;22(1):e70–4.

Takayama Y, Miura E, Miura K, Ono S, Ohkubo C. Condition of depressive symptoms among Japanese dental students. Odontology. 2011;99(2):179–87.

Sugiura G, Shinada K, Kawaguchi Y. Psychological well-being and perceptions of stress amongst Japanese dental students. J Dent Educ. 2005;9(1):17–25.

Uraz A, Tocak YS, Yozgatligil C, Cetiner S, Bal B. Psychological well-being, health, and stress sources in Turkish dental students. J Dent Educ [Internet]. 2013;77(10):1345–55.

Humphris G, Blinkhorn A, Freeman R, Gorter R, Hoad-Reddick G, Murtomaa H, et al. Psychological stress in undergraduate dental students: Baseline results from seven European dental schools. Eur J Dent Educ. 2002;6(1):22–9.

Graner KM, De Moraes ABA, Torres AR, Lima MCP, Rolim GS, De Abreu Ramos-Cerqueira AT. Prevalence and correlates of common mental disorders among dental students in Brazil. PLoS One. 2018;13(9):1–16.

Stormon N, Ford PJ, Kisely S, Bartle E, Eley DS. Depression, anxiety and stress in a cohort of Australian dentistry students. Eur J Dent Educ. 2019;23(4):507–14.

Basudan S, Binanzan N, Alhassan A. Depression, anxiety and stress in dental students. Int J Med Educ. 2017;8:179–86.

Newbury-Birch D, Lowry RJ, Kamali F. The changing patterns of drinking, illicit drug use, stress, anxiety and depression in dental students in a UK dental school: A longitudinal study. Br Dent J. 2002;192(11):646–9.

Radeef AS, Faisal GG. Stressors and Their Association with Symptoms of Depression, Anxiety and Stress in Dental Students. Makara J Heal Res [Internet]. 2018 Aug;22(2):58–62.

Yusof ZYM, Wan Hassan WN, Razak IA, Hashim SMN, Tahir MKAM, Keng SB. Personality traits and stress levels among senior dental students: Evidence from Malaysia and Singapore. Southeast Asian J Trop Med Public Health. 2016;47(6):1353–65.

Alhajj MN, Khader Y, Murad AH, Celebic A, Halboub E, Márquez JR, et al. Perceived sources of stress amongst dental students: A multicountry study. Eur J Dent Educ. 2018;22(4):258–71.

Polychronopoulou A, Divaris K. Dental students’ perceived sources of stress: a multi-country study. J Dent Educ. 2009;73(5):631–9.

Mohd Nayan NA, Che Daud AZ, Tengku Jamaluddin TIB, Talib SS. Perceived Depression, Anxiety and Stress Among UiTM Dental Undergraduates in Clinical Years. Environ Proc J [Internet]. 2017;2(6):81.

Laurence B, Williams C, Eiland D. Depressive symptoms, stress, and social support among dental students at a historically black college and university. J Am Coll Heal. 2009;58(1):56–63.

Abu-Ghazaleh SB, Sonbol HN, Rajab LD. A longitudinal study of psychological stress among undergraduate dental students at the University of Jordan. BMC Med Educ [Internet]. 2016;16(1):1–6.

Divaris K, Polychronopoulou A, Villa-Torres L, Mafla AC, Moya GA, González-Martínez F, et al. Extracurricular factors influence perceived stress in a large cohort of Colombian dental students. J Dent Educ [Internet]. 2014;78(2):213–25.

Gorter R, Freeman R, Hammen S, Murtomaa H, Blinkhorn A, Humphris G. Psychological stress and health in undergraduate dental students: Fifth year outcomes compared with first year baseline results from five European dental schools. Eur J Dent Educ. 2008;12(2):61–8.

Alzahem A, van der Molen, de Boer. Effect of year of study on stress levels in male undergraduate dental students. Adv Med Educ Pract. 2013;4:217–22.

Naidu RS, Adams JS, Simeon D, Persad S. Sources of stress and psychological disturbance among dental students in the West Indies. J Dent Educ [Internet]. 2002;66(9):1021–30.

Peker ?, Alkurt MT, Usta MG, Turkbay T. The evaluation of perceived sources of stress and stress levels among Turkish dental students. Int Dent J. 2008;58(2009):342–8.

Babar MG, Hasan SS, Ooi YJ, Ahmed SI, Wong PS, Ahmad SF, et al. Perceived sources of stress among Malaysian dental students. Int J Med Educ. 2015;6:56–61.

Jowkar Z, Masoumi M, Mahmoodian H. Psychological Stress and Stressors Among Clinical Dental Students at Shiraz School of Dentistry, Iran. Adv Med Educ Pract. 2020;11(February):113–20.

Abu-Ghazaleh SB, Sonbol HN, Rajab FD. Psychological stress among dental students at the University of Jordan. J Dent Educ. 2011;75(8):1107–14.

Sofola OO, Jeboda SO. Perceived sources of stress in Nigerian dental students. Eur J Dent Educ. 2006;10(1):20–3.

Harrison PL, Shaddox LM, Garvan CW, Behar-Horenstein LS. Wellness Among Dental Students: An Institutional Study. J Dent Educ [Internet]. 2016;80(9):1119–25.

Andre A, Pierre G, McAndrew M. Quality of Life Among Dental Students: A Survey Study. J Dent Educ. 2017;81(10):1164–70.

Acharya S. Factors affecting stress among Indian dental students. J Dent Educ [Internet]. 2003;67(10):1140–8.

Kumar S, Dagli RJ, Mathur A, Jain M, Prabu D, Kulkarni S. Perceived sources of stress amongst Indian dental students. Eur J Dent Educ. 2009;13(1):39–45.

Hayes A, Hoover JN, Karunanayake CP, Uswak GS. Perceived causes of stress among a group of western Canadian dental students. BMC Res Notes [Internet]. 2017;10(1):714.

Polychronopoulou A, Divaris K. A longitudinal study of Greek dental students’ perceived sources of stress. J Dent Educ [Internet]. 2010;74(5):524–30.

Heath JR, Macfarlane TV, Umar MS. Perceived Sources of Stress in Dental Students. Dent Updat. 1999;26:94–100.

Lewis EG, Cardwell JM. The big five personality traits , perfectionism and their association with mental health among UK students on professional degree programmes. BMC Psychol. 2020;8(1):1–10.

Jenkins S, Johnson I, Ginley J. Work, Stress and Play: Students’ perceptions of factors impacting on their studies and well-being. Eur J Dent Educ. 2019;23(3):349–54.

Galán F, Ríos-Santos JV, Polo J, Rios-Carrasco B, Bullón P. Burnout, depression and suicidal ideation in dental students. Med Oral Patol Oral Cir Bucal. 2014;19(3).

Jiménez-Ortiz JL, Islas-Valle RM, Jiménez-Ortiz JD, Pérez-Lizárraga E, Hernández-García ME, González-Salazar F. Emotional exhaustion, burnout, and perceived stress in dental students. J Int Med Res. 2019;47(9):4251–9.

Silverstein ST, Kritz-Silverstein D. A longitudinal study of stress in first-year dental students. J Dent Educ. 2010;74(8):836–48.

Ahmad MS, Yusoff MMM, Razak IA. Stress and Its Relief Among Undergraduate. Southeast Asian J Trop Med Public Heal. 2011;42(4):996–1004.

Yaacob M, Harun NA, Ramli F, Razak HA, Sajuni NA. Depression, anxiety and stress among dental undergraduate students: Prevalence, stressors and relieving factors. Int Med J Malaysia. 2016;17(Specialissue2):123–30.

Gambetta-Tessini K, Mariño R, Morgan M, Evans W, Anderson V. Stress and health-promoting attributes in Australian, New Zealand, and Chilean dental students. J Dent Educ [Internet]. 2013;77(6):801–9.

Lopez N, Johnson S, Black N. Does Peer Mentoring Work? Dental Students Assess Its Benefits as an Adaptive Coping Strategy. J Dent Educ. 2010;74(November):1197–205.

Brondani MA, Ramanula D, Pattanaporn K. Tackling stress management, addiction, and suicide prevention in a predoctoral dental curriculum. J Dent Educ [Internet]. 2014;78(9):1286–93.

Alzahem AM, Van der Molen HT, De Boer BJ. Effectiveness of a Dental Students Stress Management Program. Heal Prof Educ [Internet]. 2015;1(1):34–42.

Smith A, Scott I, Ratnayake J, Newsham-West K, Cathro P. An Intervention Study: Does a Cognitive Reappraisal Technique Reduce the Perceived Stress in Fourth-Year Dental Students in New Zealand? Int J Dent. 2019;2019.

Aboalshamat K, Hou XY, Strodl E. The impact of a self-development coaching programme on medical and dental students’ psychological health and academic performance: A randomised controlled trial. BMC Med Educ [Internet]. 2015;15(1):1–13.

Braun SE, Deeb G, Carrico C, Kinser PA. Brief Yoga Intervention for Dental and Dental Hygiene Students: A Feasibility and Acceptability Study. J Evidence-Based Integr Med. 2019;24:1–7.

Adams DF. The Embedded Counseling Model: An Application to Dental Students. J Dent Educ. 2017;81(1):29–35.




How to Cite

Abu Bakar, N., Lim, S. L., Basri, N. A., & Mohamed Ludin, S. (2021). Mental Health and Well-Being of Undergraduate Dental Students: A Systematic Review. INTERNATIONAL JOURNAL OF CARE SCHOLARS, 4(2), 56–70.