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Dentistry and unconscious bias

​Reflecting on the issue of unconscious bias and gender discrimination in dentistry.

Laura Cross
Laura Cross Consultant and Honorary Clinical Associate Professor in Restorative Dentistry, BDA board member for Scotland and Co-Chair EDI committee

Gender discrimination was a problem long before I became a dentist in 1990, and it continues to be a problem today. These days however it is more likely to be unspoken and unconscious. But what is unconscious bias and how is it relevant to dentistry today?

Moving from open discrimination to unconscious bias

When I interviewed for a junior dental hospital post in 1991, one member of the all-male interview panel told me my chance of becoming a senior clinical academic was low because “there was only one female professor in dentistry in the UK and she wasn’t married.” Many have since proved him wrong and such straightforward examples of sexism are thankfully now illegal. However, outlawing discrimination hasn’t made it magically disappear.

Outlawing discrimination hasn’t made it magically disappear.

Unspoken and unconscious biases continue to affect dentists’ lives and hold back careers. We know from the powerful examples of sexism and bias shared during a recent FGDP webinar, for example, that women still face hurdles which their male colleagues do not. And it was clear, from the hostile and dismissive attitude of some men in the chat forum, just how aggressive the response can be to speaking out about these difficulties.

What impact can unconscious bias have?

Research has shown that people can be consciously committed to egalitarianism, and deliberately work to behave without prejudice, yet still possess hidden negative prejudices or stereotypes that influence their behaviour. You, me and everyone we know likely has a set of hidden stereotypes and prejudices that we’re unaware of.

Acknowledging and accounting for these hidden biases is essential if we are to ensure they don’t unconsciously impact our interactions and behaviours. Harvard University’s Project Implicit has designed tests to help you discover your unconscious biases on a range of issues, including: gender, race and sexual orientation. Taking some of these tests may help you to understand your biases and be a useful first step in the process of identifying any appropriate behavioural change

Acknowledging and accounting for these hidden biases is essential.

Scepticism and virtue signalling

There’s been a number of encouraging steps in the right direction in recent years. Putting gender and diversity training in place was an important part of this. But it alone cannot be the magic bullet that its sceptics sometimes claim it should be. Behavioural change is hard to inspire. Particularly when those whose eyes need opening are unaware they’re shut!

Indeed, the very people who have everything to learn from such training are the ones who often confidently call inclusion and diversity discussions a waste of time and dismiss such training as a PC bureaucracy gone mad. The fiercely defensive nature of this push to shut down these important conversations shows that we need to provide more opportunities for learning and discussion, not less.

We must not be content with virtue signalling.

At an institutional level meanwhile, we must not be content with virtue signalling. Many academic institutions have, for instance, signed up to the Athena Swan Charter, a drive to support gender equality. These efforts are a fantastic step in the right direction. However, once awarded, how is an institution’s ongoing adherence to the Charter’s principles monitored? Are the requirements of the award satisfied at departmental level? When meetings continue to be scheduled at times incompatible with childcare commitments, for instance, there’s clearly still room for improvement. All parents are affected by this, but particularly women, who often shoulder the majority of childcare responsibilities.

Finding a way forward

Ongoing discussion and an openness to practical changes are needed to tackle the influence of unconscious bias in dentistry. I’ve focused on gender discrimination and my own lived experience here but that’s just one form of unconscious bias. We can all help, by taking a test, educating ourselves about our own implicit associations and by encouraging others to do so too.

As an elected member of the BDA Board I take seriously the challenge of working on behalf of all dentists. I’m involved in our ongoing work on diversity and inclusion in dentistry, because I believe that it is by open and honest engagement with these important issues that real and lasting progress can be made.