Changing faces: Dentistry sees slow but growing diversity
June 17, 2019
Editor’s note: This is the fourth article in an ADA News series examining the changing demographics and increasing diversity in dentistry
Impressions: Dr. Melanie Mayberry, right, takes a photo with students participating in her Urban Impressions program held at the University of Detroit Mercy School of Dentistry. The mentorship program exposes local seventh and eighth graders to dentistry and other health care professions.
It was about a year after earning her dental degree from a historically black university when Dr. Melanie Mayberry would notice new patients say something peculiar to her.
“Patients would tell me, ‘Oh, I expected you would look different,’” she said. “Another would say, ‘I thought you would be older, or a man.’”
Some of the patients would be more blunt.
“‘I just thought you’d be an older white man,’” said Dr. Mayberry, a 1994 graduate of Meharry Medical College School of Dentistry and a clinical associate professor at the University of Detroit Mercy School of Dentistry.
Dr. Mayberry said she took the comments in stride, but it became apparent to her that there weren’t a lot of African-American dentists.
“My father was a dentist and graduated in 1945,” she said. “I had heard a lot of stories from him about people who were not quite ready to meet a black dentist back then.”
If her father were alive today, Dr. Mayberry said, he would notice some changes.
“And I do see a little bit of that change today since graduating in 1994,” she said of a growing diversity in the profession. “The pace is slow, but it is moving in the right direction.”
While further historical data is not readily available, Dr. Mayberry’s observation appears accurate. According to ADA Health Policy Data, 28% of professionally active dentists in 2018 were from racial/ethnic minorities. That’s up 22% from 2008.
The need for a more racially diverse workforce in the profession has inspired others, including Dr. Mayberry, to create community programs to expose minority children to health care professions, including dentistry. Their hope: The exposure encourages them to pursue a career as a dentist.
“A more diverse workforce will always bring more diverse experiences,” Dr. Mayberry said. “Our conversations about the profession can become broader and richer when diversity is reflected.”
‘Wow, she looks like me’
According to the Health Policy Institute data, from 2008 to 2018, the percentage of active white dentists decreased from 78.2% to 71.9%. The largest increase among minority groups came from those of Asian background, increasing from 12.9% to 17.1%. Hispanics increased from 4.6% to 5.6%; and professionally active black dentists decreased from 3.8% to 3.7%. Dentists from other racial/ethnic background increased from 0.5% to 1.6%.
For Dr. Tawana Lee-Ware, of Indianapolis, introducing the idea that dentistry is a possible career choice to school-age children is one way of increasing those numbers. She knows from experience.
Smile: Dr. Tawana Lee-Ware, right, poses for a photo with Herica Ramirez, who completed the “Take Aim ... Ready, Set, Achieve” mentorship program in 2018.
Dr. Lee-Ware was pursuing a major in engineering in college but continued to explore other careers, including music and dance. When a mentor introduced her to an African-American dentist, Dr. Diane Stevens, something just clicked.
“I spent some time with her and observed her treating a patient,” Dr. Lee-Ware said. “I saw her put something in the patient’s mouth, and immediately the patient was sitting up straight. There was a physical change in him. Not only was she helping people, she was improving their self-esteem.”
Dr. Lee-Ware continued to explore dentistry and realized she enjoyed the artistry associated with it, the ability to improve patients’ lives and Dr. Steven’s advocacy.
“I fell in love with it,” said Dr. Lee-Ware, who graduated from Meharry in 2002.
In 2017, Dr. Lee-Ware rebranded a mentorship program that she had been doing for about a decade in the Indianapolis area. Called “Take Aim…Ready, Set, Achieve,” the program’s vision is to increase awareness of the career opportunities in the dental profession with low-income, first-generation college, disadvantaged students with a focus on those from a diverse background.
“A lot of times, the kids only know what’s in front of their noses,” Dr. Lee-Ware said. “For them to consider dentistry, they need exposure and education.”
Dr. Lee-Ware has teamed up with Upward Bound, a federally funded educational program, to host about 15 middle and high school students for a four- to six-week summer program at the Indiana University-Purdue University Indianapolis campus. She also plans to work with 15 other school-age girls through another organization called Girls Gift.
The students are introduced to and work with dental tools and shadow dentists at the dental practice. Dr. Lee-Ware said she also tries to explain her work as a business owner and her work in a laboratory.
“To me, it’s all about the one-on-one engagement,” she said. “I hope the kids think, ‘Wow, she looks like me. If she can do it, I can do it too.’”
Benefits of diversity
One of the benefits of a more diversified workforce is that patients can relate to their dental care provider more, said Dr. Ricardo Y. Mendoza, president of the Hispanic Dental Association.
“It’s not that you can’t relate to other groups,” he said. “But there’s a transmission of the message if you go to somebody who may speak the same language as you or who has similar experiences as you, the message — including how to improve a person’s oral health — gets heard a little louder.”
In 2017, according to the Henry J. Kaiser Family Foundation demographics data, Hispanics made up 18% of the U.S. population; blacks made up 12%; Asians were 6%; and whites, 61%.
“It’s not a secret that the demographics of this country are changing,” said Dr. Mendoza, who earned his dental degree in Venezuela and a master’s degree at the Boston University School of Graduate Dentistry.
He has now taught at the University of Illinois at Chicago College of Dentistry for 18 years as a clinical assistant professor in the pediatrics department.
“We have some work to do to get closer to have our profession’s diversity better reflect the U.S. population,” Dr. Mendoza said.
The Hispanic Dental Association, he said, created about five years ago a program called BOLD, or Building Our Leaders in Dentistry. Its approach is similar to Dr. Lee-Ware’s program: mentoring high school students, specifically Hispanic students, about the profession.
However, he said, there’s a family factor in the program.
“We try to engage the students and their family because the cost of dental education is a barrier for many Hispanic families,” he said. “We talk to students and encourage them that they can be doctors, but the cost is just enormous. Putting your life on hold until you become a health professional is tough. But we try to let them know that it is possible.”
The program, he said, started in San Antonio and has expanded to Dallas, Austin, Texas, Chicago and New York. Mentors in the program not only expose students to dentistry but also help them with the pathway, such as what courses to focus on.
“I truly believe that if minority groups are better represented in the profession, it doesn’t only help us,” Dr. Mendoza said. “It benefits all dentists and the entire population.”
Inspiring future dentists
In an effort to help and train promising leaders from diverse backgrounds with the potential to impact their own communities, the ADA created the Institute for Diversity in Leadership in 2003.
The Institute is designed to provide education and leadership skills to dentists who are members of racial, ethnic and/or gender groups that have been traditionally underrepresented in leadership roles within the profession and their communities.
It sought “dentists who have been identified as emerging leaders and influences within their communities, who could serve as mentors for future minority dentist leaders and role models for potential dental students,” according to a 2002 ADA Board of Trustees report.
Selected applicants attend three leadership education sessions conducted by faculty from Northwestern University Kellogg School of Management and Duke University’s Fuqua School of Business at ADA Headquarters in Chicago.
During their program year, the Institute class members develop their leadership abilities through faculty seminars and experience designing and leading projects for communities, dental organizations or other community organizations. Since 2003, over 200 dentists have been enrolled in the program.
Graduates of the program include Dr. Lee-Ware (class of 2018) and Dr. Mayberry, whose Institute project was the creation of her program Urban Impressions, A Youth Initiative in 2008. It’s a mentorship program that exposes a group of local seventh and eighth graders to dentistry and other health care professions. Dr. Mayberry and other health care provider volunteers visit the students at schools, and the students take field trips to their offices.
Since 2008, Dr. Mayberry said, more than 150 students have participated in the program, with about 60 of them now young adults. Because of limited resources, Dr. Mayberry is unable to follow the students’ career choices after leaving the program. However, she said, she’s hopeful some of them pursued a career in health care and dentistry.
“My goal was simply to expose students to dentistry,” she said. “When you ask kids today what they want to be when they grow up, not many will say dentist. But we need to give them the opportunity to see what we do and how we can help patients. I’m hopeful that it sparks their interest.”
And dentists don’t have to have a separate mentorship program to inspire, Dr. Mayberry said.
“When you meet a young patient, that dental chair can be your classroom for a few minutes,” she said. “Just start the conversation by asking the child what they want to be when they grow up.”