Underrepresented Minority Dentists: Quantifying Their Numbers And Characterizing The Communities They Serve.

The underrepresentation of Blacks, Hispanics or Latinos, and American Indians or Alaska Natives among dentists raises concerns about the diversity of the dental workforce, disparities in access to dental care and in oral health status, and social justice. We quantified the shortage of underrepresented minority dentists and examined these dentists' practice patterns in relation to the characteristics of the communities they serve. The underrepresented minority dentist workforce is disproportionately smaller than, and unevenly distributed in relation to, minority populations in the United States. Members of minority groups represent larger shares of these dentists' patient panels than of the populations in the communities where the dentists are located. Compared to counties with no underrepresented minority dentists, counties with one or more such dentists are more racially diverse and affluent but also have greater economic and social inequality. Current policy approaches to improve the diversity of the dental workforce are a critical first step, but more must be done to improve equity in dental health.

Tracking workforce diversity in dentistry: importance, methods, and challenges.

OBJECTIVES: The objectives of this paper are to describe sources of data on underrepresented minority (URM) dental providers and to perform a structured critique of primary survey research on African American (AA), Hispanic/Latino (HL), and American Indian/Alaska Native (AI/AN) dentists. METHODS: A national sample survey was conducted between October 2012 and March 2013, and secondary datasets were assessed for comparability. The survey used 21 sampling frames, with censuses of AI/AN and nonurban dentists, and assessed demographics, education, practice history, patient population, volunteerism, experiences with discrimination, and opinions on issues in dentistry. The survey was developed with constituent input, pilot-tested, and distributed online and through US mail with three reminder postcards, phone, and email follow-up. Continuing education credit and entry to a prize drawing were provided for participation. RESULTS: Existing data sources cannot answer critical research questions about URM dentists. Using best practices, the survey received a 34 percent adjusted response rate. Selection likelihood and measurable response bias were adjusted for using base and poststratification weights. CONCLUSIONS: The survey design was consistent with best practices, and our response analytics provide high confidence that the survey produced data representative of the URM dentist population. Enhanced study design, content, and response rates of existing survey efforts would be needed to provide a more robust body of knowledge on URM providers, perspectives, and practices.

End-of-Life Issues for the Oral and Maxillofacial Surgeon.

The oral and maxillofacial surgeon (OMS) plays a critical role when it comes to listening and answering patients' questions regarding prognosis, course of treatment, and overall expectations of what lies ahead. The OMS should remain an advocate for the patient, always keeping in mind that it is the patient's wishes that must be respected. The surgeon should champion patients' autonomy and cooperate with their families and other clinicians to ensure that patients have a "good death," defined as one that is pain free, peaceful, and dignified, at a place of their choosing with the relatives present and without futile heroic interventions. Indeed, the relationship and open communication between patient and surgeon may be one of the best treatments that the patient can have.

Building the minority faculty development pipeline.

The shortage of faculty in dental education is well documented, but the data also show a shortage of minorities in postgraduate programs, which develop future faculty. In the last ten years, ADEA's effort to address minority issues in dental education has made some progress. In addition, examples of pipelines for minority faculty development that have shown some success include: a partnership between Harlem Hospital and Columbia University School of Dentistry and Oral Surgery in which the school dedicates one position in its postgraduate training programs to an individual participating in the Harlem Hospital General Practice Residency program; a partnership between the National Dental Association Foundation and Colgate-Palmolive Company, which provides scholarships for advanced dental education study; and the Bronx Lebanon Hospital Center Department of Dentistry, which enrolls underrepresented minorities in its General Practice Residency Program, a new Pediatric Dentistry Residency Program, and a unique program providing hands-on experience in HIV/AIDS health care policy and AIDS development management. Critical elements in the relative success of these programs are environment, selection criteria, mentoring, networking, and finance. The true measure of the outcomes is still to be seen.