People do not leave jobs, they leave toxic work environments.

—Anonymous

The environment in which we work as dental professionals matters enormously to our mental well‐being. Negative work environments in dentistry, with behaviours such as bullying and rudeness, have wide‐spanning downstream impacts on the dental professional, the team, patients, and also our personal relationships at home. When we experience rudeness and incivility from a work colleague, it triggers a stress response and the amygdala hijack we discussed in Chapter 1. The consequences of this stress response include reduced thinking abilities and the inability to problem solve because we are lost mulling over the rude comments. We are less likely to seek help or share learnings from failures with our team, as we are operating from a space of fear. We spend so much time at work, and so if we are surrounded by toxic work cultures, no matter how much we focus on the other pillars of resilience, thriving at work becomes that much harder.

Conversely, a positive working environment encourages us to feel happier at work and connected to our team, to be more productive, and to be much more equipped to perform as a dental professional efficiently. We feel psychologically safe – that is, comfortable to bring our authentic selves to work without fear of reprimand, punishment, or discrimination. We feel safe to share concerns and have positive discussions.

The ‘E’ of the PERLE Resilience Model centres on exactly these components. This chapter hones in on an environment at work that is compassionate, positive, and centred on well‐being and allows us to perform in optimal states.

The physical environment within the dental practice also impacts our well‐being and productivity. Dental principals can bake well‐being principles into the design of their practice. This could be through:

• Well‐being notice board with well‐being tips, the Mental Wellness Check‐in (see Chapter 3), and staff recognition through posting gratitude and compliments
• Thoughts box for staff to anonymously document feelings
• Boosting natural light as much as possible, through use of windows
• Avoiding harsh fluorescent lighting: when the lighting is too harsh it can cause eye strain or headaches
• Ergonomic chairs
• Encouraging use of loupes for clinical procedures
• Dedicated staff room
• Air con.

In the next sections, we explore in depth two key ways dental professionals can be active in creating positive work environments: through improving relationships at work by boosting High‐Quality Connections, and increasing engagement by activating our top strengths with patients and the team.

High‐Quality Connections

The practice of dentistry can be a lonely endeavour. We may face a busy patient diary, with emergency appointments, referrals, and juggling record keeping in between difficult treatments, with little respite. It can be very easy to not prioritise our relationships at work and suffer from isolation in the process. However, examining our physiology when we experience loneliness shines new light on this topic: loneliness puts us in a ‘stressed’ state, with the body releasing stress hormones, such as cortisol. And as we established in Chapter 1, chronic stress states impact both our mental and physical well‐being. One large meta‐analysis of 70 studies with more than three million participants showed loneliness had a significant effect on mortality, which has been shown to be similar to effects to smoking 15 cigarettes day (Holt‐Lunstad et al. 2015).

The key to transforming the dental environment, and an effective antidote to loneliness in dentistry, is to build and nurture positive relationships. We can do this through increasing our High‐Quality Connections (HQCs) at work. HQCs can be defined as very short interactions, even seconds, that are positive, characterised by positive regard (warmth towards the other person), vitality (feeling energised and connected), and mutuality (finding common ground) (Dutton and Heaphy 2003). These micro‐moments of connection should be considered the same as any health behaviour: crucial in survival but also for us to thrive. HQCs make us feel more open and alive. They boost our levels of positive emotions, and as Fredrickson’s Broaden‐and‐Build Theory describes (see Chapter 3), our thinking is broadened as a result, and we build important psychological and psychical resources that can support us.

It has long been established that as dental professionals we benefit from prioritising connection with our patients before starting treatment, in order to build trusting relationships and avoid litigation. What is not featured, however, is the sheer possibilities of these HQCs to boost our psychological well‐being. We have moments upon moments, meeting numerous patients, to top up our levels of HQCs.

Pathways for Building HQCs in Dentistry

There are several pathways to building HQCs in dentistry, interacting both with our patients and team. We focus on four pathways: mindful listening, team gratitude, positive communication, and mentoring. Drawing from the research from Dutton and others, these pathways create an environment at work that honours respect and kindness and increases our capacity to be more helpful to our team and patients.