Mortality among dentists in Taiwan, 1985-2009

J Formos Med Assoc. 2012 Oct;111(10):567-71. doi: 10.1016/j.jfma.2011.06.010. Epub 2012 May 5.


Background/purpose: Controversy exists in the literature regarding whether dentists with multiple occupational exposures suffer from premature mortality. A cohort mortality study was conducted to evaluate the survival outcome and determine if potential exposure to harmful agents leads to premature mortality among dentists.

Methods: Using the Life Table Analysis System, we calculated standardized mortality ratios (SMRs) for a cohort of 11,700 dentists affiliated with the Taiwan Dental Association. These dentists were followed from 1985-2009. Reference rates were derived from cause-, gender-, and age-specific mortality rates of the general population of Taiwan and 18,664 Taiwanese internists, who were considered to be more socioeconomically proximal to dentists. A Cox proportional hazard model was also constructed to determine multiple risk factors associated with mortality.

Results: Compared with the general population, dentists in Taiwan consistently demonstrated reduced from all-cause mortality. However, compared with internists, significant and excess mortality were observed in dentists for overall mortality (SMR=1.13; 95% confidence interval [CI]=1.00-1.26), drowning (SMR=6.62; 95% CI=2.15-15.45), and heart diseases (SMR=1.66; 95% CI=1.22-2.21). After adjusting for other risk factors, the Cox model showed an increased hazard ratio of 1.17 (95% CI=1.01-1.37) for dentists.

Conclusion: Taiwanese dentists demonstrated significant elevated SMRs for overall causes, drowning, and heart diseases. Careful precaution should be taken to reduce these trends. Future studies are also needed for in-depth exploration of the mechanisms regarding how professional stress and exposure contribute to the increased risk of mortality in Taiwanese dentists.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cause of Death*
  • Cohort Studies
  • Dentistry / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Occupational Diseases / mortality*
  • Proportional Hazards Models
  • Stress, Psychological / mortality
  • Taiwan / epidemiology