Have Women Broken the Glass Ceiling in North American Dental Leadership?

In the last few decades, the number of women graduating from North American (NA) dental schools has increased significantly. Thus, we aimed to determine women's representation in leadership positions in NA dental and specialty associations/organizations, dental education, and dental journals, as well as the proportion of men/women researcher members of the American Association for Dental Research (AADR). We contacted NA dental associations to provide us with the total number and the men/women distribution of their members. Men/women distributions in leadership positions were accessible from the internet, as were data on the sex of deans of NA dental schools. Data on the editors in chief of NA dental journals were gathered from their websites, and the AADR provided the number and sex of its researcher members. Collected data underwent descriptive statistics and binomial tests (α = 0.05). Our findings suggest that women are underrepresented in leadership positions within the major NA dental professional associations. While the median ratio of women leaders to women members in professional associations is 0.91 in Canada, it is only 0.67 in the United States. The same underrepresentation of women is evident in the leadership of the Canadian Dental Association and the American Dental Association. We found that women are underrepresented as deans and editors in chief for NA oral health journals. Only 16 of 77 NA dental school deans are women, while 3 of 38 dental journals have women editors in chief. The probability of finding these ratios by chance is low. However, the number of women dental researcher AADR members underwent an overall increase in the past decade, while the number of men declined. These results suggest that, despite the increase in women dentists, it will take time and effort to ensure that they move through the pipeline to senior leadership positions in the same manner as their male colleagues.

The feminization of dentistry and the perceptions of public service users about gender issues in oral health / A feminização da odontologia e as percepções dos usuários do serviço público sobre as questões de gênero em saúde bucal

Abstract It was investigated the perception of service users in relation to the professional practice of dentists, based on gender differences. The Primary Care Assessment Tool (PCATool) was applied to 900 users of the Public Service in Curitiba, PR, Brazil. Sixty clinics were selected using random sampling, divided between conventional Primary Health Care (PHC) Units and PHC with Family Health System Units. The attributes of PHC that compound the PCATool were analyzed. A question was added about user preference regarding the gender of the dental professional, thus generating four dyads derived from user gender/dentist gender (FF, FM, MM, MF). The attributes were linked to the dyads by applying the independent sample t test. Using logistic regression, the dyads were linked to 23 factors relating to scaled-up care in PHC. Many users showed a clear preference for being attended by female dentists. Users who prefer to be cared for by women tend to better evaluate PHC on issues related to "active listening", while those who prefer to be cared for by male dentists highlight the attributes of "care integration" and "community guidance". In other factors and attributes studied, there is no difference between the care given by men or women, regardless the unit.

Resumo Investigou-se a percepção dos usuários do serviço quanto à prática profissional dos dentistas, com base em diferenças de gênero. O Primary Care Assessment Tool (PCATool) foi aplicado a 900 usuários do Serviço Público de Curitiba, PR, Brasil. Sessenta clínicas odontológicas foram selecionadas usando amostragem aleatória, divididas entre unidades de Atenção Primária à Saúde (APS) convencional e unidades de APS com Estratégia Saúde da Família. Os atributos da APS no PCATool foram analisados. Uma questão foi adicionada acerca da preferência do usuário em relação ao gênero do dentista, gerando quatro díades derivadas da combinação do gênero do usuário/gênero do dentista (FF, FM, MM, MF). Os atributos foram ligados às díades pelo teste t para amostras independentes. Por regressão logística, as díades foram relacionadas a 23 fatores referentes aos cuidados ampliados na APS. Muitos usuários mostraram preferência por dentistas mulheres. Esses tendem a avaliar melhor os cuidados de saúde primários quanto à "escuta ativa e qualificada", enquanto aqueles que preferem ser atendidos por homens destacam os atributos de "integração do cuidado" e "orientação comunitária". Em outros fatores e atributos estudados, não há diferença entre o atendimento prestado por homens ou mulheres, independentemente da unidade.

The feminization of dentistry and the perceptions of public service users about gender issues in oral health.

It was investigated the perception of service users in relation to the professional practice of dentists, based on gender differences. The Primary Care Assessment Tool (PCATool) was applied to 900 users of the Public Service in Curitiba, PR, Brazil. Sixty clinics were selected using random sampling, divided between conventional Primary Health Care (PHC) Units and PHC with Family Health System Units. The attributes of PHC that compound the PCATool were analyzed. A question was added about user preference regarding the gender of the dental professional, thus generating four dyads derived from user gender/dentist gender (FF, FM, MM, MF). The attributes were linked to the dyads by applying the independent sample t test. Using logistic regression, the dyads were linked to 23 factors relating to scaled-up care in PHC. Many users showed a clear preference for being attended by female dentists. Users who prefer to be cared for by women tend to better evaluate PHC on issues related to "active listening", while those who prefer to be cared for by male dentists highlight the attributes of "care integration" and "community guidance". In other factors and attributes studied, there is no difference between the care given by men or women, regardless the unit.

Gender Differences in Academic Productivity and Advancement Among Dental School Faculty.

Background: An equal number of women and men are now graduating from dental school, but women dentists have lower income and are less likely to achieve positions of leadership, including within dental academia. Materials and Methods: Demographic information and academic rank were obtained for all faculty at the eight dental schools who received the most funding from the National Institute of Dental and Craniofacial Research in 2017. Years since dental school graduation, total number of PubMed-indexed citations, first- and last-author publications, and H-index were determined for each faculty member. Gender differences in productivity and advancement were evaluated. Results: Of 702 faculty members, 36.5% were female; only 24.4% of full professors were women. Men had significantly higher numbers of publications (30.2 [95% confidence interval [CI, 28.6-39.5] vs. 20.4 [95% CI 16.3-24.6], p = 0.02) and higher H-index (8.2 [95% CI 7.1-9.1] vs. 4.7 [95% CI 3.9-5.5], p < 0.0001). Women had graduated more recently than their male colleagues at all levels of academic advancement (overall 22.83 years [95% CI 21.29-24.39] vs. 30.19 years [95% CI 28.84-31.55], p < 0.0001). When corrected for academic productivity and years since graduation, the association between gender and academic rank was not significant. Conclusions: Women are underrepresented at each academic rank except instructor; however, women may advance more quickly than their male counterparts. Increasing scholarship and mentorship opportunities for female faculty members may help improve gender equity in dental academia.

An International Survey of Female Dental Students' Perceptions About Gender Bias and Sexual Misconduct at Four Dental Schools.

As women enter the dental profession in increasing numbers in North America and around the world, the questions of how they perceive their environment and what kind of barriers they face are important subjects to be addressed. The aim of this study was to assess and compare women dental students' perceptions of bias in their environment and experiences of sexual misconduct at one dental school in each of four countries. In spring 2017, 1,293 female students at four dental schools in the U.S., Bulgaria, Brazil, and India were invited to participate in a 24-item survey developed by researchers from the four countries; 990 students responded (response rate 76.6%). The overall majority of the respondents reported thinking the admissions process at their school was fair (79.7%); but a fifth of U.S. and Brazilian students perceived their school was not fully embracing of females, with most Bulgarian students agreeing (87.2%) and all Indian students disagreeing. Most respondents overall perceived that male faculty members did not favor male students (79.5%) and did not think there was discrimination against female students by faculty (87.1%), but half of the U.S. respondents reported feeling discriminated against by both male faculty and male students. When the responses "I've been verbally harassed" and "I've been somewhat verbally harassed" were combined, 10.1% of the U.S. respondents reported verbal harassment, compared to 20% of Brazilian, 15% of Bulgarian, and 2% of Indian respondents. When the responses "I've been sexually assaulted" and "I've been somewhat sexually assaulted" were combined, 6% of U.S. respondents reported being sexually assaulted, compared to 6.2% of Brazilian, 2.5% of Bulgarian, and none of the Indian respondents. Almost half (46.9%) of these students overall perceived their school was not or only somewhat vigilant about issues of sexual misconduct, and only 54% said they would feel comfortable or very comfortable reporting misconduct. These results suggest that academic dental institutions in all four countries need improvements to make their environments more equitable and free of bias and sexual misconduct.

[A woman at the chair is nothing out of the ordinary. Dental practice by female dentists in the Netherlands.] / Een vrouw aan de stoel is heel gewoon. De beroepsuitoefening van vrouwelijke tandartsen in Nederland.

Women currently make up 40% of the dentist population in the Netherlands. On the basis of enrolment in educational programmes their share can be expected to grow to more than half. The literature shows gender differences in preferences regarding work setting and duration of the working week. Men and women also differ from each other with respect to the way dental care is provided. The presented data demonstrate an increase in the number of women working in dentistry and research data have confirmed the presumed differences between male and female dentists. Women are less likely to be the owner of a practice, women who do own a practice are more likely to collaborate with colleagues and have a shorter working week. With regard to providing dental care, women seem to be slightly more orientated to the individual patient and are more likely to pay attention to the patient's general health. Theories about work values provide explanations for these gender differences. Women's preference for collaboration accords with the general development in dental care to work in teams.

Under-representation of women in the editorial boards of medical and dental journals of Pakistan.

OBJECTIVE: To explore the representation of females in the field of medical journal editing in Pakistan. METHODS: This cross-sectional study was conducted from July 3 to 15, 2015 at Combined Military Hospital, Lahore. After exploring the website of Pakistan Medical and Dental Council, we surveyed the website of each journal and from their latest available edition discerned the editorial board's gender composition. Designations of female members were noted. Data was analysed using SPSS 20. RESULTS: A total of 2342 members served on the editorial boards of 79 journals of which 410(17.51%) were females. The maximum strength of women in a single journal was 23/30(76.6%). There were no women in the editorial boards of 11 (13.92%) journals. Among others, there were 188 (45.9%) Members of Editorial Board, 39 (9.5%) Editors, 39 (9.5%) Associate Editors, 34 (8.3 %) Members Advisory Board, 22 (5.4%) Subject Editors, 10 (2.4%) Editors-in-chief, 8 (2.0%) Student Editors, 7 (1.7%) Statisticians, 3 (0.7%) Bibliographers, 2 (0.5%) Deputy Editors-in-chief, 1 (0.2%) Trainee Editor and 1(0.2%) epidemiologist. CONCLUSIONS: There was a low representation of women in the field of journal editing. A number of factors may be incriminated for this poor visibility.

Trends in the earnings gender gap among dentists, physicians, and lawyers.

BACKGROUND: The authors examined the factors associated with sex differences in earnings for 3 professional occupations. METHODS: The authors used a multivariate Blinder-Oaxaca method to decompose the differences in mean earnings across sex. RESULTS: Although mean differences in earnings between men and women narrowed over time, there remained large, unaccountable earnings differences between men and women among all professions after multivariate adjustments. For dentists, the unexplained difference in earnings for women was approximately constant at 62% to 66%. For physicians, the unexplained difference in earnings for women ranged from 52% to 57%. For lawyers, the unexplained difference in earnings for women was the smallest of the 3 professions but also exhibited the most growth, increasing from 34% in 1990 to 45% in 2010. CONCLUSIONS: The reduction in the earnings gap is driven largely by a general convergence between men and women in some, but not all, observable characteristics over time. Nevertheless, large unexplained gender gaps in earnings remain for all 3 professions. PRACTICAL IMPLICATIONS: Policy makers must use care in efforts to alleviate earnings differences for men and women because measures could make matters worse without a clear understanding of the nature of the factors driving the differences.

An observational analysis of recent female dental enrolment figures in the Republic of Ireland.

PURPOSE/OBJECTIVE: This research investigates the participation and completion rates of Irish female undergraduate dental students from 2003 to 2014. METHODS: The Higher Education Authority database was accessed and dental students enrolment and completion figures were extracted, compiled and analysed according to gender distribution. RESULT: From 2003 to 2014, there has been a steady increase in the number of female students enrolled in and completing Ireland's undergraduate dentistry programmes. CONCLUSIONS: The findings reveal that a distinct process of feminisation has occurred in Ireland since the early 2000s. The feminisation of dentistry in Ireland will impact on workforce projections for the Irish dental service. However, more research needs to be undertaken to explore why female students are motivated to pursue a career in dentistry. Due regard also needs to be given to ensuring these women progress in their dental career. Dental education can play an important role here.

Which Way to Lean? A National Study of Women Dental Faculty Members' Career Aspirations and Choices.

The aim of this first national study of women in academic dentistry was to explore factors and perceived barriers for why administrative/leadership positions were or were not sought via data collected from full-time women dental faculty members in the U.S. In fall 2015, the researchers conducted a survey that employed a combination of response formats: forced choice from a menu, multiple allowable answers, and open-ended written comments. The overall response rate for the survey was 35.6% (537/1504). Respondents were from 48 of the 65 U.S. dental schools. Half of the respondents indicated their primary appointment was in clinical sciences, 22.9% were in administration, 7.3% in research, 7.1% in basic science, and 2.5% in behavioral science. While a quarter of the respondents indicated administration as their primary appointment, over half reported holding administrative positions, and nearly all (92.4%) reported currently holding leadership roles at their institutions. For those not currently in administrative/leadership roles, 52.6% indicated a desire for an administrative role and 70.7% a leadership role. Of those in administrative/leadership roles, 62.1% indicated not receiving extra remuneration for those responsibilities. Half of the respondents perceived that they were paid less in their current position than men doing the same work. The most dominant theme emerging from qualitative analysis of barriers the respondents experienced was the difficulty women in dental education have in a traditionally male-dominated profession. The results confirmed that women faculty members are "leaning in" to seek administrative/leadership roles in academic dentistry. However, pay equity remains an issue, and faculty development and mentoring are needed for the advancement of academic dentistry and ultimately the dental profession.

Presencia de las mujeres en los órganos de dirección de los colegios profesionales del ámbito de la salud en 2015 / Presence of women in management bodies of the profesional associations of the field of health in 2015

Fundamentos: La progresiva incorporación de las mujeres en las profesiones sanitarias no se corresponde con su presencia en puestos de responsabilidad. Dado que los colegios profesionales tienen un papel esencial en la representación y regulación profesional, se plantea como objetivo describir la frecuencia de la presencia de las mujeres en las estructuras directivas de los colegios profesionales del ámbito de la salud en España y comprobar el grado de cumplimiento de los criterios de paridad. Métodos: Se identificó el género de la persona que ocupaba la presidencia, los cargos ejecutivos y la junta directiva visitando las webs del Consejo General de los colegios profesionales de Psicología, Consejo General de Colegios Oficiales de Médicos, Consejo General de Colegios Oficiales de Enfermería de España, Consejo General de Colegios de Fisioterapeutas, Consejo General de Dentistas, Organización Farmacéutica colegial y Consejo General de Colegios oficiales de Podólogos. Se describió el porcentaje de mujeres de forma global y según profesión y se comparó con las cifras de colegiados y colegiadas según el INE para 2014. Resultados: De 251 colegios profesionales en julio de 2015, 41 (21,91%) la presidencia estaba ocupada por mujeres. También ocupaban el 34,69% de los puestos ejecutivos y el 42,80% del total de las juntas directivas. Los colegios médicos y de enfermería tenían una mujer en la presidencia en el 11,32% y 43,48% respectivamente. Los de psicología fueron los que presentaron mayor presencia femenina en la presidencia, el 45,83%. Conclusión: No existe paridad entre hombres y mujeresen el conjunto de los colegios estudiados. La presencia femenina es mayor en colegios de psicología y enfermería y mucho menor en los de odontología, fisioterapia, podología y medicina con el nivel de responsabilidad disminuye la presencia de las mujeres (AU)

Background: The gradual increase of women in the health professions does not correspond with her presence in positions of power. Given that professional colleges have an essential role in the representation and professional regulation, arises as an aim to describe the presence of women in the managerial structures of the professional colleges of health in Spain now to verify the degree of compliance with the criteria of parity. Methods: The Spanish official professionals´ colleges were compiled by visiting the websites of the General Council of the Psychology of Spain, General Council of Medical Associations of Spain, General Council of Colleges of Nursing of Spain, General Council of Physiotherapists Schools of Spain, General Dental Council , Organization collegiate Pharmaceutical General and Council of Associations of Podiatrists. All their webs were visited. The sex of the presidency, the executive and the entire board was identified. Data were analyzed according to the overall percentage of women and profession. We compared this to the INE-2014 collegiate professionals. Results: Out of 251 professionals´ colleges in July-2015, 21, 91% had a female president. Women hold 34,69% of the executive positions and 42,80% of total boards. 11, 32% of Medical colleges had a female president and 43,48% of Nursing ones. The Psychology are those with more women in the presidency, 45, 83%. Conclusion: There is no parity, being higher in Psychology and Nursing and, much lower in Dentistry, Physiotherapy, Podiatry and Medicine. It decreases with the responsibility level. Health Inequality (AU)

[Presence of women in management bodies of the professional associations of the field of health in 2015]. / Presencia de las mujeres en los órganos de dirección de los colegios profesionales del ámbito de la salud en 2015.

BACKGROUND: The gradual increase of women in the health professions does not correspond with her presence in positions of power. Given that professional colleges have an essential role in the representation and professional regulation, arises as an aim to describe the presence of women in the managerial structures of the professional colleges of health in Spain now to verify the degree of compliance with the criteria of parity. METHODS: The Spanish official professionals' colleges were compiled by visiting the websites of the General Council of the Psychology of Spain, General Council of Medical Associations of Spain, General Council of Colleges of Nursing of Spain, General Council of Physiotherapists Schools of Spain, General Dental Council, Organization collegiate Pharmaceutical General and Council of Associations of Podiatrists. All their webs were visited. The sex of the presidency, the executive and the entire board was identified. Data were analyzed according to the overall percentage of women and profession. We compared this to the INE-2014 collegiate professionals. RESULTS: Out of 251 professionals' colleges in July-2015, 21, 91% had a female president. Women hold 34,69% of the executive positions and 42,80% of total boards. 11, 32% of Medical colleges had a female president and 43,48% of Nursing ones. The Psychology are those with more women in the presidency, 45, 83%. CONCLUSION: There is no parity, being higher in Psychology and Nursing and, much lower in Dentistry, Physiotherapy, Podiatry and Medicine. It decreases with the responsibility level. Health Inequality.

County-level characteristics as predictors of dentists' ECC counseling in the USA: a survey study.

BACKGROUND: Transmission of Streptococcus mutans from mother-to-child can lead to Early Childhood Caries. A previous study identified characteristics and beliefs of general dentists about counseling pregnant women to reduce risk of infection and Early Childhood Caries. This study extends those findings with an analysis of county level factors. METHODS: In 2006, we surveyed 732 general dentists in Oregon, USA about dental care for pregnant women. Survey items asked about individual and practice characteristics. In the present study we matched those data to county level factors and used multinomial logistic regression to test the effects of the factors (i.e., dentist to population ratio, percentage of female dentists, percentage of females of childbearing age, and percentage of individuals living in poverty) on counseling behavior. RESULTS: County level factors were unrelated to counseling behavior when the models controlled for dentists' individual attitudes, beliefs, and practice level characteristics. The adjusted odds ratios for no counseling of pregnant patients (versus 100 percent counseling) were 1.1 (95% CI .8-1.7), 1.0 (1.0-1.1), 1.2 (.9-1.5), and 1.1 (1.0-1.2) for dentist/population ratio, percent female dentists, percent females of childbearing age, and percent in poverty, respectively Similar results were obtained when dentists who counseled some patients were compared to those counseling 100 percent of patients. CONCLUSIONS: Community level factors do not appear to impact the individual counseling behavior of general dentists in Oregon, USA regarding the risk of maternal transmission of Early Childhood Caries.

The role of women in dental education: monitoring the pipeline to leadership.

The purpose of this study was to analyze data collected by the American Dental Association and the American Dental Education Association over the past two decades relating to changes in the number of women active in dental education and dental practice. The concept of a pipeline of women in dentistry was explored by analyzing predoctoral, postdoctoral, dental practice, and dental education domains for the inclusion of women. Statistical analyses show that there has been a consistent and progressive increase in the number of women in all stages of the pipeline. Over the past two decades, the number of female students attending and graduating from dental school has steadily increased. In 1984-85, 23.7 percent of all predoctoral students were women; in 2009-10, 45.1 percent were women. Similarly, in 1999, the graduating class was 35.3 percent women; in 2009, it was 46.1 percent women. In the postdoctoral domain, in 1996, 29.9 percent of all residents were women; in 2010, this had increased to 39.0 percent. In dental practice, the number of actively licensed women dentists in 1999 was 15.3 percent of the workforce; in 2010, this percentage had grown to 24.0 percent. In dental education, the number of women clinical faculty members has gradually increased from 669 in 1997-98 to 902 in 2007-08. Until 2000, there had been only two women deans and very few associate/assistant deans, with only sixteen in 1990. In 2000, major changes began with three women deans and seventy-two women associate/assistant deans. In 2009-10, there were 111 associate/assistant women deans and twelve women deans. These data show a progressive increase in the presence of women in all domains of dentistry, especially in leadership positions in dental education.

Women in orthodontics and work-family balance: challenges and strategies.

The number of women entering the orthodontic profession over the past few decades has increased dramatically. A review of the literature revealed the lack of research on achieving a work-family balance among female dentists and dental specialists. Work-family balance has been researched more extensively in the field of medicine; however, despite some critical differences, parallels between these 2 professions exist. This study identified issues that Canadian female orthodontists face and strategies they use to achieve a work-family balance. A phenomenological qualitative study was used to analyze the results of semi-structured telephone interviews of a purposive sample of 13 Canadian female orthodontists. The results strongly support the role-conflict theory about the competing pressures of maternal and professional roles. Female orthodontists described their challenges and strategies to minimize role conflict in their attempt to achieve a work-family balance. The women defined balance as having success and satisfaction in both their family life and professional life. They identified specific challenges of achieving a work-family balance that are unique to orthodontic practice and strategies for adapting to their maternal and professional roles. Achieving a work-family balance is of paramount importance to female orthodontists, and the results of this study may be applied to other specialties in dentistry.

Women's leadership in the Public Dental Service in Finland.

AIM: This study aimed to examine how leadership positions in the Public Dental Service (PDS) were distributed between women and men and how the female and male lead dentists perceived themselves as managers or leaders and whether their superiors, the leading doctors and municipal decision makers or their subordinates, the public dentists, found differences between female and male lead dentists as leaders. METHODS: Gender aspects on the leadership qualities of the lead dentists in the Public Dental Service were evaluated by four professional groups using a questionnaire. The groups surveyed were: lead dentists (in charge of the municipal PDS clinics), leading doctors (lead dentists'line managers), the directors of municipal health boards, and the PDS dentists (subordinates to the lead dentists). Factor analysis, chi-square and non-parametric tests were used to analyse the data gathered. RESULTS: Women made up 50% (96/192) of the lead dentists, 80% (211/263) of the public dentists, 31% (47/152) of the leading doctors, and 27% (33/124) of directors of the municipal health boards (P<0.001). Nearly all female (92%; 86/93) and 78% (70/90) of the male lead dentists considered themselves to be good people-oriented leaders (P<0.01) and three-quarters of the men (74%; 67/90) and 59% (54/92) of the women good goal-oriented managers (P<0.05). In the eyes of their nearest superiors, the female and male lead dentists were rated equally; they were given scores as goal-oriented managers, people-oriented leaders (both medians= 3.2 on a scale from 1 to 4), and their ability (median=3.5) to take care of their tasks. Their decision authority, power in municipal decision-making (median=2.8), was considered weaker. Most, 67% (70/105), of the PDS dentists evaluated their female superiors and 50% (75/150) their male superiors good as goal-oriented managers (P<0.001), and 51% (54/105) considered their female superiors and 35% (53/150) their male superiors good as people-oriented leaders (P<0.05). CONCLUSIONS: Female dentists had not become lead dentists in proportion to their numbers in the PDS. Those who had a leading position felt that they were good leaders, their superiors considered them as good as their male colleagues, and their subordinates felt they were better.

The feminization of dentistry: implications for the profession.

Over the last 40 years, the proportion of women in dentistry has been rising steadily, raising questions about the effects of this feminization on the profession. A review of the literature, although limited, highlights potentially important areas related to gender, including impact on work hours, practice models, professional incomes, the dentist-patient relationship, clinical philosophies, specialty practice, academia and leadership. Although cohorts of predominantly female dentists are only beginning to enter the workforce and, thus, it is difficult to predict the long-term effects, some trends are evident: women are less likely than men to own their practice; women may work 4-6 fewer hours a week and see fewer patients; there is a pay differential; female general practitioners and specialists appear more likely to work in urban centres; and women are less prominent in the specialties, academia and leadership roles. Thus, the profession may shift toward less entrepreneurship, more urbanization and, possibly, fewer clinical hours available to the population as a result of feminization. With the ultimate goal of excellence in patient care, this may entail increases in student enrolment, formal incentives for practice relocation to rural communities, more business education and policies to modify advanced education and training for women with children. This knowledge, although still not robust, is relevant for policy, educational institutions and professional governing bodies.