Dentistry and Suicide Risk: Evidence-Based Assessment
Yes, dentistry is associated with an increased incidence of suicide, with both male and female dentists showing approximately twice the suicide mortality of the general population, though the evidence regarding depression prevalence is less conclusive.
Suicide Mortality in Dentists
The most recent and highest quality evidence demonstrates a clear elevation in suicide risk among dental professionals. From 1979-2018, US male dentists had a proportionate mortality ratio (PMR) of 2.01 (95% CI, 1.83-2.21) and female dentists had a PMR of 2.15 (95% CI, 1.23-3.49) compared to the general population 1. This represents approximately double the suicide rate, with statistical significance for both sexes.
Critical Temporal Trends
A concerning finding is that suicide PMRs have been steadily increasing for both male and female dentists since 1995 1. This contradicts older beliefs that dentist suicide rates were declining and represents a reversal of previous trends.
Methods of Suicide
The predominant method differs by sex:
- Male dentists: 61.4% used firearms
- Female dentists: Split between firearms (31.3%) and hanging (31.3%) 1
The high use of firearms may relate to access to lethal means, though this is less specific to dentistry than historically believed.
Suicidal Ideation Prevalence
Beyond completed suicides, suicidal ideation is alarmingly common among practicing dentists:
- 17.6% reported suicidal thoughts in the preceding 12 months
- 31.4% reported suicidal thoughts prior to the preceding 12 months
- 5.6% reported ever making a suicide attempt 2
These rates substantially exceed general population estimates and indicate widespread psychological distress in the profession.
Risk Factors Specific to Dental Professionals
Demographic and Clinical Predictors
The strongest predictors of suicidal ideation among dentists include 2:
- Male sex (OR = 2.01) - notably, despite higher ideation in males, female dentists show equal or higher suicide mortality
- Current depression diagnosis (OR = 1.62)
- Moderate psychological distress (OR = 2.76)
- Severe psychological distress (OR = 3.58)
- Illicit substance use (OR = 2.06)
- Previous suicide attempts (OR = 3.02)
- Younger age - practitioners under 40 had more than twice the odds compared to those 61+ years
Occupational Stressors
Multiple studies identify dentistry-specific risk factors 3, 4:
- High occupational stress and burnout
- Access to lethal means (though less specific than previously thought)
- Substance misuse patterns
- Mental health stigma within the profession
- Professional isolation
- Financial pressures and practice management stress
Depression in Dentistry
The evidence for elevated depression rates is present but less robust than for suicide:
64.1% of dental professionals in one study experienced moderate to severe depression 5, with a statistically significant association between depression/anxiety and suicidal ideation (p < 0.001). However, this comes from a single cross-sectional study in Pakistan, limiting generalizability.
Important Caveat
The scoping review found mixed evidence regarding whether dentists have consistently elevated suicide rates across all studies - three studies reported elevated risk while two found no difference or declining trends 3. This heterogeneity likely reflects:
- Different time periods studied
- Varying methodologies
- Geographic differences
- Changes in occupational stressors over time
Clinical Implications for Monitoring
High-Risk Periods and Populations
Prioritize monitoring for:
- Male dentists with current depression (highest combined risk)
- Younger practitioners (under 40 years)
- Those with substance use (particularly alcohol and sedatives)
- Practitioners reporting psychological distress (even moderate levels)
- Those with previous suicide attempts (3-fold increased risk)
Protective Factors
Higher resilience scores showed decreasing odds of suicidal ideation 2, suggesting resilience-building interventions may be beneficial.
Prevention Strategies
Based on the evidence:
- Reduce professional stigma around mental health help-seeking
- Implement routine mental health screening using validated tools (PHQ-9 for depression, GAD-7 for anxiety)
- Enhance access to confidential mental health services specific to dental professionals
- Address occupational stressors through practice management support
- Peer intervention programs and professional support networks
- Means restriction counseling where appropriate
Common Pitfall
Do not assume the historical narrative that "dentists have the highest suicide rate of any occupation" - while elevated, the risk is approximately 2-fold, not dramatically higher than other healthcare professionals. However, do not dismiss the risk - a doubling of suicide mortality is clinically and ethically significant and warrants targeted intervention 1.
The steady increase in suicide PMRs since 1995 suggests current support systems are inadequate and require strengthening 1.