Why is it that dentistry, specifically as a career, is linked so heavily to mental health? The idea.

That you see your work fail, it’s soul destroying when that happens over and.

Over again. We are known as perhaps being in the top five professions where suicide is the highest rate and in fact even worse. I think if you speak to most dentists, they will know somebody who has taken their own life.

What do you think is the reason why we’re so find it so hard to talk about mistakes?

Because I think it’s about vulnerability.

It’s my great pleasure to welcome Rhona Eskander into our studio for a live Dental Leaders We’ve got a new process, a new a new series, a mini series that we’re going to be looking at that deals with mental health for dentists called Mind Movers. And, you know, it was born of kind of a frustration of, you know, what’s out there for dentists who are suffering Something that Rhona said to me that, you know, that the stigma of talking about this sort of thing is one thing. And we seem to be a lot better at talking about these things now. But then, you know, after that, what can people do to to improve their situation when they’ve got some sort of stress burnout? You know, I saw in a in a survey, 17% of dentists have considered suicide in a recent survey. So it’s lovely to have you. Rhona, what are your thoughts around mental health and dentistry?

First of all, Payman, thank you so much for having me. I’m smiling here because I think you’re looking at me so seriously, but it’s always a pleasure and I’m so glad that we can bring this alive. So as many of you know, I’ve been working with Enlighten for a number of years. I think that they’re an incredible, incredible brand. And the reason why I’m saying this is because I’ve been trying to approach the subject of mental health with so many people in dentistry and no one would really listen. I think there’s a lot of stigma and taboo that has been really associated with it. You said a statistic, but actually there’s been a lot more shocking statistics I think, in the last few years. And over and over again we are known as perhaps being in the top five professions where suicide is the highest rate and in fact, even worse. I think if you speak to most dentists, they will know somebody who has taken their own life because of the stresses and pressures of our job. Now, I’ve been really open about my mental health online, and I think whether people think it’s appropriate or inappropriate, I think it’s just part of being a human. You know, mental health is something that we all very much get, you know, very much as part of us. But we need tools to basically get through it. And I think that for me, looking outside the Dental arena and having those tools available to me has made me who I am today and overcome a lot of adversity in my life or those really difficult mental states. So my vision is with Enlighten, which I’m really excited, is to bring on guests that I’ve found really inspiring, that have overcome something in some way in their life and have been really remarkable People either in their field or to other people and really share their stories on how they can help you and give you something to take away with you. So that’s really the idea of vision. And I’m really glad that we’ve got some very exciting guests coming on.

Rhona, do you think that, you know, you discussed your mental health challenges that you’ve had before. Do you think that whatever job you did, you would have those? Or do you think that being a dentist has triggered some of that?

I think that that’s a very important question. Why is it that dentistry, specifically as a career, is linked so heavily to mental health? And I was doing a lot of research around this, and I did find that there were a number of reasons specifically related to dentistry. Number one, it’s the pressures of the job number two. So that’s working in a very small confined space, for example. Number two, it’s the psychology of patients constantly telling you that they hate you and feeling undervalued somewhat by people in society. Number three, it’s also the fear of litigation, GDC, all of our governing bodies and not knowing where your career is going to go. Number four, pressures of the NHS. And number five, also feeling this was a really interesting one for me that you didn’t feel you could talk about your mental health because you viewed yourself as a healer in society in some way, because you studied medicine. You’re there to help people and heal people. You can’t really admit to having things going on yourself. So I think those are the reasons specifically linked to dentistry. However, I think that everybody suffers with mental health no matter what profession they’re in. And there’s different ways when we speak to the people that I’ve invited on here, for example, entrepreneurs that have left jobs because of their mental health and started up their own start-ups, but that also comes with its own problems. So I think that really, yes, with dentistry and other professions specifically, there is an issue. But I think as a wider picture, as a generation, mental health is becoming more and more prevalent for other reasons.

But I mean, you list things like the NHS or being sued or the GDC and these these are, you know, local two right now in UK dentistry. But you know, I think for the last 100 years all over the world, dentists have been more prone to suicide than other professionals. Yes. So the job itself, you know, it’s not the most stressful job in the world. There are more stressful jobs than dentistry. And yet we suffer with stress. Now, of course, what you said, you know, the sort of the challenges of working on a live patient who’s, you know, nervous about being there. Sure. I get that. I think, you know, your relationship with your nurse is gigantic. You know, like the way you deal with your your staff and the way it almost feels like a family atmosphere and all of that. But and I’ve always had very good relations with all of my nurses. But I can imagine if if, you know, you and your nurse don’t get on for whatever reason, that’s the one person that you spend all that time with. If you think the patients are just, you know, their work, you know, it’s quite an isolated profession in that sense, right? That you’ve got no one around you for support as a dentist. You could go in and see your patients, only see your nurse and then leave. And if your nurse hates you or if you hate your nurse for whatever reason, I’m sure it’s a massive contributor and.

I think that is a contributor, but I don’t think that’s the be all and end all because lots of people can go into their work and not like their colleagues or their companions. And sure, like you said, you may argue, well, there’s more of them, but not really, because the company that you’re in can really affect your mental health, but perhaps not to the degree of feeling so suicidal. And I think there’s other things as well. You know, dentistry, as you said, you know, working on the patient has, you know, a few. It’s massively stressful because you really feel like someone’s health is in your hands. And I think there’s pressures of really, really immense on you. And I think that dental school as well doesn’t equip you for the emotional side of dentistry or the other things in dentistry that matter. You know, I say matter. I mean, they make you safe in the sense of being able to do the clinical skills, but they don’t really teach you much about complaint handling. They may touch on it, but not really a lot. You know, things like your indemnity, as I said, the GDC, these things are touched upon, but there’s not sort of a heavy focus and they don’t really give you tools on how you deal with things and you ultimately feel like a failure a lot of the time, I think in dentistry, because by the very nature of the job people are attracted to, they attract people that are very high striving, right? You know, you’re going to get people that get straight A’s and A-levels, do extracurricular activities, do X, Y and Z, and then they get thrown into this situation in dental school where they actually feel a little bit average.

That definitely happened to me because it was suddenly like, Oh, I’m actually now striving to just pass rather than getting A’s when at school. That’s what I was doing. So you don’t feel so great about yourself? And I think because people in dentistry are the ones that put so much pressure on themselves, they take it a lot more seriously when they feel they’ve had these failures, as it were. And that’s why I think we’ve got to rewrite the narrative on failure as well, which I hope to discuss later on in the podcast. But this is an extremely complex issue and I don’t think it’s something that can be just made black and white.

But I think if you’re a cardiac surgeon. The stress of whether or not that patient is going to live is probably more than the stress of the RCT and whether whether that tooth and yet cardiac surgeons don’t have the suicide rate the dentists have.

Yeah, totally.

So there’s something in particular. Now, what I said about it’s a live, you know, awake patient that certainly has I think there’s another angle on it where what do you think of this? I mean, I haven’t researched this, but the idea that you see your work fail and much of the work that you do doesn’t benefit the patient. It’s soul destroying when that happens. Right. And and much of dentistry causes problems rather than solves them. And then you layer on top of that a patient who doesn’t want to be there, maybe layer on top of that some sort of toxic work situation. Exactly. And then I think when people go into suicidal ideation, usually it’s a perfect storm of something at home, you know, some sort of chemical imbalance. We’re going to talk to Dan today about about that, you know, about the nutritional side of it. Yeah, yeah, yeah. But when I’ve looked into it, I can’t get a really good answer for why dentistry causes that.

I think it’s like the multitude of things that you were talking about. It can’t be one single thing. And I think actually I’m going to have to disagree with you in one way. You can’t necessarily pin one thing to mental health, and I think that’s a narrative we need to get rid of. You know, people might say, why did that person take their own life? They had a perfect life. They had kids. I mean, recently there was the death, if you remember, of that amazing dancer from the Ellen Show. And it was so sad because there was a TikTok video of him dancing with his family, looking so happy. And again, everyone be like he had a beautiful wife. He had amazing kids. He had a successful career. Why did he do it? And I think that’s the problem with what’s going on. We’re trying to make it a black and white issue. You have it all. Why would you do that? It’s selfish. And I think the narrative of it’s selfish. It’s extremely dangerous, you know, because we’ve got to provide resources to people. Because I saw this actually a analysis that said when people say it’s selfish for the person that’s going through the mental health, if it means that a mind is the burning building and jumping out of the building as the suicide, that’s the hell that they’re living in. They’re not seeing it in the way that we’re seeing it, you know? So actually, which is worse to stay in the burning building or to jump out of the burning building? Do you see.

What I mean? It’s not helpful at all to say it’s selfish. I mean, the last thing someone who’s committing suicide or thinking about committing suicide needs is judgement. Yeah, exactly. On top of all the problems that they have got. Exactly. I saw some research where the guy was saying that the only thing that they found helped with people who had had some sort of suicidal ideation was something as simple as the people who said no to treatment. Half of them they sent letters to every month saying, How’s it going? We’re thinking of you, this sort of thing. And half of them they didn’t send letters to and the ones they sent letters to didn’t kill themselves as much as the ones who did think someone cares. You know, the loneliness of the job. Yeah. Coupled with triggers, you know, the stresses that happen Now, you said you went through some mental health problems. Yeah. And did you did you sort of go into why? Why did you have these problems or did you just leave that to one side and say, how do I get out of this?

So I think if I think about it properly, I’ve always been prone to being vulnerable to mental health issues. So since I was a young kid, I remember always being really sensitive to certain things in the world. I know it sounds crazy insensitive kid. Yeah, and I was a very sensitive kid, but I was very sensitive and I was very aware of people’s emotions, people’s actions and people’s words. And I think that carried on throughout my life. And I think there was this general sense of being quite disappointed by human beings. I know that sounds strange, and I think it’s because I always was perhaps a bit naive to how the world was run and really believed everything was kind of rainbows and everyone had good intentions. And as I got older, people continuously disappointed me and that used to really affect me on a deeper level. And I felt that I felt a lot more throughout my 20s. I think it was the most difficult time of my life because I really believe you just have no idea who you are in your 20s. And that’s why I find it totally crazy that people think you should be making these life changing decisions in your 20s, you know? And I went to university and it was a really difficult environment for me. So, for example, I was the only Middle Eastern girl in an extremely different environment. You know, I grew up in North London, you know, pay as well because you grew up in the same kind of like childhood background.

And suddenly I was the only Middle Eastern girl, you know, with all these white boarding school girls, which is completely fine. But I was definitely seen as the outcast in a way. And I didn’t fit in from a. Aesthetic perspective where they were like, Oh my gosh, you’re so exotic looking and you know, things like that. And, you know, it was back in the day before Kim K and all that kind of look, and I remember feeling that I just didn’t fit in and comments were constantly being made about my image and I found that really difficult. And I tried so hard to be someone I wasn’t. Like I tried so hard to dampen the way that I look. I was so embarrassed of my eyebrows. I was so embarrassed of my hair, etcetera. And even, you know, living, you know, my parents, you know, tried to dampen down that they were Middle Eastern and so forth. And it’s crazy now because I love it. I’m like, this is me and this is part of my identity. But I think university was really tough as well because I just didn’t know how to deal with so much rejection. That was rejection within Dental school, but also social aspects of my life. I had friends, sure.

And you know, I was popular, but it just goes deeper than that. And sometimes I just found that my mind would run riot, you know, telling myself that I wasn’t good enough, telling myself that I needed to be someone else, you know, putting so much pressure. And I think that that voice in my head would just constantly be there. And in some ways, you know, you’ve got to flip it around because it helped me push further because I was like, okay, you know what? If this person doesn’t believe in me, I’m going to prove them wrong. So that was my drive. But I think one of the major things that helped me is that I sought out information from people that I believe had come over struggles and had made it in life. So I’m really excited that we’re going to have Daniel Murray Certa on the show. And the reason is because when I was young as 14, all my teachers told me that I was pretty much a failure because I was really good at drama and public speaking, but was not academic at all. I used to hang out with Daniel outside school and he was academic and he wanted to apply to Oxbridge and we used to study Othello together and Shakespeare and everything. And I remember being really inspired because for some reason I associated his academic success with respect in a way.

So I saw that he was getting the respect of teachers, and I’m not saying that’s the right way, but I noticed that. And I said, okay, great, maybe I can learn from Dan. So that pushed me and I’d study with him further and I’d do other things, and I really pushed myself academically even if it didn’t come naturally to me. So I always found that, like looking up to people and Daniel, when he comes on the show, he’ll talk to you about Difficult. The loss of his father was, for example, as well. And, you know, I can’t imagine how difficult that would be, especially as, you know, I’m so close to my dad. But being able to look up to people who have come so far in life and be able to come, those horrendous moments have really helped me. And then the more and more I looked up to these people, I realised there was a whole community of people that really have been through their own struggles but overcome them, you know, somehow. And I think that’s when I realised it’s actually okay. And most of us, most human beings have stuff going on in their head. Most not everyone is in like on that super, super complex level where they overthink things. And the more we help each other and the more we develop a community and the more we talk, the better it is.

You know what you said about being the outsider that, you know, I’m very interested in this idea of your your biggest strength being your biggest weakness. Yeah. And, you know, right now you’re an outsider as far as you know, you’re an outlier in dentistry.

Am I Payman. Can you. Can you? Yeah. Can you like.

No, you are. You are. And in the way I’m thinking about it is, you know, like you said, you feel you used to feel people like almost be empathic to the way people were feeling about you. And if it was a negative. Yeah, like you said, all these girls who were being negative. Yeah. But at the same time, I’ve seen you with your staff, I’ve seen you with patients. You’ve got you’ve got that in the positive way as well, right? You can you can make people feel fantastic. You can you can understand what, what someone’s saying to you without them actually saying it. And so, you know, our biggest strength ends up being our biggest weakness. And so what you just said here about sort of gaining strength from mental health challenges. Yeah. When you see other people overcoming them, one one sort of thing that worries me, though, is, you know, we’re calling this Mind movers, right? Do you think someone who’s actually suffering would bother to listen?

Oh, 100%, because I think it was when I was suffering and my weakest points that I sought out information and people that could really help me. So for me, it was looking outside dentistry somehow, which is why I want to have the conversation within dentistry. So if it meant looking on YouTube, you know, for videos or people that had talked about different things, of course there’s days that you’re completely paralysed and I think Dan can talk about that as well. But then you might have a moment where you’re like, I need help. I want help. Does that make sense? You know? And then you start to look for sources that might be going to therapy it. Might be, as I said, finding a community that understands you. It might be talking to other people. But what do you think?

What do you think the trigger itself is to go from to go from a position of I’m sad and I deserve to be sad or I am, you know, I’m sad about being sad or I’m going to try and find a solution to this. I’m going to try and seek out help. And there’s obviously, you know, some people never, never look for help or reject help. And then they’re the ones who descend into a in a darker place. Other people will look for help and try and, you know, try things out and, you know, in the same way. But I think.

A lot of people, the ones that don’t try things out again, I think it goes back to the whole thing of the stigma that people feel like I can’t ask for help because people are going to think I’m weak. I can’t have conversations because people are going to judge me. I have a family, What are they going to think? And that’s when they spiral. But the more conversations we’re having, like today, the more media outlets that are like, this person went through this, this person went through that, let’s be kind to one another. Let’s change the narrative. The more education we have, the more people I think will seek help rather than spiral out of control.

Let’s let’s take that on to dentistry in general. Sure. And, you know, failures. And it’s actually one of the reasons why we ask the question on on this podcast is that, you know, what were your biggest mistakes clinically and so forth. What do you what do you think is the reason why we’re so sort of find it so hard to talk about mistakes and and clinical failures?

Because I think it’s about vulnerability.

Why are we more vulnerable than the, I don’t know, the next profession? No.

But I think it’s in general, I think most people people don’t like being vulnerable. It was funny because I was having a conversation with one of my best friends yesterday and she’s having an experience with a guy. Right. And she said to me, this guy has a bad reputation. He’s known for not treating women very well. And she kind of gone there and she was like, I’m really scared. People are going to judge me. I said, What do you mean? She said, Well, I’m just worried people are going to speak about me, you know, like, Oh, poor her. She got messed around by him. And I said, And for me, I recognise that she doesn’t want to be vulnerable. Right. Because that’s ultimately it. Right? And this is talking about guys situations, not talking about a job situation. Human beings in general don’t like being vulnerable. What I’ve realised over the last few years is you very much know through my social media vulnerability is a superpower because vulnerability is actually what makes you relatable. It makes you relatable, it makes you real. So don’t be afraid to share those stories. And I think, yes, as dentists, because we’ve been high achievers, we’ve been used to be like, I got an A, I got a distinction. I got this. You see what I mean? It’s even harder for us to be like, Oh my gosh, I’m suffering. I failed this. I didn’t do this treatment that well, etcetera, you know? So I think that those are some of the reasons. But take vulnerability as a superpower. And if you change that, your whole mindset can change for sure.

For sure. I mean, I’ve thought about this in in business as well. And I know Dan does something called founders where it’s like a it’s like a safe space where, you know, founders can talk to each other about things that are going wrong. But often it’s hard. Even in business, it’s really hard to admit that something’s a challenge or that you’re really bad at something. You know how in every business some people are really good at some things and really bad at other things?

Totally. Like even with Parlour, as you know, like I’m so creative, but I’m absolutely awful, awful at like the computer stuff, like putting it down on a PowerPoint or like Excel. But I have a million ideas and you probably know as well, like working with me recently, it’s like I’m the ideas person. Like I can bring all the creative ideas, but it’s I hate that. Like I hate the sort of administrative side of things.

I’ve been I’ve been quite impressed with your execution side. You know, if if we say, let’s do something by that date, you tend to do it by that date, which I didn’t think you would be, that that sort of on it.

But I’m not good at but like.

I’m certainly not but.

I but I wouldn’t send like an agenda. Do you see what I mean? You know that kind of thing. You know, we’ve got Laura. That’s okay.

She’s listening. Yeah.

All right. Well, I’m really looking forward to this. Me, too. You know, and I think there’s going to be a lot of value in it. And we’ll try and also engage the people in dentistry who are involved in this space. You know, speak to Lauren and Mahrukh and see what see what answers they’ve got. They’ve obviously they’ve been asking these questions, the ones about specific to dentistry for quite a long time and super excited about all these people that you know and that you’re bringing on. So look forward to it. Amazing.

Thank you, Payman Thank you.