Stressful Times: The Role of Dental Hygienists in Suicide Awareness

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Recent world events have created an extremely stressful situation for dental professionals. The cumulative tension of income loss, homeschooling, isolation, lack of essential items, partner power struggles, being inundated with new safety information, and returning to work with stringent infection control mandates may become unendurable for many.

Some of us are returning to work and adjusting to the “new normal.” However, dental professionals and patients are still struggling in unimaginable ways behind closed doors.

As the world slowly returns to a work/home life balance, not everyone is so fortunate. Many are out of work and/or reside in areas where shelter-in-place directives have not been completely lifted.

Solitary Confinement

This puts certain populations at an increased threat for mental health issues. Single extroverts are at high risk for feelings of isolation and loneliness. Many of our extroverted single friends were suddenly forced into extreme solitude.

Additionally, people in abusive relationships have been trapped 24 hours a day with their abusers for the last several months. For many adults and children, work or school is a refuge from violence. Many couples were in a relationship power struggle before shelter-in-place began. The tension in their homes now feels hopeless and inescapable.

Throw homeschooling on top of a volatile relationship, and you have the perfect storm for anxiety and depression.

Suicidal Thoughts

These situations can be a breeding ground for the birth of suicidal thoughts and possibly attempts. In 2015, suicide claimed the lives of over 44,000 people in the United States. That equals 123 suicide deaths every day.1

As healthcare professionals who are attempting to stay connected during this time, it is important that we are aware of the signs of potential suicide. Remaining tuned-in to behaviors and language of friends and family, colleagues, and patients can make a huge impact when encountering someone who is struggling with suicidal ideation.

Suicidal ideation is defined as thoughts about suicide that can range from fleeting considerations to a means and plan that can vary in intensity from one day to the next. Studies show that suicidal thoughts surface in the face of intense stress and depend on an individual’s perception and ability to cope.2

A Call for Help

During this time of stress and isolation, dental professionals should be aware of signs of suicidal ideation and how to respond when suspected. Some signs may be presented blatantly, such as speaking about dying, saying goodbye to loved ones as if it is the last visit, loss of interest in friends and work, and giving away all of one’s belongings.

Other signs are more covert such as making comments like, “I may not make it, I am not sure I will survive, and I am not sure what I might do.” Whether someone shows obvious or subtle signs, it is prudent to compassionately address any call for help.

Many people believe that if a sign of suicide is noticed, the negative thoughts will be exacerbated through confrontation or questioning. The opposite is true. Helping people who are showing signs of suicide is a multifaceted issue and can become quite complicated and thus cannot be completely addressed in the scope of this short article. Here are a few crisis intervention tips to employ that could save someone’s life:

Start the conversation: Be direct with questions about suicide while using a nonjudgmental tone. Ask things such as, “The things you are saying make me wonder if you are thinking about harming yourself.” “Are you planning to hurt yourself or take your own life?” This lets the person know you are open to a conversation and that you recognize he/she is in pain. Do not be afraid to keep this conversation very raw and real by asking if they have a plan or a means.

Provide support: If a plan and a means are established, this would be the time to get immediate help. For example, if someone says that they plan to use the pills in their possession later that day, go to where the person is, if possible, and call 911. If they have not thought through how or when they will end their own life, this is good news at the moment, but it does not mean that it will not change the next day.

Have a meaningful conversation about their needs and direct them to help, such as a therapist or hotline. Follow up with them daily as long as needed. Offer encouraging language like, “You can and will get through this.” Also, reminding them of things they have to live for can be very effective. “Have you thought about what your daughter will do without you? Have you thought about how much she will miss you?”

Direct to help: Facilitating help for someone with suicidal ideation is outside the scope of a lay person’s abilities. The loved one needs to be treated by a mental health professional. Search for local resources such as private counselors, support groups, or a hotline. You may need to be assertive by researching a therapist for your friend. Provide him/her with a name and phone number, assist with scheduling, and perhaps accompany them to the appointment.3

The most important step is starting the conversation. Remember that even though you are not a mental health professional, you can have a huge impact on someone’s decision. Be open and supportive by showing nonjudgmental regard for their wellbeing. Do not be afraid to initiate the important dialogue that may prevent tragedy. In a time when the world seems upside down, compassion and empathy are essential for healing and perseverance.

The national suicide prevention hotline number is (800) 273-TALK (8255). This lifeline can be called 24/7.

If you or someone you know is struggling with depression or has had thoughts of harming themselves or taking their own life, get help. The National Suicide Prevention Lifeline (1-800-273-8255) provides 24/7, free, confidential support for people in distress, as well as best practices for professionals and resources to aid in prevention and crisis situations.

Now Listen to the Today’s RDH Dental Hygiene Podcast Below:


  1. Stone, D.M., Holland, K.M., Bartholow, B., Crosby, A.E., Davis, S., and Wilkins, N. (2017). Preventing Suicide: A Technical Package of Policies, Programs, and Practices. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.
  2. Kleiman, E.M., Turner, B.J., Chapman, A.L., Nock, M.K. Fatigue Moderates the Relationship Between Perceived Stress and Suicidal Ideation: Evidence From Two High-Resolution Studies. Journal of Clinical Child and Adolescent Psychology : The Official Journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53. 2018; 47(1): 116–130.
  3. Suicide Warning Signs. American Psychological Association. Retrieved from
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Kandice Swarthout, RDH, LPC
Kandice Swarthout, RDH, LPC, is a Licensed Professional Counselor and Registered Dental Hygienist. She is a full-time dental hygiene educator in Texas, where she teaches community dentistry and research. Kandice is the owner of Inspired Education & Wellness, where she is a speaker, writer, and private practice therapist. Her unique blend of clinical expertise in both dental hygiene and mental health equips her to assist fellow healthcare professionals in recognizing not only their patients’ needs but also their own, fostering deeper connections with the healthcare community. Kandice’s dedication extends to her role as an approved provider for Texas Health and Human Services, specializing in human trafficking training for healthcare providers. Additionally, Kandice brings a touch of fun and camaraderie to the dental community as the co-owner of Muffins & Mimosas Dental Study Club. She offers engaging, in-person dental continuing education that creates a warm and welcoming environment for friends and colleagues to come together to learn. Read her articles in Today’s RDH column, Mental Health Spotlight. Contact Kandice through her website at or on social media @The Counselor Hygienist.