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NEW YORK, US: The Oral Health Workforce Research Center (OHWRC) is responsible for providing research on the oral health workforce in the US and assisting with planning within the field. OHWRC is based at the Center for Health Workforce Studies at the School of Public Health at the University at Albany, State University of New York. One of the many areas on which it has focused over recent years is that of gender diversity within the workplace, and in a recent study, researchers revealed that access to care has improved through the field becoming more diverse.
Whereas in many countries, and especially in Eastern Europe, the dental workforce has a significant female contingency, in the US it has been predominantly male. This has led to a particular structure of care that is now slowly changing. In the study, the researchers stated that approximately 50% of dental students in the US are women, and the positive impact that this is having is starting to be revealed.
In an American Dental Association (ADA) press release, Margaret Langelier, OHWRC co-deputy director, said: “Diversity within the dental profession is a widely embraced goal.” She added: “One desirable outcome is that dentistry becomes increasingly representative of the patient community, which has been shown to improve access to care.”
Regarding access to care, in the study, the researchers showed that female dentists in private practices were significantly more likely than male dentists to see children under 18 and treat patients covered by public insurance programmes. Additionally, female dentists are more likely to use preventive therapies at earlier stages of dental caries for both paediatric and adult patients compared with their male counterparts. However, in the paper, Langelier and her team noted that an Australian study found that “Rates of preventive services were lower among male than among female dentists but were higher for younger dentists overall (aged 20–29 years) than for dentists with more practice experience”. This is something that could point to a generational trend, according to the paper.
Immigration is one factor contributing to this upward trend in female dentists. The researchers reported: “The gender shift is partly influenced by immigration, especially from Eastern European and Asian countries, where the number of women in the dental profession is also rising.” A key finding from the study was that female dentists were more likely to be foreign-born (33.0%) and bilingual (35.5%) than male dentists (18.5% and 19.8%, respectively).
“Availability of culturally and linguistically competent clinicians may play an important role in addressing the needs of patients from different backgrounds or whose primary language is not English”— Margaret Langelier, OHWRC co-deputy director.
Another area of interest was around work–life balance. According to the study, dental students and dental practitioners noted that a significant motivation for choosing dentistry is the flexibility of working fewer hours when other priorities in life arise, such as caring for children and family. “Improvement in work–life balance comes from having a conducive work atmosphere and a customised approach to individual needs on an institutional level of understanding and support,” said a critical care physician and researcher who was quoted in the paper. According to the paper, “Female dentists were more likely than male dentists to report employee status (54.6% vs 33.7%) and less likely to report practice ownership (45.4% vs 66.3%).” However, the researchers said, “It is not possible to ascertain whether the high rate of employment among female dentists is driven by a desire for workplace flexibility.”
Whereas the changes to the dental workforce appear to be having a positive impact, there are still areas of concern. As in many industries, another area of concern is around equal pay. In the paper, the researchers reported that females earned a “significantly lower average annual income ($157,509) than male dentists ($210,097)”. Furthermore, 37.3% of female dentists earned $100,000 or less compared with 25.4% male dentists despite nine out of ten dentists reporting working full time with the difference between female and male being 88.4% and 92.1%, respectively.
According to the paper: “There is limited access to dental care in many rural and inner-city regions in the US, due in part to inadequate dental insurance coverage, limited transportation options, and a shortage of providers.” This point was highlighted in the study, and the researchers noted: “Male dentists were more likely to practise in the Midwest Region (20.5%) than female dentists (18.3%).” They said: “Proportionally more female dentists were located in the Pacific Division (22.2%) than male dentists (18.8%).”
“This changing gender mix within dentistry has generated questions about variation in practice patterns by gender that might affect the distribution of the dental workforce and its capacity to meet the needs of the patient population,” said the researchers, noting that successful community involvement and family involvement were also some of the most critical factors for retaining foreign-trained dental practitioners in rural areas. Despite this, the researchers concluded that, “It is important to consider that differences in practice choices may affect dental delivery, but change is endemic to healthcare and, at least to date, the oral health delivery system has adapted to both clinician needs and patient demand.”
The study, titled “Evaluating the Impact of Dentists’ Personal Characteristics on Workforce Participation”, was published by the Oral Health Workforce Research Center in December 2021.