Aim: To compare the levels, causes and the impact of stress from cohort of fifthyear dental students in the Faculties of Dental Medicine in Plovdiv, Bulgaria and Montpellier, France. Materials and methods: The questionnaire we used comprised the modified version of the 56-item Dental Environment Stress (DES) questionnaire. It was completed by fifth-year undergraduate dental students in both faculties in 2011 and 2016, totaling 335 dental students. A five-point Likert scale was used to record the responses from the subjects. Statistical analysis was performed with STATA version 14.1 (StataCorp, College Station, USA) specialized software. Results: The mean age of studied population was not significantly different between 2011 and 2016 (p=0.08). The common stress value per student was 1.74 (CI: 1.64; 1.84, range: 0.12; 4.50). It was higher in Plovdiv (1.79±0.81) than in Montpellier (1.63±0.66); it was statistically higher for girls (1.94±0.70) than for boys (1.49±0.77), and decreased between 2011 and 2016. A significant overall effect of the common mean stress was influenced by the town (p=0.008), year of study (p=0.003), gender (p=0.0001) and accommodation (p=0.01) of the student. Conclusion: Academicals and clinical factors of stress are prevailing stressors during education. The challenge is now to decrease the influence of both, without altering the quality of dental education. Regular discussions and debriefs about the clinical cases before and after clinical activity. Alternative methods of education and examination, such as interactive methods, could be considered in order to reduce the stress of theoretical exams.