While dentists have not been documented as a risk group in the suicide rate of the general population, it is well known that they are at a higher risk than other professionals.

Dentists are probably viewed by their patients more as tormentors than as healers. They tend to treat people who often don't want to be there in the first place. People often don't often appreciate what the dentist is doing and are not often very grateful for what is done. Many see their appointment as more of a punishment than a healing experience.

Added to this, dentists work incredibly hard, long hours, with few breaks, in a relatively un-aesthetic environment. I think it would be generally acceptable to say that not every mouth is a beautiful sight. Dentists work virtually nose to nose with all kinds of mouth problems - people with bad teeth, people with bad oral hygiene, people who don't care for their teeth.

CREATING AND ABSORBING PATIENT TENSION

Furthermore, dentistry is very invasive, he continues. "You are inflicting pain on a person who is fully conscious and there is nothing you can to do about it. Imagine - you are trying to do your work and you are trying to stay calm and you have someone who is white knuckled, feels threatened and resentful, and is very much in pain.

Dentists are not only are you are absorbing tension all day, but are also are actually creating tension. They then have to contend with their own and patient tension and sometimes aggression the whole day.

Another aspect of running a dental practice which adds to the general stress are the high overheads which have to be borne. Dentists use a lot of equipment and charge high fees. And while some patients might feel that their treatment is an expensive luxury, the dentist might feel that he is not earning enough in view of the effort and expense he is putting in.

And finally, dentists are often compulsive personalities, who deal with their anxiety by paying ever more attention to detail.  You have to be compulsive to be good at dentistry - it is precise, specialised, finicky work which requires great attention to detail, and you have to be compulsive to the last millimetre. And compulsive people are stressed generally.

CREATING MEANING IN LIFE THROUGH CREATING A BALANCE

All of these factors make dentistry an incredibly stressful profession, where it is very hard to find a sense of meaning. So it is not surprising if a tremendous sense of alienation and stress builds up in the individual practitioner. And on top of that, the work is done under tremendous time pressure, there is little conversation, little personal interaction.

Where does your satisfaction and meaning in life come from, when there is little positive feedback, little appreciation, and you are probably seen more as a inquisitor than a healer?

In order for human beings to stay in balance, there has to be a complementary balance between the mundane and the festive. The answer to overcoming stress lies in creating a festive domain in our lives, he says. It is this switch which neutralises the aggression, the alienation and the isolation which builds up in the mundane workday reality.

"It is only through creating a festive domain in your life that your work becomes worthwhile. You have to actually do things which say life is worth it, my life is worth it."

SELF-NURTURING FOR HEALTH CARE PROFESSIONALS

• People in the caring professions are always nurturing and giving to others without taking anything back for themselves - it is important to do things in life which are self-nurturing.
• It is vital to have another pursuit which is part of your lifestyle and which engages your creativity, which uses another part of your brain, which takes you into the festive realm - it doesn't have to be for hours a day, it can be a few minutes a day, or even once a week.
• The pursuit should be expansive rather than focused - having a massage, aroma therapy, listening to music, doing something creative, sport - all are antidotes to the incredibly focused nature of dentistry.
• Releasing tension and being nurtured on a physical level is also vital - sitting hunched over patients all day is very taxing on the upper body and spine.
• If you have a sphere where you are admired or loved, it doesn't matter whether you are being admired or loved at work - having good relationships around you, cultivating friendships, cultivating other interests, provides other sources of feedback.
• Working with one person after another leads to the unbroken build-up of incredible stress the whole day - if after each session you relax and relieve that stress, you don't have that accumulation over the day.
• Intersperse your work with something meaningful - for instance a well known chiropractor gets rid of his stress by taking just a couple of minutes to read something inspirational between each patient, even if his waiting room is full.
• Because dentistry is a profession which doesn't have many sources of positive feedback, evaluation of work should not be dependant on patients and their feedback.
• It is important to find other ways of evaluation - such as using your records to measure performance from check-up to check-up, or initiating more discussion with your chairside assistant nurse who is a witness to your work and can be a valuable source of feedback.
• Be sure to employ a chairside assistant who is patient and empathic - and will have the personality to be supportive both to you and to your patients.