Why women dentists in the current generation are indeed pioneers

October 2, 2015

Article

“The current generation of women dentists will be a bridge generation that deals with the many challenges of being pioneers in the way women practice dentistry.”

The practice of dentistry has evolved from its humble origins when barbers were the only “professionals” providing oral health care. Today, there are eight dental specialities (endodontist, orthodontist, periodontist, prosthodontist, pediatric dentist, general dentist, oral surgeon and oral pathologist) tasked with restoring dentition to a healthy status. Dental hygienists, in contrast, are primarily disease-prevention specialists. Through patient education and calculus removal techniques, they work to maintain a healthy periodontium, the foundation of the dentition. Together, these professionals are responsible for the oral health of Americans. Traditionally, as with most careers, dentistry was a male-dominated profession. However, the modern dental workforce is overwhelmingly female.

The first American woman to earn a degree in dentistry was Lucy Hobbs Taylor, and she did so in secrecy. The year was 1865 and, having been denied entry into Eclectic College of Medicine because she was a woman, Lucy obtained her dental education from the dean of the Ohio College of Dental Surgery privately. She did not receive a degree upon completion. After an apprenticeship with a male dentist, she ventured out on her own and opened a practice in Cincinnati in 1861. The practice quickly became successful, and, in 1865, The Iowa State Dental Society granted her membership, stating, “the profession has nothing in its pursuits foreign to the instincts of women.” She received her degree in 1866 from Ohio College of Dental Surgery. Lucy was, by all accounts, a powerful lady. She was a suffragist, advocate and educator, having trained her own husband to become a dentist. By the turn of the 20th century, there were 1,000 women dentists.

The dental hygiene profession originated from the mind of Dr. Albert C. Fones, a Connecticut dentist who realized that proper oral hygiene was the key to preventing dental disease. He wrote a textbook, “Mouth Hygiene: a course of instruction for dental hygienists,” in which he details the techniques he created to secure “extreme cleanliness.” After training his cousin, Irene Newman, in plaque and calculus removal techniques, she became the world’s first dental hygienist. Dedicated to his vision, Dr. Fones, working against organized dentistry (they highly disapproved of dental hygienists), opened his own school in a carriage house behind his private practice. In 1914, 27 women graduated from the Fones Clinic for Dental Hygienists.

Today there are approximately:

185,000 dental hygienists and 186,000 dentists in the United States.

96 percent of dental hygienists and 47 percent of dentists are female.

That means of 373,000 dental care providers, 264,000 are women.

The implications of these numbers are unknown, but some trends regarding dentists are evident:

Women are less likely than men to own their own practices (54 percent vs. 74 percent, respectively).

Women are less prominent in organized dentistry and leadership roles.

Women make lower salaries.

Women work less hours (89 percent of male dentists worked full-time vs. 75 percent of women dentists).

Women are more likely to treat oral disease conservatively.

Female health care providers are perceived as more empathetic than male providers (empathy is crucial to positive patient outcomes).

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In academia and publication status, women still lag behind. In a recent study examining the gender differences in the number and rate of publications, only 13 percent of first authors and 9 percent of last authors were women. Although women are more likely than men to pursue academic careers (this is assumed to be due to women’s desire to work less hours to balance family and career), they only account for one-third of the full time faculty in dental teaching institutions. Women report significant gender disparities in the world of academia; men are predominant in positions of tenure, deanship and scholarly activity. Strong efforts have been made by leading organizations, such as the American Dental Association and the American Dental Education Association, to provide women with the training and opportunities necessary to close the gap.

Women are also beginning to earn more visible leadership positions. The president of the American Dental Association, the American Dental Hygienists Association, the American Academy of Periodontology, the American Academy for Oral Systemic Health and the American Dental Assistants Association are all women. In fact, the entire board of the ADAA is female! Women are also strongly represented in the sister profession of public health. Fourteen percent of the presidents of the American Association of Public Health Dentistry were female, and there has been a significant increase of female authorship in the Journal of Public Health.

The effects of all this feminization are yet to be seen. I like to think the tenderness and compassion inherent of women will positively affect the practice of dentistry. Current trends in public policy and science support the need for a holistic approach to health, which produces better outcomes (healthier, happier people) and reduces cost. In my own experience, I’ve noticed differences in the way women care for their patients. While I can’t attest to differences in quality of care (I have worked with excellent clinicians both male and female), there are noticeable differences in delivery of care. Women take more time and pay less attention to the profits. Patients appreciate this, and studies show they are more likely to adopt healthy behaviors when cared for this way. Dr. Lynn Carlisle discusses this more in-depth and makes a final observation.

“The current generation of women dentists will be a bridge generation that deals with the many challenges of being pioneers in the way women practice dentistry,” she says. “Hopefully, the current bridge generation of women in dentistry will integrate the feminine and masculine into a more humane, holistic, caring, relationship-based dental profession. Hopefully, they will add to the rich tradition of women as healers and men as healers.”

Diana Macri is an assistant professor in the dental hygiene department at Hostos Community College. She obtained a bachelor’s degree from the University of Bridgeport and a master’s degree in higher education administration from Baruch College