S1 E6: Be well

An ADA Wellness Ambassador offers practical ways to ease the daily stress of caring for your patients and yourself.

Dental Sound Bites with Be Well featuring image of Dr. Alex Barrera

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Episode notes

Stress is part of being a dentist. Here’s how to protect your well-being

There are times when dentistry can be physically, mentally and emotionally challenging. For many, the busy holiday season is one of those times. The holidays can bring stressful moments, both personally and professionally. In this episode, you’ll find self-care and wellness resources and tips from guest Dr. Alex Barrera, a member of ADA Wellness Ambassador program, to help you incorporate wellness into your everyday life.

As Dr. Barrera explains: “Little by little we (can) incorporate more healthy habits. That's how we get to do that ‘mental flossing.’ It's preventative care, right? Just like going to your dentist every six months is preventative care. It's sort of the same thing with mental health.”

Marko Vujicic, PhD head shot
Dr. Alex Barrera

Show notes

  • Barrera draws on experiences working with diverse groups within dentistry and his training as a certified yoga instructor to offer listeners tips and advice on how to make wellness and self-care a daily habit.
  • He is a general dentist in Houston, Texas who works at a federally-qualified health center. He has a passion to serve the underserved and vulnerable populations.
  • In 2019, he helped found the first official LGBTQ-focused organized dentistry group called the Houston Equality Dental Network and has been highly involved with the Hispanic Dental Association.
  • He is dedicated to educating dental professionals and dental students on how to better treat and serve the LGBTQ community.
  • As a yoga teacher with a passion for wellness and self-care, he enjoys educating others about the benefits of “mental flossing,” or daily self-care activities that prioritize mental health.
    The results of the 2021 Dentists Well-Being Survey report indicated an increase of dentists affected by mental and emotional health concerns. Barrera isn’t surprised by this finding. He says he has experienced high-functioning anxiety and depression himself in the past.
  • Dentistry often attracts detail-oriented people, who Barrera says may find complete satisfaction from checking something off their to-do list and always seeking out the next task. While this trait isn’t bad, Barrera says it can leave little time to focus on self-care and wellness.
  • The ADA Wellness Ambassadors are rolling out projects around their districts that include and incorporate wellness more deeply into the community.
  • The three things Barerra suggests doing every day as part of “mental flossing”:
  1. Practicing gratitude. This can be done by jotting down three things you are grateful for every day.
  2. Moving your body. A daily walk, stretching every morning or night or hitting the gym or yoga studio on a regular basis is a great way to lessen stress.
  3. Breathing exercises.  Barerra suggests a method called “box breathing,” which includes breathing in four counts, holding your breath for four counts, exhaling for four counts, then holding the breath out for four counts. 


View episode transcript


Hanlon [00:00:00] Hey, everyone. I'm Dr. Hanlon

Wright [00:00:02] And I'm Dr. Wright.

Hanlon [00:00:03] And this is Dental Sound Bites and ADA podcast where dentists share solutions to challenges in life and at work. In this episode, we are bringing you steps that you can take to improve your physical and mental well-being in and out of the operatory in our personal search for wellness.

Announcer [00:00:21] From the American Dental Association. This is Dental Sound Bites created for dentists by dentists. Ready? Let's dive right into real talk on dentistry's daily wins and sticky situations.

Wright [00:00:37] For today's conversation, please welcome Dr. Alex Barrera.

Barrera [00:00:40] Hello, everyone. Good to be here. I'm excited to be here.

Hanlon [00:00:43] We are so happy to have you here. So, Alex, tell us a little bit about yourself in the wellness work you do in your community.

Barrera [00:00:50] I am a general dentist in Houston, Texas. I actually work at a federally qualified health center. I had a huge passion to serve the underserved that started to grow and develop during dental school. So, I knew upon finishing up that I wanted to be out there and I wanted to work at a center where I can treat those that are underserved and those that are in vulnerable populations. So, I've been doing that since graduating for the past about five years now. I've also been pretty involved in the world of organized dentistry. I am a past alumni of the ADA's Institute for Diversity and Leadership, and I'm also been involved with my state and local organization as well, and always been pretty highly involved with the Hispanic Dental Association.

Hanlon [00:01:38] Awesome.

The Houston Equality Dental Network- LGBTQ Dentistry

Barrera [00:01:38] In 2019, I helped found the first official LGBTQ-focused organized dentistry group called the Houston Equality Dental Network. And so we started in 2019 and, you know, quickly realized that we had a much broader reach. We're doing webinars and articles and presentations all over the nation now. So, the purpose of that organization was to kind of bring together LGBTQ dentists, hygienists, dental professionals in an environment where they can feel safe and included but also grow and network as a professional. At the same time, we learned that we can have a pretty big impact by becoming educators to educate the dental professionals out there today and also educate dental students on how to better treat and serve the LGBTQ community. At the same time, we're also giving back to the local community. So, that's where I spend a majority of my time and efforts. I'm also very, very passionate about the wellness world. I am a certified yoga teacher, so I do that part time. And that has been my introduction to the world of wellness. And primarily the past year I've been really focusing on how I can combine these two passions of wellness and dentistry.

Wright [00:02:54] You mentioned the Houston Equality Dental Network. I would love to go a little bit deeper into the work of that project, if you would. Talk about some of the challenges that are facing the LGBTQ community of dentists and the patients.

Barrera [00:03:07] This is something that started sort of as a social group, as, you know, a conversation between a few friends, colleagues. I was hearing the stories of people who are really passionate, excited to volunteer, excited to serve, but never really felt fully included in the world of organized dentistry or in the dental profession as a whole. Always maybe feeling a little bit reserved and a little bit worried about what others might think, what patients might think. And, you know, we started this as a social group to just to bring networking within a group of dental professionals. And little by little, we found out that this was so much more. We have started to present and host and teach at dental schools, dental programs, conferences on how to better serve the queer community. Something that we may not consider, but there's a lot of health disparities that still exist within the LGBTQ community. People who identify under the LGBTQ umbrella have much higher rates of things like anxiety, depression, drug use and abuse, alcoholism. We know that HIV and STDs are still a much higher burden in the community. And overall, you know, there are a lot of things that we just still don't know or are just starting to learn about the health of queer individuals, because it's a population, a group that had been lacking in research and studies and programs for so long. Because anxiety and depression exist so much in this population, this leads to these individuals to probably not seek oral health care as often as someone else would. This leads to these individuals being a lot more insecure about going to see a medical provider or insecure about their teeth and oral health, leading to, of course, much further problems as we neglect seeing a dentist.

Announcer [00:05:00] Announcing the new...wait. This calls for a drum roll. Perfect. Announcing the newly reimagined. ADA member app designed for dentists by dentists. It puts ADA membership in the palm of your hand with features like a personalized news feed, member chat groups, personal documents, storage, even episode exclusives from Dental Sound Bites. The new ADA podcast. Tap into all the possibilities by searching for a ADA member app in your App Store.

Prioritizing mental health in the dental community

Wright [00:05:38] A really big segment of this episode is mental health. We know that there's a sense of urgency to tackle mental health in our community. We want to talk about some symptoms and main reasons behind anxiety and burnout and stress.

Barrera [00:05:52] I think as dental professionals, we enjoy staying busy, we enjoy working hard, we're very detail oriented, and these are all skills that we kind of needed to develop to lead us to where we are right now. And we stick with that, right? We stick with all these these detailed-oriented tendencies so that we can provide good dentistry, so that we can be good to our patients. And with all of this, I think we really forget to kind of take a step back a lot of the times, and it's hard for us. It becomes difficult for us to be still. And that's because we're just you know, we built the habits of always being busy, always moving. And when I was finally given that space to be still, it just opened a whole new world for me. I'm someone that has always struggled with anxiety and depression, and that's something that yoga also helped me kind of understand a little bit more now, as I've done that for a couple of years and I've kind of, you know, done different things to combat anxiety and depression, I'm able to just understand the way that my body, the way of my brain, the way that my my emotions work a little bit more. And just having that understanding is really important because, you know, it makes sense that we're not going to be our best at our best every day.

Symptoms of mental and emotional health concerns

Hanlon [00:07:07] You know, several episodes of our podcast, our guests have talked about feeling isolated and and in our profession, you know, not just by themselves, but also, you know, stepping away from not being included. In the results of the 2021 Dentists Well-Being survey indicated an increase of dentists affected with mental and emotional health concerns. So, my question to you is, you know, what are the symptoms and the reasons behind all of this?

Barrera [00:07:36] Just like anything else, right, our mental health is a spectrum and things like anxiety and depression are a spectrum. And there's a lot of different types of issues with our mental health that we can combat. As you know, as far as being isolated, having depression or anxiety goes, the with our world is and the way that, you know, our our culture has been the past couple of years, we are constantly being bombarded with inputs, with noise, right. With stuff going on that are central nervous system is just really always triggered and always on. And yeah, it makes sense that, you know, now we're in a world where, you know, these rates of anxiety and depression have gone up.

Wright [00:08:15] Right.

Barrera [00:08:16] People react to different emotions and feelings really differently. You know, for me personally, someone that has struggled with both depression and anxiety now after doing things like seeking therapy, doing things like yoga, doing things like journaling that have all kind of helped me kind of figure out where I am right now. It's funny because sometimes I can notice my thinking or behavior going in a certain way, but now with kind of the tools and knowledge I have, I can kind of laugh at it. I'm like, "Oh, that's your anxiety. And it's no go away." You know? And so for me, a lot of my anxiety actually manifests as doing more. I feel like I have something called high functioning anxiety, and I think that's something that a lot of dentists can relate or a lot of people who are go-getters can relate, right? Always wanting to find the next task to complete. It's those of us that get like complete satisfaction from checking something off our to do list, right? And that's the type of person I am when I have a lot to get done or.

Hanlon [00:09:16] Know that was a bad thing, Dr. Barrera (laughs).

Barrera [00:09:17]  Yeah. And then it's not a, you know, not necessarily a bad thing, but it's a thing. It's a behavior, right? And for me, you know, that led me to realize that I'm always kind of looking at the next thing and I'm never fully present in the moment. And that's the way that my anxiety manifests by trying to tackle on more things.

Identifying how we respond to stress

Wright [00:09:37] Can you walk us through like what steps can we take maybe to identify when we're we're really not feeling our best?

Barrera [00:09:43] Something we can easily look at is how we treat strangers, how we treat the person that cuts us off. They're terrible person. I'm really upset and I'm going to go home to my family and be even more upset and ruin their day. Right. So how do we treat other people and also recognizing thoughts that we have throughout the day that might be negative. Right. Thoughts like that. And it'd be a terrible day like, oh, I know patient so-and-so is coming in. I know they're going to be a headache. I know this staff members and ask me a question, this question today that I've been dreading. So, things like that, right. And how we respond to stress. Right. We all experience stress and maybe starting to recognize how we respond to them. You know, is it man, I can't wait to get out of my office and go to the bar. I can't wait to get out of the office and, you know, just grab a bunch a pint of ice. Even, you know, 32 liters of soda and just drown it out because I need that. I need that release. Aw, man. It's like I can't wait till the end of the week. I'm just gonna go crazy. I'm just not, you know, blah blah, blah? Um, what is it that we're reaching for when we're stressed? Right? And are those habits helping or hurting us? You know, we hear a lot about self-care, but the truth is, is that self-care should not be something that you resort to because you're so overwhelmed that you have to call in sick to work the next day or that you're so overwhelmed that you can't do the laundry or do the dishes, or you're so overwhelmed that you get in a fight with your spouse or your your child or your best friend.

Wright [00:11:21] Right.

Barrera [00:11:21] Self-care should be something that we incorporate into our day. Little by little.

Wright [00:11:27] As a practice.

Barrera [00:11:28] Yeah. And that's something, you know, that that means starting from, like, how you go to bed the night before, are you going to go to bed eating junk food in bed and watching, you know, reality TV, which I obviously do a lot of times, right. That's okay. A little bit now and then. But when we wake up or are we going to kind of take a moment to ourselves to make sure that we do what we have to do to feel ready and energized, energized for the day? Or are we going to maybe take a step back for lunch? Are we going to, you know, take a little break for ourselves throughout the day, do little things like that that are just going to kind of maintain our wellness throughout the day, throughout the week, throughout the years.

Wright [00:12:07] Right.

Hanlon [00:12:07] I want to thank you for sharing your story, and I want to thank you for sharing so much great insight on some of the things that we can do. I have to share that, one of the things that I realized during COVID that I didn't know that I was overwhelmed and depressed. And it was only after reflecting back during that time, after it was over, that I realized that I was going through some sort of depression. And, you know, there was a lot of things going on at the time. Obviously, COVID impacted all of us differently. My role was to keep things going and figure out how I was going to manage having, you know, students come back into the school that I was at. But I didn't realize that I was being sidelined at the same time and I couldn't figure out what was going on. I remember having many outbursts with my family members. You know, if you notice that you're taking things out on your family more so than you would ever do it in the past, that might be a signal also that things are not going well or that you need stress reduction or some type of stress reduction. I just wanted to share that little piece of of my life. ArNelle, do you have something that you want to share?

Wright [00:13:24] So you guys all know that I was diagnosed with breast cancer last year, and I went through chemotherapy, radiation, surgery. But at the same time, I did hire a therapist and I made sure that I spoke with her on a regular basis. And I still have meetings with her actually probably once a month in the very least, because I notice that I would just be irritable. And part of my irritability was I feel that it was due to some of the medications that I was taking at that time and some of the medications that I'm still taking. So, I did really want to make sure that I leaned in and tapped into someone who was a professional who could help me just walk through that that difficult time of my life, you know. So, for me, that's kind of where, you know, this whole wellness journey, like, I guess peaks for me. I feel like I've been on the wellness tip for about six years since dental school and even my senior year of dental school. That's when I really started going in to like see a therapist to make sure that, you know, once I enrolled in the working world, I was like my best self. I was super healthy. And now it's just one of my passions where I try to help other women do the exact same thing because I feel like we it's something that we just overlook quite frequently.

Barrera [00:14:35] I'm glad that you said that about to see a therapist, even if it's monthly or kind of regularly, because that's what it comes down to. Just how we maintain our car, how we maintain our houses, how we maintain our physical bodies by exercise, by watching when we eat. It's the exact same thing, right? We have to maintain that because we we don't have the wait to the point where we have a panic attack, to the point that we're we're so depressed that we can't get out of bed or the point where we're so irritable to our loved ones.

Hanlon [00:15:04] And I think it's important to realize, too, that that some of our teammates may be experiencing things also. And we've got to be aware of that. You know, certain behaviors that all of a sudden become prominent that never used to be there, that could be an indication of of some issues happening in their lives. And and helping them to prioritize their mental health is is important for all of us as dentists to realize and support them.

Barrera [00:15:34] Absolutely. You know, it's our responsibility as professionals. As providers, as caregivers, as employers to watch for these things, whether it's a staff member or a patient. We might be the only person that they interact with that entire year that may see the symptoms or see what's going on and can maybe provide some sort of help.

Wright [00:15:52] I love that you said the phrase watch for these things. I feel like it's easy, as dentists, to kind of just put your head down and focus on like the clinical dentistry, but watching for certain behaviors and certain patterns in our teammates or the people who work right alongside us. It's easy to kind of pick up on those things if you're alert and if you're aware of them.

Hanlon [00:16:14] So, what do you think we can do to prioritize our mental health on a day-to-day basis?

Barrera [00:16:18] We're dentists and we understand the importance of flossing. Right. So we need to kind of incorporate a little bit of mental flossing within our lives.

Wright [00:16:26] I love it.

Barrera [00:16:27] Yeah. Yeah.

Wright [00:16:28] I love it.

Barrera [00:16:29] Something that was very helpful for me when I was, you know, really struggling was to journal. And it's something I don't do as often anymore. But there was a time where I just did a gratitude journal, whether it's on a phone or a physical piece of paper every morning. I would just write three things that I was grateful for. And when I kind of removed any pressure of how monumental or crazy these things have to be, that's when the habit kind of really became easy for me. I would wake up and the first things that would pop in my head or I was grateful for my mom because I spoke to her yesterday. I'm grateful for this breakfast that I'm about to eat. I'm grateful for my carpet because it felt nice when I got off the bed. You know, I think little simple things like that. And that just it just it plays tricks on our brain that were just quickly things you know start the day off with a good note whether it's in the morning or at nighttime. And, you know, if we journal, for example, we're able to kind of just put our feelings, our emotions out there. These are all things that, of course, develop time to turn into habits. We need to turn them into our routine. And it doesn't have to be, you know, writing something down physically. We can kind of figure out what is the mental flossing that we need individually, right? For me, you know, it's it means leaving the office during my lunch hour just to get some air to go somewhere to get a different environment. I know I have other colleagues that like taking the naps in the dental chair right during the lunch break if they can. Other people might get a coffee or might, you know, do something to kind of just break up their day a little bit. And same thing, you know, after the office, maybe it is listening to really good music at the end of the day, maybe it's calling a loved one or family member after the you know, after you finish at work, maybe it means cooking dinner or doing something with a loved one. Right. So little by little, we incorporate more healthy habits. That's how we get to do that mental flossing. And so that we it's preventative care, right? Just like going to your dentist every six months is preventative care. It's sort of the same thing with mental health.

Hanlon [00:18:28] That's awesome.

Wellness programs available to dentists

Wright [00:18:28] Alex, can you tell us what kind of wellbeing programs there are that are available for dentists and how we can approach them?

Barrera [00:18:36] So just recently the ADA created a Wellness Ambassador program, and so this is a subcommittee within the Council on Dental Practice. And the purpose of the Wellness Ambassador program was intended to express and expand this awareness of physical, mental well-being and the challenges faced in the dental profession, but also to prioritize the needs that dentists have, the different needs that we'll have throughout the different stages in our community, starting from being a student to buying a practice to afterwards. Right. How do we make sure that we are well as a profession throughout this entire career that we've chosen? And so, you know, there are already a lot of great resources online. Members can go to the ADA.org/wellness There are a lot of fantastic resources, but with the new ADA Wellness Ambassador program, these are ten dentists, including myself, that are from all around the country that are all going to start creating projects around their districts, including and incorporating wellness a little bit more deeply into the community. And so for a lot of us, for me, specifically in Texas, that is one of my my project goals is to create either a wellness committee or have some, you know, some sort of representative or an ambassador as well per say, that can be the go to person when someone is struggling, whether it be with addiction, with anxiety, with depression, someone I can help distribute these resources and put on programs and events. My other project will be teaching yoga for the ADA members and this is something that will be virtual and be incorporated every couple of months or so and will be included for for our members.

Ways to improve mental health

Wright [00:20:24] Excellent. You know, Alex, I'm hoping that we can leave our listeners with some concrete things that they can do. So just give us three things to practice every day that might improve our mental health.

Barrera [00:20:37] If I would narrow down to three things. Number one would be to practice gratitude like we talked about, whether it's something small or something more significant. And it could be in any way that works for you, that works for your daily routine, that works for your lifestyle, whether it's gratitude, whether it's looking in the mirror and just saying what you're grateful for, whether it's writing on your phone or just expressing to someone that you love, that you're grateful for them. And we can show or even thinking that if we can just sit down and enjoy a meal in silence and say, Man, I'm grateful for this food. I'm grateful for my home, I'm grateful for my practice. Any sort of sense of gratitude is really important. The next thing I would say is to move your body, right? Find something that makes your body feel good. Whether it's going in a walk in nature, whether it's going on a jog, whether it's finding some sort of exercise or gym routine, whether it's yoga, dance, whether it's dancing with your kids in the living room. It could be even, you know, stretching in the morning or stretching at night, stretching during your lunch break. Find a way to physically move the body in something that's constant, right? Something that can be a habit. And lastly, I would say focus on your breath. We tend to hold our breath. We tend to clinch our drawers. And if we really start kind of noticing a little bit more notice, it's like, oh, we're just holding my breath for the past like 20 seconds because I was stressed about something else grinding my teeth and I was, you know, thinking about what I had to do later on and thinking about this next patient. Whenever we have a stressful situation or something, I would suggest something that I practice is is box breathing. There are many different breathing techniques, but what box breathing is is breathing in four, four counts, holding your breath for four counts, exhaling for four, four counts, then holding the breath out for four counts. So creating a square sort of deal with the counts, right? So practicing that a couple of times is really beneficial. Looking into things like a meditation app, a guided meditation app. There are a lot out there. There are a lot that have specials for medical providers. And stay tuned because that's something that the wellness ambassadors may bring towards for our members soon. So access to that.

Wright [00:22:50] On the next Dental Sound Bites. New year, new budgets. It's time to set your financial goals for 2023. Listen in for expert financial advice that will help you set yourself up for success this year.

Hanlon [00:23:08] Alex, you have shared some great insights with us today, and we can't thank you enough for taking the time to be with us.

Barrera [00:23:15] Yeah, well, thank you so much. I was really excited and happy to be here. And at the end of the day, you know, we're all dentists and we can't lose sense of that community. Right. Community is a very important aspect to wellness as well. So, surround yourself with people that you love. Surround yourself with those that make you better. And remember that, you know, as a profession, we're here to support one.

Hanlon [00:23:35] Another, especially with the holidays coming up. We know that it can be stressful. So, I think you've given us so many good self-care tips, so we thank you so much for your time, Dr. Barrera, for being here. All of the information that you shared with us and our listeners, I was taking notes frantically, so.

Barrera [00:23:52] Thank you both so much for having me. I was really excited to be here.

Hanlon [00:23:55] Now, if you like this episode and think it can help a friend or a colleague, go ahead and share it with them. Also, please subscribe to this podcast wherever you are listening so that you can get the latest episodes. We'd also like to invite you to rate and write a review and follow us on social media.

Hanlon [00:24:14] Thank you for joining us. Dental Sound Bites is an American Dental Association podcast. You can also find this show resources and more on the ADA member app and online at ADA.org/podcast.