http://www.smh.com.au/articles/2004/08/26/1093456711038.html?oneclick=true
Suicide myth bites the dust
August 26, 2004
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Grin and bear it: Darlinghurst dentist Dr Mark Levi says pressure to perform is part of the burden of his career. Photo: Natalie Boog
Despite the pressure of their jobs, the theory that dentists are prone to suicide is unproven, writes Patrick Watson.
A dentist in Britain named John Wishart recently drank three bottles of wine before killing himself. Known for his sense of humour, the dentist left a fourth bottle for the police along with a note recommending the claret.
According to London's Daily Telegraph, the coroner who dealt with the case said: "He retained his sense of humour to the very end." Which brings us to an unsourced idea that has been popular for years - that dentists are the professional group with the highest rate of suicide. Is there any basis to it?
Dr John Snowdon, professor at the Sydney Central Clinical School of Psychological Medicine, says past studies have shown that dentists do have a high rate of suicide, but he is not aware of any current research on the topic. However, suicide rates for doctors overall are higher than most professions, he says, though nobody knows why.
Snowdon says suicide is a complex phenomenon but he puts forward one reason those in the medical professions may have higher rates of suicide: they have the knowledge and the tools to carry it out.
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Darlinghurst dentist Dr Mark Levi adds another perspective. He says dentists work under immense pressure with little social contact. "There's a responsibility to perform. To work in a confined space which is wet, dark and sensitive - that's a challenge, you see.
"They want to do their best, but there's a lot of pressure to perform. You have a patient on a chair, jumping around, crying, and that can lead to you thinking you've not achieved your best. Perfectionism is the problem."
In one Australian study (which applied to men only), occupation and suicide tables indicate that between the years 1968 and 1981, dentists were ranked 33rd on a list of those most likely to commit suicide by occupation, with 15.5 dentists per 100,000 doing so. Doctors ranked 10th (34.5 per 100,000) and nurses at number two (55.7), while sailors (58.2) were the most likely to commit suicide.
In Suicide Explained - The Australian Experience, sociologist Riaz Hassan says there is relationship between occupational prestige and suicide, and that the suicide rate of those in the bottom fifth of occupational prestige is almost double that of those in the highest fifth. This evidence is supported by the Australian Institute of Health and Welfare.
Levi, however, says: "[It has] nothing to do with job satisfaction; loneliness is a big factor."
He has a point. If doctors are higher on the suicide list than dentists, then lack of prestige seems less likely to be a factor.
The statistics, however, may simply be leading us astray. American writer Cecil Adams says suicide research is always dubious.
"[This is], in part, because suicides are often concealed," he writes. "Equally important from, a statistical standpoint, is the problem of small numbers: dentists represent only a small fraction of the total population, only a small fraction of them die in a given year, and only a small fraction of those who die are suicides. So you've got people drawing grand conclusions based on tiny samples."
Hugo Sasch, president of the NSW branch of the Australian Dental Association, says he is aware of the suicide rate theory, but knows of no evidence to support it.
The mystery, it seems, remains. Considering the high suicide rate of seafarers, Levi wonders whether his new hobby is a good idea. He has recently started learning to sail.
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