Dentist Suicide: Is Dentistry Really the Cause?

Is dentistry really the cause?

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For decades, dentists have heard a grim piece of professional folklore. Dentistry, the story goes, is so stressful that dentists have one of the highest suicide rates of any occupation. The newest research suggests something more complicated. Dentistry does appear to have a legitimate suicide problem, but the evidence increasingly suggests that the explanation cannot be reduced to difficult patients, practice debt, insurance headaches, divorce, or burnout.

Suicide may be better understood as the final outcome of several pathways converging at the same time. A major 2025 study in The Journal of the American Dental Association (JADA) examined records for 21,928 deceased U.S. dentists from 1979 through 2018 and identified 475 suicide deaths. Suicide represented approximately twice the expected proportion of deaths among both male and female dentists after adjusting for age, sex, race, and calendar period.

That evidence makes it increasingly difficult to dismiss dentist suicide as professional folklore. But it does not prove the statement frequently repeated afterward, that dentists are exactly twice as likely to die by suicide as everyone else. The researchers calculated proportionate mortality ratios, asking whether suicide represented an unusually large share of deaths among dentists who had already died, not the annual suicide incidence among practicing dentists.

The distinction matters because the evidence is concerning enough without exaggerating it. Centers for Disease Control and Prevention occupational data also do not support the familiar claim that dentistry has America’s highest suicide rate. Several construction, extraction, agricultural, and service occupations have reported higher rates. Dentistry appears to have a problem. The harder question is why.

For much of dental history, the answer has been occupational stress, and that explanation is certainly plausible. Dentistry combines clinical precision with patient anxiety, financial responsibility, employees, debt, insurance disputes, and often professional isolation. Practice ownership can intensify nearly all of those factors.

But consider two dentists working under nearly identical conditions. Both have difficult patients, struggle with PPO reimbursements, have employees calling in sick, owe money, and experience bad months. One becomes frustrated and exhausted. The other becomes suicidal. What explains the difference?

Modern suicide research is increasingly looking beyond the visible stressor and into the person experiencing it. Stroke survivors, patients with traumatic brain injury, and people with epilepsy all show elevated rates of suicidal thoughts, attempts, and deaths. Chronic pain is an established risk factor. Serious infections have been followed by increased psychiatric illness and suicidal behavior. One large study of U.S. veterans found higher rates of suicide attempts after COVID-19 infection than among matched uninfected veterans. Severe autoimmune diseases including Sjögren’s syndrome and lupus have been associated with increased suicide mortality. None of this proves direct causation. What it shows is that the medical condition of the person matters.

Inflammatory markers including C-reactive protein and interleukin-6 appear elevated in some suicidal populations, abnormal cortisol regulation has repeatedly been reported, and genetic studies demonstrate measurable inherited susceptibility. The evidence is not equally strong across all of it. The neurological and autoimmune findings rest on substantial longitudinal evidence, while the biomarkers remain promising signals that cannot yet predict who will become suicidal. There is no suicide blood test, suicide gene, or single chemical imbalance, and there is almost certainly no single occupational explanation. A more useful model is vulnerability plus stress plus timing.

Imagine a dentist going through a divorce. Divorce alone can produce enormous grief. Now imagine that same event occurring in someone with severe insomnia, chronic back pain, increasing alcohol use, a previous concussion, major depression, a family history of suicide, and immediate access to a firearm. The external event may be identical, but the person experiencing it is biologically and psychologically very different.

When a colleague begins deteriorating, the question should not simply be, “What is stressing them out?” A better question is, “What has changed?” Sleep may have collapsed. Chronic pain may have worsened. Alcohol or drug use may have increased. There may have been a head injury, serious infection, new neurological diagnosis, medication change, relationship crisis, licensing complaint, or worsening psychiatric illness. Family history and previous suicidal behavior also matter.

Firearm access deserves particular attention. In the 2025 JADA study, firearms accounted for more than 60% of male dentist suicides. The transition from suicidal thinking to death depends not only on why someone becomes suicidal, but also on whether a highly lethal method is immediately available during an acute crisis.

The profession should also reconsider what prevention looks like. Exercise, meditation, vacations, social connection, and resilience can improve well-being, but they cannot substitute for medical and psychiatric care when someone is developing a serious illness. A struggling dentist may have occupational stress and a medical, psychiatric, neurological, substance-use, pain, or sleep problem at the same time.

Dentists also need to feel safe seeking care. Fear that treatment for depression, anxiety, substance use, or another psychiatric condition could threaten licensing or professional standing can discourage clinicians from seeking help until a problem becomes severe. Telling dentists to seek treatment while maintaining systems that make them afraid to do so is a systems problem, not an individual resilience problem.

Future research should move beyond surveys asking whether dentistry is stressful. Researchers should compare dentists who died by suicide with matched dentists who did not and reconstruct what happened medically, professionally, and personally before death. Psychiatric illness, previous attempts, substance use, chronic pain, sleep disorders, neurological injury, professional discipline, financial distress, and access to lethal means all deserve examination on the same timeline.

Only then might we begin separating what belongs to dentistry from what belongs to the individual. The emerging science neither absolves dentistry of its stresses nor reduces suicide to biology. Rather than asking why dentistry causes suicide, perhaps we should ask why one dentist exposed to pressures shared by thousands of colleagues enters a suicidal state while the overwhelming majority do not. The answer will probably not be found in one profession, one molecule, one diagnosis, or one terrible day. It will more likely be found where biology, psychiatric illness, medical disease, life circumstances, occupational stress, and opportunity intersect.

What if the greatest mistake in understanding dentist suicide has been assuming there must be one cause?

If you or someone you know is in crisis, the 988 Suicide & Crisis Lifeline is available 24 hours a day. Call or text 988.

The American Dental Association’s Dentist Well-Being Program Directory connects dentists and dental team members with state-based peer support and confidential assistance for mental health, substance use, stress, and burnout. Visit ADA.org/wellness.

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