A study published in Clinical and Experimental Dental Research found that patient behavior significantly increases emotional burden and stress for dentists in implant dentistry, affecting clinical performance and decision-making more than the difficulty of the procedure itself.
- Patient behavior was strongly associated with clinician emotional burden and interaction difficulty, more so than procedural complexity.
- Dentists experiencing greater emotional burden showed avoidance of similar patients and perceived lower clinical performance.
- Emotional burden was firmly linked to interaction difficulty, avoidance behavior, and perceived clinical performance decline.
- Findings suggest interpersonal and human-factor dimensions significantly influence clinician experience and treatment decisions in implant practice.
When dentists faced challenging implant cases, patient behavior appeared to increase clinicians' emotional burden and perceived interaction difficulty. The study was recently published in Clinical and Experimental Dental Research.
Additionally, while patient behavior wasn’t directly correlated with lower perceived clinical performance, greater emotional burden was associated with a greater perceived effect of challenging cases and avoidance of similar patients, the authors wrote.
“These findings highlight the potential relevance of interpersonal and human‐factor dimensions in implant practice and suggest that patient‐related factors may contribute to clinician experience and treatment‐related decision‐making,” wrote lead author Dr. Aspasia Pachiou of the University of Zurich in Switzerland (Clin Exp Dent Res, September 8, 2026).
Clinical performance can be affected by stress and mental workload. Furthermore, feeling emotionally burdened can be linked to weakened decision-making, an increased likelihood of making mistakes, and more. Research has shown that performance and well-being can be negatively affected by factors, including case difficulty and time pressure.
However, limited evidence examining how patients and challenging cases affect dentists’ clinical performance and emotional burden in implant dentistry exists.
To investigate the link between patient behavior and clinician emotional burden, perceived clinical performance and interaction difficulty, and decision‐making in implant dentistry, a cross-sectional study was conducted.
An online survey was sent to dentists, and 127 responded. They had to answer questions about demographics, emotional responses, and the perceived impact of patient‐related factors on clinical performance and decision‐making. Correlations were assessed using Spearman's correlation and linear regression analyses, according to the study.
The findings suggest that more challenging patient behavior was significantly associated with greater clinician emotional burden (ρ = 0.50, p < 0.001) and interaction difficulty (ρ = 0.46, p < 0.001). When typical clinical cases were compared to patient behavior, similar findings were observed (both p < 0.001), the authors wrote.
In terms of emotional burden and interaction difficulty, procedural difficulty revealed weak or insignificant correlations.
Furthermore, emotional burden was firmly linked to the following:
- Interaction difficulty (ρ = 0.84, p < 0.001)
- Avoidance of scheduling similar patients (ρ = 0.47, p < 0.001)
- Lower perceived clinical performance (ρ = 0.27, p = 0.002)
Regression analyses confirmed that emotional burden and patient behavior were linked significantly (p < 0.001), the authors wrote.
Nonetheless, the study had several limitations, including its cross-sectional design. The design prevents causal inference, they wrote.
“Patient behavior appears to be associated with clinician emotional burden and perceived clinical performance more strongly than case difficulty in implant dentistry,” Pachiou and colleagues wrote.
