Sir, I am a third-year dental student at Queen Mary's University London. As a student that is enthusiastic about dental education, I am constantly observing and reflecting on areas that require change. While the focus on the Black Lives Matter (BLM) movement has subsided, with fewer local demonstrations and reduced media coverage, it does not mean that my passion for equality has also diminished.
From my perspective, the problems in dentistry are two-fold. Firstly, the under-representation of black dental professionals within the workforce. Secondly, unconscious bias, where the consequences are evident in areas from dental education to the recognition of clinical manifestations of diseases, leading to delayed and missed diagnoses.
More role models will pave the way for future black dentists. But why is it that in 2014, when 3,410 prospective students applied to dentistry, of the 135 black students only 25 were accepted (19% acceptance rate)? This compares with 460 accepted Asian applicants (40.9%) and 549 accepted white applicants (54.1%).1 These results highlight the risks of not separating the terms 'BAME' and 'black' in dentistry.
Under-representation consequently plays a part in clinical diagnosis. Low numbers of black academics and specialists limits the research, educational teaching and overall momentum on how skin colour affects the clinical manifestation of diseases.
Fortunately, I do believe change and adaptation is happening in dentistry. Medics are also taking a structured and academic approach, with a new handbook due out on the presentation of different skin diseases written by a medical student at St George's University London.2 The oral mucosa is not exempt in this, with racial pigmentation being misdiagnosed and delayed recognition of herpes labialis and Kaposi's sarcoma.
Social media is helping communities to grow, such as 'Melanin Medics', 'Black Budding Dentists' and the African & Caribbean Dental Association (ACDA). These have united, encouraged and inspired young black dentists and potential dental school applicants.
In July 2020, I, along with five other black dental students were invited to meet with the GDC's Head of Education, Head of Research and Head of Policy to discuss our views and concerns. This positive recognition with active listening and suggestions for improvement, felt like dentistry is finally reacting to the BLM movement.
BLM isn't over now, with changes occurring in our dental schools, the GDC, medical education and in our dental CPD. I ask of the GDPs up and down the UK, to reflect on their own impact within the dental community and consider engaging in verifiable online CPD webinars, discussions and articles investigating and bringing light to problems that exist with diversity and equality.
In order to sustain the momentum in striving for equality and the highest standard of care, we must commit to this form of life-long learning. I'm sure dental professionals will be eager to understand more about the specific problems that manifest from a group of under-represented individuals. Together with my peers, we shall continue to research and actively work on these barriers in dentistry, thus striving for equality.
Gallagher J E, Calvert A, Niven V, Cabot L. Do high tuition fees make a difference? Characteristics of applicants to UK medical and dental schools before and after the introduction of high tuition fees in 2012. Br Dent J 2017; 222: 181-190.
Rimmer A. Presenting clinical features on darker skin: five minutes with ... Malone Mukwende. BMJ 2020; 369: m2578. doi: 10.1136/bmj.m2578.
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Kadiyo, T., Mellish, V. Is Black Lives Matter over now?. Br Dent J 229, 326 (2020). https://doi.org/10.1038/s41415-020-2184-4
British Dental Journal (2020)