Power, gender and silence: Understanding sexual misconduct in dentistry

Iveta Ramonaite, Dental Tribune International

Tue. 4. November 2025

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Although awareness of sexual misconduct in healthcare has increased in recent years, the issue remains largely under-explored in dentistry. Dr Aaron Drovandi, senior lecturer in medical education research at the University of Manchester in England, has recently co-authored a comprehensive review on the topic. In this interview with Dental Tribune International, he discusses the study’s key findings, the cultural and structural factors involved, and the measures needed to create safer, more transparent dental workplaces.

Health sciences researcher Dr Aaron Drovandi believes that normalising conversations about sexual misconduct, clarifying reporting pathways and protecting those who speak up are essential first steps towards safer dental workplaces. (Image: Dr Aaron Drovandi)

Dr Drovandi, what motivated you to focus on sexual misconduct specifically in dentistry, rather than in the broader health professions?
Our research team focuses on development of the health workforce, including the well-being of healthcare professionals as an essential factor in providing care to communities. The UK General Dental Council has recognised that, compared with the medical field, little is known about the prevalence and contributing factors of sexual misconduct within dentistry and provided resources to support our investigation.

One striking finding is the very wide reported prevalence range for sexual misconduct (5%–86%) in different dental populations. What factors do you think explain this variation?
We have theorised that a few factors contribute to this. Firstly, the studies examined different populations, such as dental students, dental hygienists and dentists. We found that dental hygienists in some studies reported the highest rate of experiencing sexual misconduct, whereas dentists reported comparably low rates. Secondly, the research is international, covering data from more than ten countries, where differences in the regulation of health professionals and in social standards of acceptable behaviour would contribute to this variation. Finally, social norms around reporting may vary significantly across countries and areas of practice—some environments may facilitate reporting, while others may have stigma or barriers that discourage it.

You highlight that dental hygienists reported higher rates of misconduct than dentists or dental students did. What might account for this difference?
We believe that this may be due to both the gender make-up of the dental workforce and the power imbalances within dental workplaces. Dental hygienists have historically tended to be women, who are more likely to experience sexual misconduct by male colleagues. Hygienists are also often viewed as having a subordinate role compared with dentists and oral surgeons, and this power imbalance may contribute to misconduct. While students are also on the lower rung of these dynamics, they may be partly protected by their dental school, which serves as an additional pathway for reporting and is responsible for quality assurance regarding placement providers.

The review notes that most perpetrators were male. To what extent do you think that this reflects traditional gender roles and hierarchies within dental education and practice, and how might shifting gender dynamics affect this in the future?
We believe that this partly reflects traditional gender roles and power dynamics. Although the gender balance across the various roles in dentistry is changing, some studies still describe dental surgery as an “old boys’ club” where inappropriate behaviours persist. However, we also believe that there may be under-reporting by male victims owing to social perceptions and pressures that cause guilt or shame.

Many incidents of sexual misconduct occur in informal settings, such as social events or gatherings involving alcohol. How can dental organisations foster safer social environments while maintaining opportunities for collegial interaction and mentorship?
Opportunities to socialise and build professional relationships are important in the workplace. However, these events must be organised with care to avoid environments in which unwanted sexual behaviour might occur. Although the provision of detailed guidance was outside the scope of this study, structured social and team-building events—rather than unstructured gatherings or parties—may be more effective in ensuring safety.

“We found that dental hygienists in some studies reported the highest rate of experiencing sexual misconduct.”

You mention that reporting pathways are often opaque or distrusted by victims. What factors most undermine confidence in these systems, and how could systems be redesigned to ensure safety, confidentiality and accountability for all parties involved?
In addition to a lack of awareness of reporting pathways within workplaces, individuals may feel uncomfortable reporting a patient or colleague because of concerns about future working relationships. A lack of trust also arises from fear of retaliation or job loss and the belief that reporting will not lead to meaningful feedback or outcomes. Organisations should ensure that reporting processes are clearly defined and communicated, including mechanisms for regular updates and feedback on outcomes to those who make reports.

Given the scarcity of tested interventions, what immediate steps can dental schools, practices or regulators take to address sexual misconduct more proactively—and what key enablers or barriers do you see to implementing such measures?
Organisations employing dental staff or training students must overcome the stigma surrounding discussions of sexual misconduct. These discussions should be normalised, and there should be a clear understanding of appropriate and inappropriate behaviours in the workplace. This needs to be reinforced through explicit descriptions of reporting pathways and assurance that those who report are not disadvantaged in any way and are kept informed about the progress and outcomes of their complaints.

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