The main idea behind the current study was to explore a new aspect of stress levels associated with demographic and professional standing. Interestingly, in the present study, all groups representing a senior status of dentists, including 40 and above age, highest range of income, most years of experience, and highest designation, have appeared with lower stress than groups representing the junior status of dentists. Hence, establishing a shred of evidence that with growing age, income, experience, and higher designation, the level of stress decreases among dentists.
In our study, a significant proportion of dentists demonstrated stress, favoring many previous international studies, thus, highlighting the stressful nature of dentistry worldwide [19,20,21,22,23]. Although stress levels in female dentists were slightly higher (18.85 5.842) than in males (17.424.425), there was no significant difference in mean PSS scores between the two genders. Similarly, Jahi and Pouradeli found no significant differences in stress levels between male and female dentists [21, 22].
Female gender was confirmed as a predictor of stress in a previous study conducted on Pakistani dentists [5], whereas in current study, female gender appeared as an insignificant factor in the linear regression. However, when gender was included in the multiple regression model alongside age, years of experience, working sector, and designations (3 dummy variables), female gender turned out to be significantly associated with stress.
In the current study, age was found to have a significant relationship with stress in both simple and multiple regression. These findings are consistent with the findings of a previous study of Pakistani dentists [5], in which age of dentists had a significant association with stress in both simple and multiple regression. In our study, young dentists (20–29 years old) experienced significantly more stress than senior dentists (40 and above). Our findings are similar to those of Yemeni and Indian studies, where young dentists appeared to be more stressed [24, 25]. These findings suggest that young dentists may face more uncertainty as a result of their lack of practical experience, leading to anxiety and stress.
According to a study, post-graduate trainee doctors from public sector universities in Pakistan appeared to be more stressed than those from private sector universities in Pakistan [26]. Resembling this scenario of Pakistani doctors, in our study, dentists employed in government sectors have shown significantly higher stress levels (mean: 20.39 ± 4.692) than dentists employed in private sectors (mean: 17.74 ± 5.487). Moreover, employment in the government sector has emerged as an independent and confounding factor significantly associated with stress in dentists.
The current study has discovered a decent proportion of dentists working without pay (Honoree), signifying a high demand for dental jobs in Karachi. Furthermore, their mean PSS score was significantly higher than that of the dentists who were paid. The lowest stress was observed for dentists with the highest income in the study. These findings are in line with the studies conducted on Romanian [27] and Korean dentists [23, 28], where high income was found to have a negligible relationship with mental stress.
Years of experience were found to have a significant negative correlation with stress among dentists in the current study. Similarly, few previous studies [29, 30] found a negative relationship between dentists’ years of experience and stress. According to our study, the mean PSS scores have declined with more years of experience and increased with fewer years of experience. These findings are consistent with the findings of a study by Maroof, which identified a similar scenario of Pakistani health care workers based on work experience [31]. In 2002, Newbury-Birch explained the reasons that fear of making mistakes and workload causes stress in dentists’ initial years of practice [32].
Although, the mean score of stress appeared marginally lower for specialists than non-specialists in our study, the difference in mean score was not significant. Likewise, in a Romanian study, both specialists and non-specialist dentists were equally stressed out [27]. Reduced stress level amongst specialist dentists in the current study possibly explains that the specialist training and post-graduation promote to a higher rank job with increased pay, thereby contributing to stress reduction.
According to the current study, working at a junior level is associated with stress. House officers and post-graduate trainees exhibit higher stress levels than Assistant Professor, Associate Professors, and Professors. These results are in agreement with a study by Alkindi, in which senior dental specialists were less mentally stressed than post-graduate trainees [19]. Thus, it leads to an evidence that senior dentists experience less stress due to their postgraduate education, since it qualifies them for a higher designation and a higher salary. In addition to that, the dual role of teaching and clinical practice has been previously considered a means of reducing work-related stress in dentists [33].
The authors believe that the present study is the first one in Pakistan to investigate a novel aspect of reduced stress related to age and professional standing. Although, the area is noteworthy and requires dental professionals' input to discuss the issue of stress in dentistry, hesitation in participation in the study, mainly from senior and older dentists has been observed by the researcher. One of the main limitations of the present study recognised by the authors is a small sample size, particularly low numbers of older participants, which has restricted the authors from improving the generalisation of the study. An additional file of complete data set shows small numbers of senior dentists [see Additional file 2]. Few studies on Pakistani dentists were available to compare the results. However, this supports the authors’ claim that the current study is a new one in Pakistan which has explored the association of stress with demographic and professional backgrounds.