Tackling racism in dentistry

​BDA President Russ Ladwa discusses racism in dentistry and how we can combat it.

International events around Black Lives Matter, the impact of the pandemic on ethnic minorities and issues that have come to the surface in dentistry, have made it clear that racism is, sadly,  not something that society has relegated to the past. Racism remains an ever-present reality for many of our colleagues and is deep-rooted in our culture.

That’s why, we’ve committed to tackling racism within dentistry. As part of this work, I felt it was essential to bring together ethnic minority dentists from across the profession to discuss our experiences and the action we want to see undertaken.

I want to share the outcomes of this discussion here, in order to illustrate the ways in which racism manifests in dentistry and how it affects the lives of those who experience it. I also want to outline the course of action that we need to follow as we begin this journey to tackle racism and to finally eliminate this shameful phenomenon from our profession.

How racism manifests in dentistry

Subtle and overt abuse

At our first meeting, I found it moving and distressing to hear of the appalling incidents of racism that our ethnic minority dentists have experienced. These encompassed racism in all its ugly forms from Islamophobia to antisemitism, anti-Black and anti-Asian racism. This racism had come from other dentists, staff, patients, and, in universities, other students and academic staff.

Many discussed the covert and subtle forms of racism, but we also heard of very serious incidents too, including a racially-motivated physical assault. Attendees shared their experiences of being treated differently, and how the attitudes of people towards them were sometimes perceptibly different to White colleagues.

To tackle racism we first need to acknowledge it. Subtle forms of racism, often resulting from unconscious biases, can be much more difficult to challenge. It is crucial that when they are called out, this type of racism is not minimised, dismissed or explained away as jokes or the victim labelled a snowflake.

Victims are afraid to speak out

Many dentists are simply too afraid to raise issues of racism out of fear that they would be perceived as a troublemaker or that it could prevent career progression. They fear that vocalising their experiences would provoke retribution or social isolation or that it might damage the reputation of the profession.

Ethnic minority dentists believe they need to make themselves ‘unfireable’ before they are in a position in which they can raise complaints. We know that reports of racism have, at times, been brushed under the carpet, which has further deterred dentists from coming forward.

It must not be forgotten that the impact of these experiences on the individual is profound and cumulative. It undermines self-esteem and confidence, causes poor mental health, damages wellbeing, and leads to sickness absence.

Lack of representation

It is not just interpersonal racism that concerned us. Even with the ethnic diversity we see in dentistry today, the under-representation of Black people is concerning. The reality is Black people comprise just one per cent of those on the GDC register.

The administration process of dental schools needs to be carefully reviewed in order to gain further insight here. We also need to understand the factors that lie much earlier in people’s lives that determine their life chances.

Representation among the leadership of the profession must also be included in any review.  In many ways it still reflects the ‘snowy white peaks’ seen across the senior levels of healthcare and this is quite simply not adequate. It’s vital that the BDA gets its own house in order on this – from branches and sections to the board – as well as working with others for profession-wide change.

Hindered career progression

Many ethnic minority dentists believe their ethnicity has hindered their career progression. Numerous examples of being passed over for promotion in favour of someone less qualified were discussed as were the struggles to find a permanent associate position. Many felt that they had to wait for practices to exhaust the White applicants first before they would consider ethnic minority candidates.

All-White interview panels, inappropriate interview questions and the role of unconscious biases in recruitment processes are yet further ways in which racism can manifest and ultimately undermine the career aspirations and confidence of ethnic minority dentists.

It is deeply concerning that ethnic minority and overseas qualified dentists are over-represented in cases that come before the GDC, relative to their proportion within the profession. Our regulator cannot ignore potentially uncomfortable truths about biases in its processes and must examine what lies behind these worrying statistics.

What needs to happen now

1. Give people a voice

Giving ethnic minorities a voice is an important step to dealing with racism. There is an overwhelming need for a form of support group, network, peer support and community to encourage dentists to speak up about their experiences.

We feel that the BDA should encourage regular input of this kind. We must also build stronger relationships with external organisations, such as the African and Caribbean Dental Association, the Sikh Dental Association and the Muslim Dental Association.

2. Improve the process for reporting racism

It is essential that there is a clear system in place for anonymously reporting racist incidents in dentistry. Our discussion group firmly believed the BDA must take ownership of this system. We need to be able to anonymously log all racist incidents so as to understand the scale of the problem and identify patterns.

This mechanism for reporting racism could be linked to a form of peer pastoral support, in which ethnic minority dentists share advice on how to handle racism at work. More experienced dentists might also be able to offer valuable advice to those who have concerns about challenging racism.

3. Provide equality and diversity training

Equality and diversity, or unconscious bias, training can aide behavioural change and promote an understanding of racism. However, as we are painfully aware, it is often those whose views and behaviours are most problematic that are least likely to meaningfully engage with such training. Therefore, in-person training is preferable to online courses as participants are more likely to actively engage, discuss issues and be challenged, rather than it being a ‘tick box’ session.

Equality and diversity should be an embedded part of wider training and not seen as an optional bolt on. We also discussed adopting a training session on different faiths and their interaction with dentistry that has already been delivered to some dental schools.

4. Celebrate and promote diversity

While there were clearly a number of difficult issues facing ethnic minority dentists, there is a view that the diversity of dentistry should be celebrated. We should promote the positive achievements and accomplishments of ethnic minority dentists.

5. Share your experiences

This discussion is only the beginning and must now lead to prompt, serious and sustainable action.  We must address both the causes of the problem – racism – and its effect – racial inequality. There are no quick solutions and a do-once approach will be insufficient.

Over the coming months, we will set out the actions that the BDA will take to tackle racism and it is vital that the voices of ethnic minority dentists continue to be heard as we move forward.

We will also be launching a call for evidence to gather your views. Please take the time to complete our survey when it arrives. Our voice and your experiences matter.

Russ Ladwa
BDA President