Author ORCID Identifier

https://orcid.org/0009-0002-5040-2238

Defense Date

2026

Document Type

Thesis

Degree Name

Master of Science in Dentistry

Department

Dentistry

First Advisor

Tiffany Williams

Second Advisor

Caroline Carrico

Third Advisor

Jeffrey Johnson

Fourth Advisor

Rafael Amorim Cavalcanti de Siqueira

Abstract

Background: Burnout represents a well-documented occupational hazard across health professions, yet its prevalence and determinants remain poorly characterized within pediatric dentistry. This study examined burnout among pediatric dental residents and program directors nationwide, with the aims of quantifying its prevalence, identifying contributing and protective factors, and evaluating the relationship between perceived program director burnout and resident well-being.

Methods: A cross-sectional survey was distributed to pediatric dental residents and program directors across the United States, Canada, and US territories via the American Academy of Pediatric Dentistry (AAPD) listserv. The Maslach Burnout Inventory- Human Services Survey (MBI-HSS) assessed burnout among three subscales: Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA). Responses were analyzed alongside demographics, program characteristics, workload expectations, and perceptions of program director burnout.

Results: A total of 187 responses were received (17.7%), including 25 program directors and 162 residents; 22 program directors and 125 residents completed the MBI-HSS. Applying previously established cutoffs, 66% of residents demonstrated high EE, 40% high DP, and 38% low PA, compared with 32%, 14%, and 23% of program directors, respectively; 14% of residents met criteria for full burnout across all three subscales simultaneously, versus 4% of program directors. Residents reported significantly higher EE (3.4 + 1.38 vs 2.5 + 1.43; p = 0.0049) and lower PA (4.2 + 0.97 vs 4.8 + 0.82; p = 0.0106) than program directors. Burnout scores did not vary by year of training, program region, institution setting, or concurrent master’s degree enrollment. Prior private practice experience was independently associated with lower EE (p = 0.0476). Perceived program director burnout was significantly associated with higher resident EE (p = 0.0047) and DP (p = 0.0020). Residents who had considered leaving their program demonstrated significantly higher EE and DP (p < 0.0001 and p = 0.0073, respectively) and lower PA (p = 0.0016). Greater-than-expected administrative clinical workload (p = 0.0042), patient volume (p = 0.0087), and new patient and recall visit frequency (p = 0.0149) were significantly associated with elevated EE. Conversely, greater-than-expected exposure to treatment with general anesthesia was associated with lower EE (p = 0.0104), lower DP (p = 0.0272), and higher PA (p = 0.0005); greater-than-expected work-life balance was associated with lower EE (p = 0.0004).

Conclusion: Burnout is prevalent among pediatric dental residents and is significantly associated with perceived leadership well-being. The absence of burnout variation among training years indicates distress emerges by the first year and persists throughout residency, consistent with burnout as a structural feature of the training environment rather than a consequence of cumulative exposure. The association between perceived program director burnout and resident emotional exhaustion and depersonalization suggest that investing in program director well-being may yield meaningful downstream benefits for residents and enhance the overall training experience. Additionally, greater transparency during recruitment regarding the scope of clinical and administrative demands may narrow expectation gaps and attenuate burnout risk. Targeted wellness efforts that address both residents and program directors, alongside initiatives to reduce administrative burden, promote work-life balance, and expand access to complex clinical experiences, may collectively strengthen the sustainability of pediatric dental training.

Rights

© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

5-21-2026

Available for download on Saturday, May 20, 2028

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