Q&A: Dr. Carlos Smith on increasing diversity, inclusion in dentistry

Photo of Dr. Smith

Dr. Smith:  "The profession is made stronger by a more diverse and representative body to meet the oral health needs of so, so many." Photo courtesy of Dr. Carlos Smith.

Carlos Smith, D.D.S., in 2020 was appointed by the Virginia Commonwealth University School of Dentistry to be its inaugural director of diversity, equity and inclusion.

In this inaugural position, Dr. Smith has provided oversight and leadership for all diversity, equity and inclusion activities that support students, faculty and staff in the dental school and VCU Dental Care.

A general dentist and ethicist, he has collaborated with stakeholders responsible for diversity, inclusion and health equity across both campuses of VCU, serving as chair of the culture and climate subcommittee of VCU’s Institutional Equity Council and has partnered with external groups such as the Virginia Health Catalyst, as a member of its Future of Public Oral Health (FPOH) Taskforce, and co-leading its Workforce subcommittee. He has also partnered with the American Dental Education Association where he has been a vital contributor to their groundbreaking work in dental school climate assessment, advancing inclusion and belonging in the nation’s dental schools. A member of the American College of Dentists, he also served as a guest editor for the College’s 2021 double issue dedicated to issues of diversity, equity and inclusion.

Here, the New Dentist News spoke with Dr. Smith to learn more about his dental career, his mentors, what dentists and organized dentistry can do to increase diversity in the profession, and what advice he would give the next generation of Black dentists.

NDN: What influenced your decision to go into dentistry?

Dr. Smith: I honestly think my love of Lego as a child really stirred within me a love for working with my hands. I always had a desire to enter the health professions, perhaps that was innate on some level and my parents were always encouraging of that goal. I had close friends growing up whose parents were cardiologists and obstetricians, so I had the opportunity to shadow them on rounds and in hospitals and quickly realized that was not my preferred environment. I have an older sister and her getting braces was the initial spark for me, igniting an eventual passion for oral health and working to mitigate oral health disparities. 

NDN: In honor of Black History Month, is there a Black dentist who you looked up to or considered a mentor?

Dr. Smith: Without question, my foremost mentor has been Dr. Fred L. Sykes, of Columbia, South Carolina, my hometown. Dr. Sykes was the first African-American endodontist in the state of South Carolina and now practices alongside his daughter, Dr. Chandra Sykes Smith, also an endodontist. They are both Meharry graduates. One of the beauties of growing up in a city like Columbia was the storied history of a large Black professional and service-oriented community.

There is no way I can speak of Black dentists and South Carolina and not mention the late Dr. Noble P. Cooper Sr. Two of Dr. Cooper’s sons are dentists, one a general dentist and one an orthodontist. Dr. Cooper was my late grandmother’s dentist. He was one of the first Black members of the South Carolina Dental Association and the first African-American dentist from South Carolina awarded fellowship in the American College of Dentists.

I also have to mention Dr. Felicia Goins, an African-American and Native female pediatric dentist whose office I shadowed in as a college student and who is still a great mentor and friend. Also, Dr. Desiree Palmer of Durham, North Carolina, for whom I was an associate for several years. I’d also be remiss if I didn’t speak of the storied and important history of both the National Dental Association and the Student National Dental Association. These organizations have been at the forefront of advancing not only the needs and purposes of Black dentists but also of Black patients and patients of all races and ethnicities that often find themselves locked out of traditional oral health care delivery systems and insurance or fee-for-service programs.

Within dental education, I’ve had and continue to have many mentors: Drs. Todd Ester, Marilyn Woolkfolk, Lee Jones and Dean Leo Rouse: of course I don’t know anyone in dental education, as a Black faculty member, who wouldn’t speak the name of the incomparable Dr. Jeanne Sinkford, the first female dean of any dental school. Drs. Cooper, Goins, Rouse and Sinkford are all products of Howard University. The importance of our historically black college and university (HBCU) dental schools cannot be understated. I’ve also had mentors and colleagues who are not Black that have opened doors and opportunities for me, who saw my passion for DEI and ethics and have encouraged me such as Drs. Marita Inglehart, Theresa S. Gonzales, former VCU Dean David Sarrett and retired department chair Fred Certosimo, and many colleagues from the American Society of Dental Ethics like Pam Zarkowski, Fred More, Larry Garetto and others. Back to African American mentors, many of the NDA past presidents and leaders such as Drs. Sheila Brown, Nate Fletcher, Leslie Grant, Kim Perry and more have been mentors and examples up close or by proxy, as I like to call it.

NDN: Of the dental workforce, 3.8% are Black. From your perspective, what can organized dentistry and dental professionals do to help increase diversity and representation in the profession? What does it mean for you to be Black and working in this field?

Dr. Smith: Organized dentistry and dental professionals must first acknowledge the significant barriers that limit those underrepresented and historically excluded in our profession (African-American, Hispanic or Latin, Indigenous and Native Americans) from actually entering into our profession. This acknowledgement is a first step, but the challenges honestly are largely both systemic and societal. Research is beginning to show that students entering dental school make the decision to pursue dentistry as early as the middle school years. So while that might seem daunting to the active clinician, it leaves lots of opportunity. Be an advocate for your local middle school with tooth talks, career days, etc. Create shadowing opportunities within your office that especially target students earlier in their educational pathways. Perhaps there is an opportunity to supplement a science or art lesson with a dental emphasis. Or one’s advocacy could extend to school board or other school system service. Setting up scholarships or aiding one’s dental school alma mater in the recruitment and admissions process as well as communicating with organized dentistry leaders the dire importance of actionable practices that advance increasing the number of underrepresented minority dentists. 

NDN: As a Black dentist, what adversity have you faced, if any? And how did you face or navigate those challenges?

Dr. Smith: All individuals, irrespective of race or ethnicity, have experienced challenges at some point or another. Often African-Americans may lack the power and privilege that could aid in navigating challenges. Power being the ability to decide who will have access to resources; the capacity to direct or influence the behavior of others, oneself, and/or the course of events. And privilege being the unearned access to resources only readily available to some people as a result of their advantaged social group membership. Research supports, as well as many anecdotal experiences of friends and colleagues, how African-Americans may experience the dental school experience or even organized dentistry can vary greatly from our white counterparts. Whether experiences of being one of few Black persons in a lecture hall, or times where you’re called the name of one of the other of only two Black individuals in your cohort, or denied opportunities because of an “ethnic sounding name,” or attending a CE event and continually being told you’re in the wrong room… one fact we must accept is that racism and discrimination are part and parcel of our larger society and dentistry is a microcosm of larger society. But we must not simply accept that fact. We, as a profession, can be better and do more, we can actually live out our ethical promise to advance oral health care for all, and that means all, and opening the doors of the profession fully to all - with support, resources, policies, programs, services and practices that lead to a more equitable and just profession.

NDN: When did you participate in the ADA Institute for Diversity in Leadership, and can you tell us about your project?

Dr. Smith: I participated in the IDL program in the 2018-19 class. My project focused on the presence, or lack thereof, of dental school public commitments to diversity, equity, inclusion and belonging. Mostly focused on dental school websites, one of the most public-facing modalities of which dental schools communicate with their respective stakeholders: potential students, current students, alumni, donors, faculty and prospective faculty, patients and more. We found that this arena presents quite the opportunity due to the gap that exists not only in public commitments, but the tension that exists between articulated or espoused organizational commitments and the reality of experiences of those in the organization, on the ground, so to speak. 

NDN: What advice would you give to the next generation of Black dentists?

Dr. Smith: We need you, patients need you, colleagues need you. We are waiting for you and the way is prepared for you. One of the beauties of upholding values of diversity, equity, inclusion and belonging is that the advancements made — are to the benefit of all. For example, in teaching dental students and residents — my experiences and what I bring to their understanding of professional identity and ethical practice are beneficial to health care providers of all backgrounds and demographics, not just historically marginalized or racialized communities. The part truly does benefit and inform the whole. The profession is made stronger by a more diverse and representative body to meet the oral health needs of so, so many.