Dentistry Isn’t Just Straight White Teeth
If the dental profession really wants to attract more Black, Latino, and Indigenous students, then they have to rebrand it to emanate its full spectrum of color.
“Under a microscope, your tooth looks like a white picket fence.” Whew! I really need to stop saying that expression to patients when they complain of tooth sensitivity. It’s dated, not entirely accurate, and totally giving 1950’s. But old habits really are tough to break and new regimens are even more difficult to adopt — take it from a dentist who relentlessly tries to convince patients to floss.
Quite frankly, most of my dental references are old-fashioned even though I graduated from dental school in the new millennium. This can be attributed to the fact that I was taught dentistry by a much older generation. I’ll readily reference the imperfect smiles of Audrey Hepburn and Jacqueline Kennedy as most photographed of all time — which in a Beyoncé era sounds bizarre! Dentistry is one of the last industries to modernize and as our nation has become more colorful over time, dental therapies have also evolved from extractions and dentures to digital impressions and 3D guided implant surgery. However, as a profession that is still nearly 70% White, its face reflects that of the 19th century father of operative dentistry, G.V. Black, and our dental institutions continue to be led by deans and faculty who look like him.
Greene Vardiman Black is credited with developing dentistry into a scientific profession from once a mechanical art. He was the author of many dental textbooks, research important to dentistry including definitive work in dental anatomy and histology, providing the basis for the principles of cavity preparation. Black invented and designed many instruments used in dentistry. He was also a pioneer in the use of the microscope for studying dental disease. His work in microbiology and cellular pathology led to a better understanding of dental caries, periodontal disease and other pathological conditions and subsequently contributed to improved methods of treatment.
The work and teachings of G.V. Black are foundational to the basis of restorative dentistry and its evolution. Over the last century, dental medicine has matured into a complex practice — one that is enhanced by continued scientific study, technological advancements, and growing cultural relevance. Moreover, oral healthcare has become an umbrella of innovative therapies and procedures, manufactures, researchers, and practitioners. As a field of medicine, dentistry is also greatly influenced by the needs and desires of its patient base — one that is racially and ethnically diverse. However, the dental provider workforce does not reflect that variance, specifically with regards to the Black and Latino percentages of dentists at only 3% and 5% respectively, which is significantly less than their national populations.
Being so greatly under-indexed not only impacts access to care for Black, Latino, and Indigenous populations — as research shows that patients seek providers that look like them and have better outcomes because of racial concordance— but this disparity also directly affects the ability for historically underrepresented racial groups to create the circular effect in bringing more people from their communities into the profession. People tend to venture into areas where they feel welcomed and the first wave of acceptance is physical representation. In order to make dentistry more inclusive and dental care more equitable, the profession must prioritize dental leadership positions in both academia and across the entire industry to reflect the full spectrum of our colorful society.
Diversity, Equity, and Inclusion on Campus
Recruiting and retaining historically underrepresented racial and ethnic dental faculty is imperative to attract more Black, Latino, and Indigenous students. These instructors, professors, and deans not only help groom a culturally competent workforce and perform research to address disparities but often because of their lived experiences as marginalized minorities, these faculty members go beyond their regular duties and contribute to the development of culturally and ethnically diverse campus communities.
Dr. Todd Ester, who was recently appointed Associate Dean for Diversity, Equity, and Inclusion at the University of Michigan School of Dentistry, exemplifies the valuable role of diverse faculty. In his new position, he will serve as the advisor to the school’s leadership in advocating on institutional issues that relate to diversity, cultural sensitivity, and health equities to support cultural competency. Consideration and incentives must be provided for underrepresented minority faculty to remain in academia as they are often not legacy dentists with the cushion of wealth to support the financial sacrifice attached to working in full time academic posts.
Pathway Programs
Racially diverse faculty also enhance the impact of university pipeline programs such as University of Michigan’s Profile for Success, which helps prepare undergraduate students for careers in dentistry and broadens the pathway for historically underrepresented racial and ethnic students, staff, and faculty. Similar programs at Tufts University and Columbia University have been successful in significantly increasing their percentages of Black, Latino, and Indigenous students.
Tufts University School of Dental Medicine is one of the top three dental schools in the United States for enrollment of African-American/Black and Hispanic/Latinx students, including the Historically Black Colleges and Universities (HBCUs) of Howard University and Meharry Medical College. Since the 2013–2014 cycle, they have had a stunning increase in their applicant pool of students of African descent, nearly 130 percent. Twenty-eight percent of their most recent class identifies as Black/African American or Hispanic, nearly 32 percent identify as Asian, and 56 percent of the class is female. Over 70 students in the most recent entering class are from economically disadvantaged backgrounds.
Business Opportunity for Generational Wealth
Initiatives must also be made by the dental profession to make it more palatable to historically underrepresented groups. As a widely inherited profession, most White dental students are exposed to the field from birth and can see first hand its full lifestyle benefits. Showcasing dentistry as an entrepreneurial profession that allows business ownership and wealth creation is paramount in the recruitment of historically underrepresented groups that have been excluded from wealth building opportunities in this country. Executive leadership at dental service organizations and lending institutions should share this vision as dental practices rank highest as the most successful small businesses.
Oral Care Market
It should also be highlighted that dentistry is not merely an exclusive commercialized American experience of teeth bleaching and porcelain veneers but also a health necessity that has existed for thousands of years all over the world. Many cultures have utilized natural remedies for oral care such as the Miswak Stick, a plant with antimicrobial properties that is indigenous to parts of Africa and South America. Furthermore, Indigenous Americans traditionally utilized sap from evergreen trees for its oral health benefits. Today’s oral care industry values at over $64 billion developing products for a consumer market rich in racial and ethnic diversity. Our big pharmaceutical and dental supply companies should illuminate more Black, Latino, and Indigenous dental providers in the roles of executives, researchers, and board members.
STEM
The once antiquated dental space is now blooming with the advancements in technology from AI assisted caries detection, excavation, and chart transcription services to digital dental impressions, computer assisted manufacturing, and 3D printers. This reality welcomes an opportunity for the dental profession to recruit a wider following of Black, Latino, and Indigenous high school and college students interested in science, technology, engineering, and mathematics (STEM). Supporting and funding STEM programs for minorities can reduce the racial gaps that exist in the dental field.
As a scientific profession, dentistry is ever evolving and has sprouted into an industry much more vibrant than the age of G.V. Black. This development is sustained by our emerging population and thus requires leadership that reflects its all-inclusive mission to provide equitable dental care. Like the crystalized structure of tooth enamel, each facet of the dental profession must allow all colors of society to emanate from within.
Dr. Brigitte White is a cosmetic dentist in the Washington, DC metro area and adjunct faculty at University of Pennsylvania School of Dental Medicine. Follow her on Instagram, Spotify, and Youtube.
