COVID-19 Infection and Female Gender Linked to Lower Well-Being in Dental Students

A new study of undergraduate dental students in Pakistan has found that two factors stand out when it comes to mental well-being: being female and having been infected with COVID-19. The research, published in BMC Medical Education, analyzed survey data from 210 dental students across three colleges in Islamabad and used a validated well-being questionnaire to measure how the students were really feeling. The results suggest that the psychological aftershocks of the pandemic are still measurable in this group of future clinicians, and that women in dental training may be carrying a heavier emotional load than their male classmates.

The study was led by Aysha Sadaf and colleagues at Shifa College of Dentistry, part of Shifa Tameer-e-Millat University in Islamabad. Rather than collecting new data, the team carried out a retrospective secondary analysis of an existing multicentre cross-sectional survey. This means they went back to data that had already been gathered from students at three dental colleges and re-examined it with a specific question in mind: do gender and a previous COVID-19 infection show measurable associations with mental well-being? The original survey used a census sampling approach, meaning every eligible student was invited to take part, and all consenting respondents were included in the final dataset.

To measure mental well-being, the researchers used the Warwick–Edinburgh Mental Well-Being Scale, commonly abbreviated to WEMWBS. This instrument is widely used in population health research and consists of a series of statements about positive aspects of mental health, such as feeling useful, having energy, feeling close to other people, and being able to make up one’s own mind about things. Respondents rate each statement, and the answers are summed to produce an overall score in which higher values indicate better mental well-being. Unlike scales that focus narrowly on symptoms of depression or anxiety, WEMWBS is designed to capture a broader, more positive picture of psychological functioning, which makes it particularly useful for studying student populations where the goal is to understand flourishing rather than just diagnosing illness.

The headline finding was the average score. Across the 210 students, the mean WEMWBS score was 44.05 with a standard deviation of 10.2. For context, WEMWBS scores in general adult populations typically cluster well above this level, and lower scores are interpreted as indicating poorer mental well-being. A mean in the mid-forties for a cohort of young people in professional training is a signal worth taking seriously, particularly in a field like dentistry, where students face demanding clinical workloads, high-stakes examinations, and, during the pandemic years, disrupted hands-on education and heightened infection concerns.

The statistical core of the study was a multivariable linear regression analysis. This technique allows researchers to estimate the independent association of each factor with the outcome while holding the other variables constant. In this model, female gender was significantly associated with lower WEMWBS scores, with an unstandardized coefficient of −3.85, a standardized beta of −0.24, and a 95 percent confidence interval running from −5.90 to −1.80, corresponding to a p-value of 0.002. In practical terms, after adjusting for the other variables in the model, female students scored, on average, nearly four points lower on the well-being scale than their male peers. The standardized beta of −0.24 indicates a modest but meaningful effect size for a study of this design.

Previous COVID-19 infection told a similar story. Students who reported having been infected with the virus scored lower on mental well-being than those who had not, with a coefficient of −3.74, a standardized beta of −0.19, and a 95 percent confidence interval from −6.20 to −1.30, and a p-value of 0.011. Again, the difference of roughly three to four points is not trivial on a scale of this kind. The finding aligns with a growing international literature documenting that a history of SARS-CoV-2 infection is associated with worse psychological outcomes, whether through the direct biological effects of the illness, the stress of isolation and recovery, or the lingering uncertainty that accompanied infection during the pandemic years.

Not everything the researchers examined turned out to matter. Age and academic year, the other demographic variables included in the model, were not significantly associated with mental well-being scores. This is an interesting negative result. It suggests that the well-being deficit in this cohort was not simply a matter of being a fresh first-year student adjusting to a new environment, or of being a senior student facing imminent clinical examinations. Instead, the associations concentrated around gender and infection history, pointing to factors that cut across the whole trajectory of dental education rather than being tied to a particular stage of it.

The overall model performed respectably for research of this type. The full regression was statistically significant, with an R-squared of 0.175 and an adjusted R-squared of 0.155, and a p-value below 0.001. In plain language, the variables in the model together explained roughly 15 to 17 percent of the variation in well-being scores. That leaves the majority of the variation unexplained, which is typical for studies of complex psychological outcomes, but it confirms that gender and infection history are not statistical noise; they carry genuine signal. The authors suggest that these findings could help dental institutions develop targeted educational and mental well-being support strategies, focusing resources on the groups identified as most at risk.

The study was conducted with attention to ethical safeguards. Approval came from the Institutional Review Board of Shifa College of Dentistry at Shifa Tameer-e-Millat University, granted in February 2022 before data collection began. The work followed the ethical principles of the 2013 revision of the Declaration of Helsinki, and electronic informed consent was obtained from every participant. Participation was voluntary, students could withdraw at any stage without consequence, and personal identifiers were removed to protect anonymity. The authors also disclose that they used an AI language tool to assist with editing and manuscript organization, while stating that the tool played no role in generating, analyzing, or interpreting the data or in formulating the scientific conclusions.

As with any cross-sectional analysis, the study has limits that readers should keep in mind. The data capture a single point in time, so the associations cannot prove that a previous infection caused lower well-being, and the sample comes from three colleges in a single city, which may limit how far the findings generalize to other settings. Self-reported infection status may also be imperfect. Nevertheless, the consistency of the gender gap with findings from other student populations, and the plausible link between infection history and psychological strain, make this a study with practical implications. For dental schools in Pakistan and beyond, the message is that well-being support cannot be one-size-fits-all: female students and those with a history of COVID-19 may need particular attention as the profession continues to recover from the pandemic era.

Subject of Research: Mental well-being among undergraduate dental students in relation to gender and prior COVID-19 infection

Article Title: Associations of gender and previous COVID-19 infection with mental well-being among Pakistani undergraduate dental students: a retrospective secondary analysis of a multicentre cross-sectional survey

Article References: Sadaf, A., Sajid, A., Bint-e-Nadeem, T., & Javed, M. (2026). Associations of gender and previous COVID-19 infection with mental well-being among Pakistani undergraduate dental students: a retrospective secondary analysis of a multicentre cross-sectional survey. BMC Medical Education. https://doi.org/10.1186/s12909-026-10467-5

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10467-5

Keywords: COVID-19, mental well-being, dental students, WEMWBS, Pakistan, gender differences, dental education, cross-sectional survey, linear regression, medical education, pandemic, student health