Stressors, psychological well-being, and overall health amongst students from public and private dental schools

  • Francisco Wilker Mustafa Gomes Muniz
  • Marcelo Bruno Lemos de Oliveira
  • Isadora Daniel Barros
  • Patrícia Maria Costa de Oliveira
  • Lidiany Karla Azevedo Rodrigues
  • Rosimary de Sousa Carvalho


Aim: This study aimed to correlate stressors with psychological well-being and health factors in dental students from public and private schools. Methods: From February to May 2015, three different instruments (Dental Environment Stress – DES – Psychological General Well-Being – PGWB – and SF-36 Health Survey) were applied to students from two public and two private dental schools from the State of Ceará, Brazil. Mann- Whitney test or t test for independent samples were used in order to compare the stressors between private and public dental schools students. Correlations to each DES domain were performed using Kendall’s Tau C test. Results: A total of 92 (45.32%) and 111 (56.68%) students from public and private schools, respectively, answered the questionnaire. Students from public schools demonstrated significantly higher scores in DES/academic performance and DES/personal and institutional factors (p<0.05). Significant negative correlations were detected between PGWB/anxiety and PGWB/general with all DES domains for both public and private schools (p<0.05). Additionally, DES/academic performance was significantly correlated with several SF-36 domains, such as physical function, vitality, and social functioning, to both public and private schools (p<0.05). However, DES/academic performance and SF-36/role physical was only significantly correlated in private school students (r=-0.171, p=0.039), while SF-36/bodily pain (r=-0.274, p<0.001), general health (r=-0.245, p=0.001), and mental health (r=-0.286, p<0.001) were significantly correlated with DES/academic performance only in public school students. Conclusion: Students from public and private dental schools presented different stressor patterns. Additionally, most of DES domains were significantly associated with PGWB and SF-36 to both public and private schools.


1. Butler G. Definitions of stress. Occas Pap R Coll Gen Pract. 1993 Aug;(61):1-5.
2. Tosevski DL, Milovancevic MP, Gajic SD. Personality and psychopathology of university students. Curr
Opin Psychiatry. 2010 Jan;23(1):48-52. doi: 10.1097/YCO.0b013e328333d625.
3. Sugiura G, Shinada K, Kawaguchi Y. Psychological well-being and perceptions of stress amongst
Japanese dental students. Eur J Dent Educ. 2005 Feb;9(1):17-25.
4. Uraz A, Tocak YS, Yozgatligil C, Cetiner S, Bal B. Psychological well-being, health, and stress sources
in Turkish dental students. J Dent Educ. 2013 Oct;77(10):1345-55.
5. Al-Sowygh ZH. Academic distress, perceived stress and coping strategies among dental students in
Saudi Arabia. Saudi Dent J. 2013 Jul;25(3):97-105. doi: 10.1016/j.sdentj.2013.05.002.
6. Cooper CL, Watts J, Kelly M. Job satisfaction, mental health, and job stressors among general dental
practitioners in the UK. Br Dent J. 1987 Jan;162(2):77-81.
7. Fonseca E, Rocha C, Kruger E, Tennant M, Mialhe F, Meneghim M. Distribution of dental schools in
Brazil. Eur J Gen Dent. 2016 Apr;5(2):47-52. doi: 10.4103/2278-9626.179534.
8. Sangiorgio J, Araujo P, Navarro C, Zen IR, Costa SC, Riberio PHV, et al. Dental Environment Stress:
Findings among Lusophone Dental Students. Braz Res Ped Dent Integr Clin. 2016 Dec;16(1):411-24.
doi: 10.4034/PBOCI.2016.161.43.
9. Langoski J, Klipan L, Bordin D, Ferracioli M, Pinto M, Fadel C. Stress among Brazilian Dental
students in different periods: prevalence and perceptions. Physchol. 2015 Feb;6(3):297-304.
doi: 10.4236/psych.2015.63030.
10. Ciconelli R, Ferraz M, Santos W, Meinão I, Quaresma M. Brazilian-Portuguese version of the SF-36.
A reliable and valid quality of life outcome measure. Rev Bras Reumatol. 1999 Jan;39(3):143-50.
11. Santo R. [Psychological well-being: validation of Psychological General Well-being scale to
portuguese population] [dissertation]. Porto: Faculdade de Psicologia, Educação e Desporto,
Universidade Lusófona do Porto; 2015. Portuguese.
12. Petta CA, Ferriani RA, Abrao MS, et al. Randomized clinical trial of a levonorgestrel-releasing
intrauterine system and a depot GnRH analogue for the treatment of chronic pelvic pain in women
with endometriosis. Hum Reprod. 2005 Jul;20(7):1993-8.
13. Davies A, Ware Jr J. Measuring health perceptions in the health insurance experiment. Santa Monica:
Rand; 1981.
14. Lazarus R, Folkman S. Stress, appraisal, and coping. New York: Springer; 1984.
15. Sohail N. Stress and academic performance among medical students. J Coll Physicians Surg Pak.
2013 Jan;23(1):67-71. doi: 01.2013/JCPSP.6771.
16. Garbee WH, Zucker SB, Selby GR. Perceived sources of stress among dental students. J Am Dent
Assoc. 1980 Jun;100(6):853-7.
17. Awa WL, Plaumann M, Walter U. Burnout prevention: a review of intervention programs. Patient Educ
Couns. 2010 Feb;78(2):184-90. doi: 10.1016/j.pec.2009.04.008.
18. Ahmad MS, Md Yusoff MM, Abdul Razak I. Stress and its relief among undergraduate dental students
in Malaysia. Southeast Asian J Trop Med Public Health. 2011 Jul;42(4):996-1004.
19. 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 Feb;6(1):22-9.
20. 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 May;12(2):61-8.
doi: 10.1111/j.1600-0579.2008.00468.x.
21. Elani HW, Allison PJ, Kumar RA, Mancini L, Lambrou A, Bedos C. A systematic review of stress in
dental students. J Dent Educ. 2014 Feb;78(2):226-42.
22. 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 May 2;6:56-61. doi: 10.5116/ijme.5521.3b2d.
23. Azevedo M, Gomes T, Barbosa R, Barros A, Silva A, Sette-de-Souza P. [Historical series of Enade
grades in Dentistry: were there changes throughout three evaluative cycles?] Rev ABENO.
2017;17(1):109-13. Portuguese.
24. Jameson M, Smith J. Voices of students in competition: Health Science First Year at the University of
Otago, Dunedin. N Z Med J. 2011 Jul;124(1338):55-67.
25. Bathla M, Singh M, Kulhara P, Chandna S, Aneja J. Evaluation of anxiety, depression and
suicidal intent in undergraduate dental students: A cross-sectional study. Contemp Clin Dent.
2015 Apr-Jun;6(2):215-22. doi: 10.4103/0976-237X.156050.
26. Dhama K, Gupta R, Singla A, Patthi B, Ali I, Niraj LK, et al. An Insight into Spiritual Health and Coping
Tactics among Dental Students; A Gain or Blight: A Cross-sectional Study. J Clin Diagn Res. 2017
Aug;11(8):ZC33-ZC38. doi: 10.7860/JCDR/2017/25358.10371.
How to Cite
MUNIZ, Francisco Wilker Mustafa Gomes et al. Stressors, psychological well-being, and overall health amongst students from public and private dental schools. Brazilian Journal of Oral Sciences, [S.l.], p. e181210, jan. 2019. ISSN 1677-3225. Available at: <>. Date accessed: 16 july 2019. doi:
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