The report refutes a long-held perception that suicide is a risk of the profession, according to the study's author, Dr. Roger E. Alexander of Baylor College of Dentistry in Dallas.

"The media portrays dentists and other health professionals as being at risk for suicide," Alexander said. "This message is accepted without question, but very little reliable data verifies this alleged risk."

A review of 8,945 American and Canadian dentists' death certificates in 1976 revealed that dentists, when the cause of death was known, actually had a lower death rate during the period 1960-1965 than the general white-male population. Another study cited research in North Carolina where only 10 dentists' suicides were reported in a 5-year period (1978-1982), the lowest rate in that state among all major health care professionals.

Suicide was the eighth-leading cause of death in United States in 1998 (30,575, or 11.3 deaths per 100,000 population), according to the Centers for Disease Control and Prevention, and men are more than four times more likely than women to kill themselves.

There are, however, no reliable figures on how widespread suicides by dentists are. Most numbers dealing with this are old and not relevant today, Alexander said, because the profession has changed from strictly white-male to one that encompasses an influx of women and immigrants.

The dental suicide myth was traced by Alexander to a 1933 study and was broached and repeated in the 1960s, when several articles noted that dentists, attorneys and/or physicians had 2½ to 5½ times the overall suicide rate of other white-collar workers.

The ADA last reported nationwide data on dentists' mortality for 1968 through 1972. The data did not support the premise that dentists ended their lives prematurely through suicide in numbers greater than the general public did.

In fact, when all causes of death were considered, dentists lived 2.8 years longer, on average, than the general population, the JADA study said.

But statistics can only hint at how much of a toll suicide takes on patients and co-workers. "My dentist committed suicide 10 years ago," said Richard Lukins, 65, a New York City businessman. "I never got over it."

"People develop a relationship with their dentist. I never understood [the suicide]," Lukins added.

Commenting on the JADA study, Dr. George Hetson, a dentist in Kent, Conn., said, "if you subtract dentists who are already terminal [with a disease], it's probably no higher."

Hetson added, "We [dentists] learn to solve problems. If there is a toothache, we fix it. Suicide is dealing with a problem now."

The JADA report speculated that dentists' personality traits emphasize control of emotional expression, compulsive attention to details, conscientiousness and deferral of gratification. It did not say if any of these factors had anything to do with suicide rates or patterns.

Dr. Herbert Hendin, a New York psychiatrist and medical director of the American Foundation for Suicide Prevention, noted that "educated people have a higher suicide rate than the general population."

In addition, he said, "the rate of men to women is 4 to 1. White men have a higher rate than non-whites and men over 65 have the highest rate."

Dentists probably got a bad rap, Hendin added, because they appeared at the top of some suicide list one year and people tend to remember and repeat that fact. Every year another profession gets to be on top. It's a small database that's easily skewed, he said.

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