The impact of the SARS-CoV-2 pandemic on stress and anxiety in dentistry students

Objectives: To investigate the impact of the SARS-CoV-2 pandemic on stress and anxiety in preclinical and clinical dentistry students. Materials and Methods: Dentistry students in clinical course(CC; n=64) or preclinical course(PCC; n=53) were included. The subjective perceived levels of stress and anxiety were evaluated using the Dental Environment Stress(DES) and the Depression, Anxiety and Stress Scales(DASS) questionnaire. Cortisol levels were measured in saliva samples. Knowledge of the pandemic was evaluated. All data were collected twice: during the university holidays and during term time. Descriptive and bivariate statistics were used to compare data between baseline and follow-up. Multivariate linear regression models were computed to analyze possible influencing factors. Results: 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. 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. Intra-individual 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.  Conclusion: Intra-individual 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 dentistry students. A follow-up study when the pandemic is over would be useful to control for stress under normal circumstances.  Clinical Relevance: These results highlight the importance of individual stress management in dentistry students.