Dental Environment Stress and The Related Factors in the Iranian Dental Students: A Systematic Review and Meta-Analysis

Background: Stress is an influential factor in mental health; and can lead to psychological disorders. Thus, it has always been a concern for the medical personnel, and particularly dental students. This systematic review aimed to assess the dental environment stress and the related factors in the Iranian dental students. Methods: In this systematic review, an electronic search of the literature was carried out in the Iranian and international databases, and all possible combinations of relevant keywords were searched using the Boolean operators. Data were analyzed using STATA SE 13.1 meta-analysis software. Heterogeneity of the data was evaluated using the I2 statistics, and the correlation between age and level of stress was analyzed by meta-regression. In the Chi-square (X2) heterogeneity test, P-value < 0.05 was considered significant. Results: A total of 16 eligible articles (3,521 dental students) out of 821 retrieved studies were reviewed in this systematic review. The mean overall stress level of the Iranian dental students was 2.18 (95% CI:1.87-2.49). The maximum (2.21) and minimum (2.10) mean overall stress values of the Iranian dental students were associated with the dental environment stress (DES) questionnaire and the depression, anxiety and stress scale (DASS-21), respectively (P>0.05). Also, the 4th and 5th year dental students had the maximum (2.24) and minimum (2.01) mean overall stress levels, respectively (P>0.05). Gender had no correlation with the stress level (P=0.520). Conclusion: The mean stress level of the Iranian dental students is moderate to high. Since stress reduction is directly correlated with the promotion of mental health and function, the authorities are required to revise the educational curricula following consultation with the counselors and implement effective programs to minimize the stress level of dental students. Also, achieving efficient communication between dental students and instructors can greatly improve the quality of clinical education.