'Moving on' is a term often used when recovering from an adverse life experience. Ironically, often it can also have the effect of shutting down helpful conversations. I am honoured and humbled to be asked to be the editor of this themed edition of BDJ in Practice, and with this opportunity I hope we can move on our conversations in wellness and mental health in dentistry.

The high levels of stress and poor mental health in dentistry has been well evidenced1 and while the SARS-Cov-2 pandemic has shone a spotlight and altered some of the stressors,2,3,4 the need to address this issue is certainly not going away as the pandemic subsides.

It is not just dentists that are impacted, but the whole dental team, and recent research has shown that levels of stress and anxiety are also present at worrying levels at an early stage in our dental students.5 The links between stress, our attitudes and behaviour, as well as patients' safety, are also well evidenced.6 We all must acknowledge these facts and move on.

The need to do something to ensure psychological safety in the dental workplace is clear. But what? The factors causing the stress in dentistry are complex,2,3,4 and interactive with our own personality traits and mental health. The tools to help us understand this complexity were given to us and describe micro, mesio and macro determinates.7 All three determinates are equally important, and it is necessary to address all together.

Micro determinates are factors that we as individuals have control over and which, with awareness, we can take actions to improve our own wellbeing. Healthy eating, exercise and having a life outside dentistry from which we gain fulfilment are all important, as well as having strong, healthy professional and social networks. Simple mindfulness exercises can be extremely effective if you don't want to go with organised activities such as yoga or mediation. Taking time out to understand the role and impact your ethical and moral compass has in your day to day clinical and business decision-making is important. Remember to say thank you and well-done, including to yourself.

Although essential in helping to keep us well, addressing these micro factors alone is not always enough, and it is important for us and others to recognise when there is a need to move on from personal actions, to asking for help.

Macro determinates are influences within our workplace including our working relationships, the environment we work in, our workload and the degree of autonomy we have, as well as financial and personal influences.8 Burnout is defined by the World Health Organisation as 'a syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed'. Like all other workspaces, a dental clinic or laboratory can be psychologically unsafe.

As a profession we have a responsibility in effecting change in the workplace that will improve our own and the team's wellbeing.9 Tools have been developed to help, such as the Mental Health Wellness in Dentistry Framework and Support for Dental Teams, and no doubt many more tools will be produced in the future. Including the team in designing and implementing these tools will facilitate their adaption and effectiveness in individual workspaces.

It is important this does not become a tick-box exercise and another folder to pull out when the CQC or equivalent come to visit. It is about embedding wellness in all dental workplaces and normalising non-judgemental conversations within the team. It is about reaching out and being kind and supportive. It is about embedding wellbeing in all practice policies, mentoring, coaching and personal development plans. It is about considering identifying and training Mental Health First Aiders. Above all it is about early intervention and safe signposting for those in psychological difficulty.

Finally, there are the macro determinates, mainly the regulators and the systems we work in, which have been clearly demonstrated as significant factors in determining stress in the dental team.2,3,4 These organisations too must shoulder their responsibility in the role they must play to support the wellbeing of dental team members as well as the profession, while also fulfilling their statutory duties. Compassionate leadership which exhibits humanity and humility is a strong and effective leadership style, and one where these roles need not be in conflict.

These are all massive challenges. I have faith in our honourable profession. We are intelligent, skilful, and capable, and we and the healthcare we deliver are valued every day by our patients. I hope you enjoy reading, and are enthused by, the varied contributions to this edition of BDJ in Practice and let's move the conversations on and support each other to effect change and improve wellness and mental health in all our dental workspaces.

If you are feeling overwhelmed, please reach out for help. â—†