Shaun Sellars continues this essential series on ethical dilemmas in dentistry which appears in every second issue of the BDJ.

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The politics of representation has received renewed focus over recent years. The Everyday Sexism Project has been documenting examples of normalised sexism from around the world since 2012 and has ushered in a new wave of feminism. And it's been impossible to miss the recent surge of the Black Lives Matter movement, including the worldwide protests, political statements and inevitable misguided backlash. But how does dentistry relate to this?

According to the most recent GDC accounts,1 the ratio of male to female registered dentists is almost exactly 1:1. This doesn't tell the whole story, with specific sectors of the profession often dominated by one gender. Women are significantly less likely to enter into implant dentistry or become practice owners, while men are underrepresented in community dentistry.2 This, along with the part-time positions women often take up to accommodate child care roles, may go some way to explaining the gender pay gap of up to 39%.3

The issues are more profound than this, thanks to the male-led tradition of dentistry. When discussing the use of the title 'Dr' for dentists, one of my female friends remarked that 'it's OK for you… You don't get mistaken for the nurse.'

Dentistry is moving on from the 'pale, male and stale' stereotype but there are improvements to be made. The 'manel' (a conference/webinar or leadership panel made up solely of men) is still too common. Improving female representation is essential for providing differing viewpoints and solutions. This should be easy enough to resolve. I was on a panel at a science communication conference a few years ago where the organisers originally had a 'no manel' policy. They soon found that it was no longer needed because it soon became the new norm.

When it comes to ethnic diversity, the numbers are starker. Dentistry has a legacy of being a 'white' profession, and while the profession is becoming ethnically more diverse, there are still significant issues. Around half of the dentists in the country are 'white' with the next most represented ethnic identity being 'Asian' or 'Asian British' echoing the ethnic mix of the country. But only 1% of registered dentists identify as being Black British4 which is a significant departure from the representation of 3% in the UK population.5 In addition, those of a BAME background are less likely to enter clinical teaching or academic roles.4

This matters because increasing representation encourages future participation. That is, women or BAME persons in a position will act as role models for future generations entering those positions. In a diverse society, diversity in dentistry is desirable, as it can remove barriers for access to unrepresented groups and help understand the unique challenges of overlooked patient cohorts. This is the basis of ethics: recognising yourselves in others makes treating others as yourself become second nature.

Why should a white, male, middle-class dentist (like me) be interested in any of this? Because we're the ones that can change it.