Gender Inequalities in the Dental Workforce: Global Perspectives

Gender equity in The Journal of the American Dental Association: A review of the past 2 plus decades

BACKGROUND

Considering evidence of closing the gender gap in dental scholarship, this study assessed women's participation as authors, reviewers, and members of the editorial board for The Journal of the American Dental Association (JADA) from 2000 through 2022.

METHODS

The study authors downloaded author names from PubMed and retrieved names of reviewers and editorial board members from JADA's pages. The authors used Gender-API software to determine gender on the basis of first names. They used logistic regression to test for trends.

RESULTS

From January 2000 through December 2022, there were 2,935 full-length articles, 2,775 reviewers, 4 editors in chief, and 85 editorial board members. The percentage of women authors increased by 1.2% annually (95% CI, 1.03% to 1.33%), reaching 47% in 2022. First authorship increased by 2.1% annually (95% CI, 1.84% to 2.39%) and has been at more than 50% since 2016. In articles with multiple authors, there was a modest increase; second authorship increased 0.7% annually (95% CI, 0.36% to 1.09%) and last authorship by 0.7% (95% CI, 0.03% to 1.00%). Women reviewers increased 0.8% annually (95% CI, 0.68% to 0.97%), but the percentage of women on the editorial board did not increase significantly and was 41% in 2022.

CONCLUSIONS

It was anticipated that 50% of JADA authors would be women by 2024. However, women are still underrepresented on the editorial board. A comprehensive effort is needed to foster role models, provide mentorship opportunities for women, and support women's professional advancement in dental research and publications.

PRACTICAL IMPLICATIONS

Gender-based disparities affect women in dental education and clinical practice. Serving as an editorial board member, reviewer, or author can affect academic promotion and the type of scientific investigation being conducted and indirectly affects women's health outcomes.

O-HEALTH-EDU: A viewpoint into the current state of Oral Health Professional education in Europe: Part 1: Programme-level data

INTRODUCTION

Current legislation leaves Oral Health Professional (OHP) education open to wide interpretation and may result in significant variation in educational practice and resultant professional attributes across Europe. Data regarding the current state of OHP education across Europe is limited. The aim of Part 1 of this series is to provide programme-level data for Primary Dental Degree Programmes, Dental Hygiene and Postgraduate Education.

METHODS

A 91-item questionnaire was developed following the Delphi method. The questionnaire and the Articulate glossary of OHP education terms were developed concurrently to facilitate a common understanding of language. Piloting was performed in multiple stages and included institutions internal and external to the research group. The questionnaire was uploaded online and converted to a data hub, allowing dental schools to control their own data and update the data provided whenever they wish. All ADEE member schools (n = 144) were invited to provide data. Forty questions relating to school details, Primary Dental Degree Programmes, Dental Hygiene and Postgraduate Education were included in this part of the series.

RESULTS

Seventy-one institutions from 25 European countries provided data between June 2021 and April 2023, which represents a response rate of 49.3% of ADEE members. Programme-level data for Primary Dental Degree Programmes, Dental Hygiene and Postgraduate Education is presented including programme length, funding, languages and fees, student numbers and demographics, student admission and selection processes and permission to practice after graduation.

CONCLUSION

This series of papers, as far as the authors are aware, are the first attempts to build a comprehensive picture of the current state of OHP education in Europe. A comprehensive view of the state of OHP education in Europe is not yet available but the O-Health-Edu data hub provides a means for all education providers in Europe to contribute data to reach this goal. It is anticipated that the data hub will be updated and built upon over time to continually establish a clearer picture of the state of OHP education in Europe.

O-Health-Edu: A viewpoint into the current state of oral health professional education in Europe: Part 2: Curriculum structure, facilities, staffing and quality assurance

INTRODUCTION

Oral health professional (OHP) education is likely to vary across Europe in accordance with an EU directive that is open to broad interpretation. It is not clear how OHP curricula are structured or delivered across Europe. The objectives of Part 2 of this paper series are: (i) to provide an overview of common practices in curriculum structure, the availability of facilities, staffing (faculty) and quality assurance processes and (ii) to consider how the existing programme structures align to stakeholder guidance documents.

METHODS

A total of 27 questions from a 91-item questionnaire were used for this manuscript. The questionnaire was developed following the Delphi method to establish consensus from a group of experts. Members of the research team and colleagues from other countries in Europe completed a multi-step piloting process. An online data hub was created to allow the respondents to be data controllers and respond to the questionnaire. ADEE member schools (n = 144) were invited to provide data.

RESULTS

Totally, 71 institutions from 25 European countries provided data between June 2021 and April 2023, which represents a response rate of 49.3% of ADEE members. Data on curriculum approaches, teaching methods, integration of topics of interest, clinical education, staff-student ratios, access to facilities and new technologies, teaching staff (faculty) and quality assurance processes are presented for Primary Dental Degree Programmes.

CONCLUSION

To the best of our knowledge, this series of papers are the first attempts to provide a comprehensive overview of OHP education in Europe. Results showed that the majority of European dental programmes are engaged in providing innovative and scientifically grounded education in order to develop quality future OHPs. Nevertheless, significant variability in the delivery of clinical education across the European OHP schools was notable in this dataset. A comprehensive view of the state of OHP education in Europe is not yet available but the O-Health-Edu data hub provides a means for all education providers in Europe to contribute data to reach this goal. It is anticipated that the data hub will be updated and built upon over time to continually establish a clearer picture of the state of OHP education in Europe.

Gender and geographic diversity of global oral health organisations

Introduction Diversity of leadership of global oral health organisations is critical to ensure a global agenda.Aim To analyse the gender and geographic diversity of global oral health organisations.Methods Publicly available data on the gender of their staff and leadership, and congress locations, were analysed. Gender was allocated from photographs if available, and using Genderize, an online allocation platform. Location of leaders and global congresses were analysed by country, region and World Bank income category. The organisations analysed were the International Association of Dental Research (IADR), FDI World Dental Federation, International Federation of Dental Hygienists (IFDH) and 15 dental specialist global associations.Results The majority of headquarter staff in the IADR (76%) and FDI (84%) are female. Gender diversity in the leadership differs across the various organisations, with recent progress towards gender parity. The IFDH was and is exclusively female-led. The majority of leaders are from high-income countries in Europe and North America. Of the 370 congress locations, 90% were held in high-income countries.Conclusion There is recent progress towards gender diversity in the leadership; however, this leadership is essentially from high-income countries. There is an urgent need to publicly commit to diversity goals and implement strategies to reflect the oral health workforce and be truly diverse and global.

The Presence of Women in the Dental Profession: A Global Survey

OBJECTIVES

The aim of this research was to acquire knowledge about the female dental workforce, identifying factors to pursue specialty training and career choices and working in dental institutions/associations.

METHODS

An original online questionnaire was developed, validated (n = 22), and sent to 189 member associations in 133 countries of the Women Dentists Worldwide section of the FDI World Dental Federation.

RESULTS

In all, 3232 female dentists from 81 countries participated. Results were divided into 5 geographic areas by continent. Difference in proportion amongst questionnaire items was evaluated with χ2 test or Fisher exact test. Ordinal multinomial linear regression analysis was performed to evaluate the association of questionnaire items with total work experience in dentistry (in years), motivation to study dentistry, type of specialisation, working hours per week, perception of female dentists about working hours, sex-based inequalities, job security after maternity leaves, as well as involvement in political organisations within their country of residence and their role in dental associations. A majority of participating female dentists are self-employed (57.7%), and 60.0% have 10 to 30 years of experience. The most popular form of practice is the single private practice (29.7%), followed by the group private practice (28.8%). Further, 44.8% work 31 to 40 h/wk, 29.1% part-time up to 30 h/wk, and 26.0% more than 40 h/wk.

CONCLUSIONS

Women are still poorly represented in professional organisations, and few are officers in representative assemblies, members of the board, or president. Family life with children influences perceptions and has an impact on professional life, especially in academia and political/professional associations, so that taking on leadership positions poses additional challenges.

Women in leadership positions in dentistry: A scoping review

BACKGROUND

The objectives of this scoping review were to calculate the prevalence of women in leadership positions in dentistry, present existing research on gender (male, female) disparities affecting dentistry globally, identify gaps in the literature that can drive future research, and provide recommendations for achieving gender parity in leadership positions.

TYPES OF STUDIES REVIEWED

A search of PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Embase, Google Scholar, and Cochrane Central Register of Controlled Trials databases was performed using search terms. The search strategies were developed to cover English-language articles from January 2016 through April 2022 that examined the prevalence of women in leadership positions in dentistry. Abstracts, newsletters, qualitative reports, and letters to the editors were excluded.

RESULTS

Eighteen studies met all inclusion criteria and were included in the final analysis. Low prevalence was noted of women in leadership positions in dentistry globally. Multiple reasons that have led to gender disparities were identified and recommendations for decreasing gender disparities and achieving gender equity in dentistry were provided.

PRACTICAL IMPLICATIONS

Over the years, several factors have contributed to gender inequalities in dentistry. However, during the past decade, gender equity, inclusion, and diversity have been recognized increasingly as core values of the dental profession. Presenting and analyzing all available data surrounding this topic are of paramount importance to start formulating appropriate strategies to achieve gender parity in all areas of dental leadership.

Discriminatory episodes negatively impact the quality of life of Brazilian dental students: A cross-sectional study

PURPOSE

This study aimed to evaluate whether discriminatory episodes occurring in the university environment were associated with dental students' self-perceived overall quality of life and assess the cumulative effect of perceived discriminatory experiences on the overall quality of life.

METHODS

In this cross-sectional study, all students enrolled in three Brazilian dental schools were invited to participate in a survey between August and October 2019. The outcome was students' self-perceived quality of life, measured through the overall quality of life item of the World Health Organization-Quality of Life Abbreviated Version (WHOQOL-BREF). Descriptive, bivariate, and multivariable logistic regression analyses (95% confidence intervals and α of 5%) were conducted using RStudio software.

RESULTS

The sample was composed of 732 students (70.2% response rate). The great part was female (66.9%), white or yellow skin color (67.9%), and were children of highly educated mothers. About 68% of the students reported having experienced at least one of the seven discriminatory experiences presented in the questionnaire and 18.1% reported neutral or negative quality of life. In multivariable analyses, it was estimated that students who experienced at least one episode of discrimination were 2.54 times (95% CI: 1.47-4.34) more likely to report worse quality of life than their counterparts who reported no experience of discrimination. There was also a 25% (95% CI: 1.10-1.42) increase in the odds of reporting poorer quality of life for each additional discriminatory experience reported.

CONCLUSION

Reporting at least one discriminatory situation in the academic environment was associated with worse quality of life among dental students, and a cumulative effect was also noted.

Leadership through a gender lens: Disparities in Dental Research

This study aimed to analyze the 100 most-cited papers in Dentistry, with a focus on female leadership in dental research. Papers were retrieved from the Web of Science Core Collection (WoS- CC) in the category 'Dentistry, Oral Surgery & Medicine'. Gender was assessed through WoS-CC, Scopus, ResearchGate, social media, institutional websites, and software that assigns gender according to first names (https://genderapi.io). Characteristics of authors in leadership roles were retrieved, such as affiliation, publication history, citations, H factor, and i500. The 100 most-cited papers in Dentistry were authored by 394 researchers, 326 (82.7%) men, and 68 (17.3%) women - there were 4.8 male authors for each female. Among the lead authors, there were 11.3 males for each female. Among female senior authors, there were 7 males for each female. Among lead/senior authors of the 100 most-cited papers (first and last authors, respectively), 18 were women. There was an increase in the participation of women in the top cited papers regardless of authorship role across the six decades, with a peak of two female authors in the first decade of the 21st century. For female authors in leadership roles, their publication history shows the time between their first and last papers in WoS-CC ranged from 4 to 42 years for lead authors and 1 to 39 years for senior authors. Women were found to be largely underrepresented as leaders of the 100 most-cited papers, highlighting pervasive gender inequalities in dental research publications.

Metaresearch study highlights the gender gap in randomized controlled trials in dentistry

BACKGROUND AND OBJECTIVES

This study aimed to assess the gender gap in randomized controlled trials (RCTs) in dentistry in terms of authorship, collaborations, metrics, funding and reporting of good research practice and transparecy.

METHODS

The search was performed in PubMed for RCTs restricted to English texts in the dental field, indexed from 12/31/2016 to 12/31/2021. Two reviewers screened the studies in line with the eligibility criteria. A total of 844 articles were included. The name and gender of authors, citation metrics, funding, reporting of characteristics of good research practice and transparency were extracted. We considered "collaboration between authors" when the corresponding author was different from the first author.

RESULTS

The proportion of women as first authors was 46.56% and 40.12% for corresponding authors. The analysis showed that when a woman is the corresponding author, the probability of the first author also being a woman is 57% higher compared to the first author being a man. For "protocol registration" and "data sharing," the prevalence of reporting was higher when women were first authors.

CONCLUSION

A gender gap in dentistry RCTs was identified and related to the participation of women as first and corresponding authors and the collaboration between authors.

Gender inequities in dental research publications: Findings from 20 years

BACKGROUND

The first steps towards gender equity in science are measuring the magnitude of inequity and increasing awareness of the problem.

OBJECTIVES

To describe trends in gender disparities in first and last authorship in the most cited dental publications and general dental literature over a 20-year period.

METHODS

Articles and bibliometric data were retrieved from the Scopus database for the period 1996 to 2015. Two groups of 1000 articles each were retrieved: a random sample and another sample of top-cited articles for each year. The gender of the first and last author of each publication was manually identified. When this was not possible, we used an online software platform (https://genderize.io/). Descriptive analyses identified the proportion of women first and last authors in both samples, stratifying by dental discipline and geographic region. Trends were ascertained by frequency metrics across years. Gender disparity was observed in both first and last authorship, with a larger gap being observed in the top-cited sample.

RESULTS

Women led 28.4% and 20.3% of articles in the random and top-cited samples, respectively. A similar pattern was observed for the last authorship group (22.1% and 16.1%, respectively). An increasing trend in the proportion of articles led by women over time was observed in both samples. This increase was larger in the top-cited sample (from 15.0% in 1996-2000 to 25.1% in 2015) than in the random sample (from 26.3% in 1996-2000 to 33.2% in 2011).

CONCLUSIONS

Clear gender disparities in dental research publications in the last 20 years were identified in both general and top-cited manuscripts, across dental disciplines, across countries, across first and last authorship, and over time. It is paramount that actions are taken to attract, retain and promote women in science, as well as to monitor and ensure progress towards gender equity.

Gender inequality among the editorial boards of periodontology and implantology journals

OBJECTIVES

The aim of the present study was to investigate gender composition of the editorial board members of the journals in the field of periodontology and implantology.

MATERIALS AND METHODS

A rigorous search was performed through Web of Science database to identify journals, scoping on the periodontology and implantology research fields. Data on journal's demographic information, gender of the editorial board members were gathered from the journals fulfilling the predefined inclusion/exclusion criteria. Variables including journal impact factor and quartiles were extracted as well.

RESULTS

The proportion of women in the editorial team in periodontology journals was 27.3%, whereas it was almost 19% in implantology journals. As for editorial leadership, these ratios were 22.1% and 19.8%, respectively. There were significantly less women than men in editor-in-chief position in periodontology journals (p = 0.042). Journal metrics had no impact on the gender distribution of editor-in-chief positions in both fields.

CONCLUSIONS

Women seem to be under-represented as editorial leaders or board members in journals of periodontology and implantology. The proportion of women in periodontology journals has increased in the last decade; however, there is still a clear need for further increase to have a gender balance.

Gender representation amongst orthodontic editorial boards: trends over time

OBJECTIVE

To assess trends in gender representation within editorial boards of European and North American orthodontic journals from 2000 to 2023.

MATERIALS AND METHODS

Retrospective cross-sectional study of editorial boards of orthodontic journals. The first issue of volumes of identified journals from the years 2000, 2010 and 2023 were investigated to demonstrate trends over time.

RESULTS

Eight journals were included. Across the period investigated, a total of 810 editorial board positions were identified with most positions held by men (657/810; 81.1%). The proportion of female editorial board members increased from 14.7% (36/245) in 2000 to 24.5% (73/298) in 2023. The number of female Editor-in-Chief increased from zero in 2000 to two in 2023. Three journals demonstrated a reduction in female representation from 2000 to 2023.

CONCLUSION

Females remain underrepresented within editorial boards of orthodontic journals which is a key metric of presence and leadership in orthodontic academia.

The impact of gender on citation rates: An observational study on the most cited dental articles

OBJECTIVE

This cross-sectional study aims to determine whether the gender of the authors plays a role in the position of authorship within the 100 most cited articles in dentistry.

METHODS

An electronic search was performed in October 2022 in the SCOPUS database, considering filters by 'subject area' [dentistry], 'document type' [article], and 'source type' [journal]. The search was performed without restriction on the study design, publication yearor language. Information regarding each article was then extracted. The gender of the first and last author was determined by associating their first names with the probability of the name being male or female, using the Genderize database. Comparative evaluation of gender distribution was performed with the Chi-Square test.

RESULTS

Articles ranged from 5214 to 579 citations. Included studies were published between 1964 and 2019, with the majority being from journals with the highest impact factors in the field. There were statistical significance differences between the gender distribution of the first and last authors, with a predominance of man in both authorships positions (all p<0.00). Only 15% and 12.6% the most cited papers in dental research presented a woman as first and last authors, respectively.

CONCLUSION

In conclusion, female authors are not as regarded as male authors in prestigious authorship positions in the most cited dental publications, and gender bias can still be considered prominent in the dental research community.

CLINICAL RELEVANCE

The findings of the present study indicate that the gender imbalance in citation practices, reported in several areas, also occurs in the field of Dentistry. It is essential that more discussions be raised about gender disparities and about the female presence in the scientific community.

Gender diversity of the oral health leadership in Australia

BACKGROUND

Gender diversity in oral health leadership is important. Globally, this is dominated by men and does not equitably represent the increasing women in the workforce.

METHODS

Publicly available and gathered data on leadership positions for Australian professional associations, accrediting body, specialist academies, training institutions and the public dental sector were analysed for gender (men and women) diversity.

RESULTS

The gender diversity of the leadership varies across the oral health organizations and training institutions. Of the 383 identified leadership positions, 229 (60%) are held by men. Of the eight national dentist association presidents, six (75%) are men. Of the 65 leadership positions across 13 training institutions, 39 (59%) are held by men, and all schools training dentists are led by men. Men also dominate leadership roles in the specialist academies (62%), the research organizations (56%) and public dental sector (67%). Women do have the majority of senior leadership roles in the accrediting body (67%).

CONCLUSION

Gender diversity of the oral health leadership shows some positive findings, but there is still an effort required to increase women leaders across many areas of this leadership. This should urgently be recognized as a problem, with the implementation of strategies to address this important issue. © 2023 Australian Dental Association.

Characterizing the One Health workforce to promote interdisciplinary, multisectoral approaches in global health problem-solving

BACKGROUND

In recognition of the interconnected nature of complex challenges such as COVID-19, a collaborative, multisectoral, and transdisciplinary approach, referred to as One Health, has been employed to address sustainable development and strengthen global health security. Although significant investments have been made to build global health capacity, characterization of the One Health is absent from the literature.

METHODS AND FINDINGS

We collected and analyzed perspectives from students, graduates, workers, and employers in One Health through a multinational online survey across health disciplines and sectors. Respondents were recruited through professional networks. A total of 828 respondents from 66 countries participated, representing governmental and academic institutions and students, among others; 57% were female, and 56% had completed professional health degrees. Interpersonal communication, communication with non-scientific audiences, and the ability to work in transdisciplinary teams were valued in the workplace and were considered essential competencies to build an interdisciplinary health workforce. Employers indicated difficulty recruiting workers, while workers indicated limited availability of positions. Employers identified limited funding and ill-defined career pathways as prominent challenges for retaining One Health workers.

CONCLUSIONS

Successful One Health workers use interpersonal skills and scientific knowledge to address complex health challenges. Aligning the definition of One Health will likely improve the matching of job seekers and employers. Encouraging the employment of the One Health approach for a diverse range of positions, even if they do not explicitly include "One Health" in the job title, and clarifying the expectations, roles and responsibilities within a transdisciplinary team will lead to building a stronger workforce. As One Health has evolved to address food insecurity, emerging diseases, and antimicrobial resistance, it holds promise for supporting an interdisciplinary global health workforce that can make substantial progress on Sustainable Development Goals and improve global health security for all.

An Update on the Progress Toward Gender Equity in US Academic Pharmacy

Objective. To evaluate the status of gender equity in US pharmacy education since the two previous publications on the topic in 2004 and 2014.Methods. Data were gathered from existing national databases, internal American Association of Colleges of Pharmacy (AACP) databases, AACP meeting minutes, published reports, scholarly articles, pharmacy association websites, individual school websites, and LinkedIn profiles. Differences between men and women were evaluated on degree completion, discipline, rank, tenure status, research, leadership development, leadership positions, salaries, and professional awards. Comparisons were also made to academic medicine and dentistry.Results. Fifty-one percent of full-time faculty members across all academic pharmacy disciplines are women. The percentage of women at the rank of professor was 36.6%, compared to 25% in 2014. Of the 2992 tenured or tenure track pharmacy faculty, 39.2% were women. Out of 388 department chairs, 146 were women. Throughout 2014-2021, there were 121 chief executive officer (CEO) dean permanent appointments, with men holding 91 (75.2%) and women holding 30 (24.8%). Women received 29.7% of the National Institutes of Health grants awarded to pharmacy schools compared to men (70.3%), although women's funding amount was higher. In both the pharmacy practice discipline and all sciences disciplines, the total salary across all ranks and years in rank was significantly higher for men than women, even for department chairs, but there were no differences for CEO deans. To date, women have received 13% of four national pharmacy organizations' top 13 awards.Conclusion. Since 2014, some achievement gaps have narrowed, but areas of concern still exist and need continued attention and resources so inequities can be eliminated. Women in academic pharmacy need mentoring and support to extend throughout the trajectory of their careers in areas such as academic advancement, grant applications, salary negotiation, leadership pursuit, and award applications.

Perception of COVID-19 pandemic restrictions on dental researchers

BACKGROUND/OBJECTIVES

Historical evidence shows a gender-based disproportionate effect of pandemics across different populations. In 2020, the coronavirus disease 2019 (COVID-19) pandemic began spreading its devastating effects worldwide. The goal of the present study was to investigate the effect of the COVID-19 pandemic on research productivity, work-life arrangements, and mental health of dental professionals worldwide with focus on gender differences.

METHODS

A 38-item survey, concerning demographics, career stage, employer support, family structure, mental health, and relationships, was distributed to 7692 active members of the International Association for Dental Research. Bivariate associations between independent variables and the primary outcome variable were tested using Spearman's correlation test. A logistic regression model was used to assess the simultaneous, independent associations between each variable and researcher productivity.

RESULTS

A total of 722 responses were obtained, indicating a 9.4% response rate. Higher productivity was reported by male respondents (p = 0.021), and by those in senior career stages (p = 0.001). Institutional support was associated with higher productivity (p < 0.0001). Lower productivity was reported by younger researchers (p = 0.003). Remote work negatively affected productivity (p < 0.0001) and female respondents reported working more hours, regardless of work location (p = 0.004). Poor mental health was associated with low productivity (p < 0.0001).

CONCLUSIONS

Our results showed that the COVID-19 pandemic significantly affected dental professionals' perceived productivity and mental health around the globe. Younger individuals and women were disproportionally affected, and institutional support had a significant influence to mitigate effects of the pandemic for dental researchers.

Gender and Leadership Positions in Spanish Dentistry

Dentists in Spain reached equal gender representation in 2012 and the number of female dentists has continued to grow (until 57.3% in 2020). This study aims to increase evidence about the gender distribution on the high responsibility positions and opinion leaders of the dental profession and academia. Composition of the executive comities of the main dental institutions of Spain (regional professional associations, national dental association, and scientific societies), members of the Faculty of Dentistry of the University of Granada in 2020 and speakers of the main dental congresses of 2019 (due to the lack of congress in 2020) were recorded and analyzed by genders using chi-squared test (P < .05). Mean representation of female dentists in executive committees of professional associations was 35.6%. More than 70% of presidents and vice-presidents of professional colleges and more than 60% of these positions in scientific societies were occupied by male dentists. None of dental congresses of 2019 reached equal gender participation, being 81.3% of lecturers presenting on main auditoriums male dentists. Although dental workforce in Spain is slightly overrepresented by females, leadership positions and figures among Spanish dentists doesn’t seem to reflect the gender distribution of the collective. There is a lack of women occupying high-level positions in dentistry that proves the existence of the so-called “glass ceiling effect” on the profession. Further studies about sociodemographic aspects of dental workforce are needed to develop evidence-based policies for the collective.

A gender- based approach to the current situation of Spanish dentists

Background

To determine the perception of Spanish dentists about the situation of the profession nowadays and how the changes occurred in dental workforce (in number and gender of the past twenty years) have affected their personal and professional lives, under a gender-based approach.

Material and Methods

An online survey comprising of 51 opinion and socio-economic questions, divided into 9 sections of different topics, which was administered between the members of 13 professional associations. Chi-squared tests were calculated (p<0.05).

Results

Valid responses were received from 422 participants with a mean age of 41 years old and 66% of female dentists. Most dentists considered their selves in a “good” position, however, 72.3% of them said the profession “has had worsened”. Opinions significantly differed between women and men in gender equity and the pay gap between them could be observed (29.4% of males earned more of 4000 euros a month, while only 15.1% female dentists did). Also, 49.5% of female dentists felt underrepresented in the highest association of Spanish dentists (General Council of Dentist - Consejo General de Dentistas) and 38.4% declared they have had suffered verbal violence coming from patients repeatedly.

Conclusions

A generally negative perception of dentists’ work quality was found among respondents. Also, opinions between males and females differed in important aspects of professional development. Further research projects are needed to have growing evidence on problems and disparities in the dental workforce which would help the institutions to make improvement actions.

Key words:Dentists, Health Workforce, Survey, Gender, Spain.

Influence of Oral Health Care Systems on Future Career Environment of Dental Students in Europe

Oral healthcare is organized subsidiarily and independently by nation states in Europe and also within the EU and consequently, major differences between the nation states and the various oral healthcare systems in Europe are present. The socialization in the respective catchment area can have an impact on the job choice and the perception of employment opportunities of different professional groups. Therefore, the purpose of this survey was to elucidate the influence of different oral healthcare systems on students living or studying in the respective catchment area. A questionnaire (in English, French, German, Italian, and Spanish) with 18 different components was administered. Data on gender, age, country of origin, university, semester, nationality, expected time of graduation, and forecast for future professional practices were gathered. In addition, 3851 students participated (2863 f/988 m). The sample distribution was uneven with predominantly Bismarckian and Southern European System participants. The National oral health care system was statistically significantly linked (p < 0.01) to the ownership period of a dental practice. Students in Bismarckian and Nordic systems tended to find their own practice earlier than in the Beverdigian system or Southern European and Transitional-East European systems. An association between the oral health care system and vocational training was inhomogeneous, but also significantly different (p < 0.01). The majority (47.51%, n = 1555) would like to work in their own practice, 18.95% (n = 621) want to establish a practice with two or more owners. It was striking that no student would like to work in the investor practice/practice chain of both Nordic, Beveridgian and Transitional-East European countries systems (p < 0.01). The oral health care system in which a dental student grows up/resides/studies influences the career choice/perception of future professional practice.

Gender inequality among medical, pharmaceutical and dental practitioners in French hospitals: Where have we been and where are we now?

INTRODUCTION

Women are under-represented in senior academic and hospital positions in many countries. The authors aim to assess the place and the evolution of all appointed female and male health practitioners' working in French public Hospitals.

MATERIALS AND METHODS

Data of this observational study were collected from the National Management Centre (Centre National de Gestion) from 2015 up to January 1, 2020. First, the authors described demographic characteristics and specialties of all appointed medicine, pharmacy, and dentistry doctors' working as Hospital Practitioners, Associate Professors, and Full Professors in French General and University-affiliated Hospitals in 2020. Then, they retrospectively reported the annual incidence of new entrance according to gender and professional status from 1999 to 2019 thanks to the appointment date of all practitioners in activity between 2015 and 2020.

RESULTS

In 2020, 51 401 appointed practitioners (49.7% of female) were in activity in French public hospitals with a large majority being medical doctors (92.4%) compared to pharmacists (6%) and dentists (1.6%). Women represented 52.5% of the Hospital Practitioners, 48.6% of the Associate Professors, and 22.0% of the Full Professors (p < 0.001). There were disparities between the rates of female Full Professors in medicine (20.6%), pharmacy (36.1%), and dentistry (44.3%, p < 0.001). Women were appointed Hospital Practitioners and Associate Professors earlier than men (respectively 37.1 versus 38.8 years, p < 0.001 and 36.1 versus 36.5 years, p = 0.04), and at a later age among Full Professors (43.7 versus 41.9 years, p < 0.001). Compared to men, the annual proportion of appointed women varied significantly between 1999 and 2019 from 47.6% to 60.4% for Hospital Practitioners, from 50.0% to 44.6% for Associate Professors, and from 11.2% to 33.3% for Full Professors (p < 0.001 for trend).

CONCLUSIONS

Although more and more women occupy positions in French hospitals, there is still a gender gap regarding access to Full Professor status in medicine and pharmacy, but not in dentistry. The disparity in numbers makes comparison difficult. Despite a trend towards gender equality during the last twenty years, it has not yet been achieved regarding access to the highest positions.

Gender gap in authorship within published orthodontic research. An observational study on evidence and time-trends over a decade

AIM

To assess the representation of female authors in senior and leading positions in orthodontic research publications, as well as the fraction of women participating in the publication reports, for over a decade. In addition, association of women representation in orthodontic research and characteristics such as journal of publication, year, study design/topic, and others, were sought.

MATERIALS AND METHODS

Electronic search was performed within three major orthodontic journals, namely the European Journal of Orthodontics (EJO), the American Journal of Orthodontics and Dentofacial Orthopedics (AJODO), and the Angle Orthodontist (ANGLE) to identify all types of research articles published within two distinct year cohorts, the 2008-10 and the 2018-20. The outcomes of interest pertained to proportion of women in senior (last) and leading (first) position, and fraction of overall participation in the author list.

RESULTS

A total of 2539 articles were eligible for inclusion, with an overall number of contributing authors being 11 608, of which 34.4% were female. For seniority in authorship, 30.1% (312/1038) of the publications within 2018-20 were attributed to female authors, while 25.8% (388/1501) was identified in 2008-10. Publication timeline, geographic region, and thematic topic of publication were determined as significant predictors. For leading (first) authorship, the respective percentages were 44.7% (464/1038) within 2018-20, and 34.7% (521/1501) in 2008-10. Dissemination timeline, geographic region and journal of publication were identified by the multivariable analysis, as revealing evidence of association with female leading publication authorship. Overall, the median proportion of female authors within the author list was 33.0%.

CONCLUSIONS

A gender gap related to Orthodontic research publications is persistent, with participation of women either as senior, or as leading authors, being suboptimal. Consistent efforts should be set in place, to facilitate more equal representation of women in research publishing, being supported by academia.

The impact of gender on researchers' assessment: A randomized controlled trial

OBJECTIVES

This randomized controlled trial aimed to test whether women or men would be preferred with identical curriculum vitae (CV); and the impact of the career stage in the evaluators' choice.

STUDY DESIGN AND SETTING

A simulated post-doctoral process was carried forward to be assessed for judgment. Level 1 and 2 Brazilian fellow researchers in the field of Dentistry were invited to act as external reviewers in a post-doctoral process and were randomly assigned to receive a CV from a woman or a man. They were required to rate the CV from 0 to 10 in scientific contribution, leadership potential, ability to work in groups, and international experience.

RESULTS

For all categories of CVs evaluated, CVs from men received higher scores compared to the CVs from women. Robust variance Poisson regressions demonstrated that men were more likely to receive higher scores in all categories, despite applicants' career stage. For example, CVs from men were nearly three quarters more likely to be seen as having leadership potential than equivalent CVs from women.

CONCLUSION

Gender bias is powerfully prevalent in academia in the dentistry field, despite researchers' career stage. Actions like implicit bias training must be urgently implemented to avoid (or at least decrease) that more women are harmed.

Gender inequalities in the dental science: An analysis of high impact publications

OBJECTIVE

To assess the participation of women in publications of dental journals with a high impact factor.

METHODS

Articles published in 2016, 2011, and 2006 in 10 dental journals chosen for their highest impact factors in each dental fields were included in this research. Articles-related variables collected included the country of origin of each author, the type of study, and gender of the researchers. Gender was examined through PubMed, Scopus, ResearchGate, and respective affiliated institutions. Furthermore, a website designed to discover the gender of names was used when the previous alternatives were not conclusive. Forward stepwise Poisson regression models were used for data analysis.

RESULTS

A total of 3365 studies were included in the first authorship analysis and 3398 in analysis related to last authorship. The prevalence of women as first authors was 37.2% (confidence interval (CI) 95% 34.5-37.5) and as last authors was 22.6% (CI 95% 21.3-23.9). Having a woman as the last author increased the presence of women in the first author position in scientific dental articles by 16% (prevalence ratio = 1.16, CI 95% [1.04-1.29]). The year of publication, journal, and region of the author were associated with an increase in the prevalence of women as last authors. From 2006 to 2016, the prevalence of women as last authors increased by 61%. Despite these trends, women were still underrepresented in science in the evaluated period.

CONCLUSIONS

There are meaningful gender inequalities in publications of scientific dental papers. Encouraging women to lead research groups can reduce the inequities observed in the present study.

Gender Differences in Work Status during Early Career of Dentists: An Analysis of National Survey Cohort Data of 10 Years in Japan

Few studies have evaluated gender differences in young dentists’ career focusing on career breaks and return to work. We created a cohort dataset for dentists registered in 2006 using the national survey between 2006–2016 (men, 1680; women, 984), and examined the work setting of dentists by gender 10 years after registration. The proportion of dentists on career break increased each survey year, and was more pronounced in women than in men (2006 to 2016, men, 11.2% to 14.2%; women, 7.9% to 31.0%). The proportion of those who had career breaks between 2006–2016 was 44.8% in men and 62.9% in women. In the multiple logistic regression for examining the associations between those who returned to work compared to those working continuously, in women, the odds ratios (OR) were significantly higher in those working in dental clinics (owner, OR: 5.39; employee, OR: 3.10), and those working part-time (OR: 2.07); however, in men, there was no significant association with part-time work. These results suggest during early career phase, female dentists are more likely than males to take career breaks and choose part-time on returning. These gender differences should be considered for ensuring adequate workforce in dentistry in the future.

Expectations Regarding Dental Practice: A Cross-Sectional Survey of European Dental Students

Obtaining information on expectations among dental students regarding their career planning was the main purpose of this observational online survey. The questionnaire was designed with 18 items in five different languages: English, French, German, Italian and Spanish. Data were collected on nationality, age, sex, country of residence, university attended, semester, expected year of graduation and expectations about future career. More than 3000 participants (n = 3851, 2863 females 74.34% and 988 males 25.66% with a sex ratio of 0.35) participated in the survey. Almost one-third (31.29%) of the participants plan to start their own practice at least three years after vocational training, a quarter (25.76%) after three, and only 12.59% after one year. A positive influence of the family in the decision to start a practice was observed in 50.07% of the sample with a statistically significant difference regarding sex (p < 0.01). Almost one-third of the participants did not wish to work in an institution run by private equity or insurance companies, while 21.79% would work in that environment (p < 0.01). European dental students desire mainly to become self-employed and start their own practice. New professional practices also offer them options for their future career that they have not yet decided on or thought about.

Empowering Women Researchers in the New Century: IADR's Strategic Direction

Gender inequality in science, medicine, and dentistry remains a central concern for the biomedical research workforce today. Although progress in areas of inclusivity and gender diversity was reported, growth has been slow. Women still face multiple challenges in reaching higher ranks and leadership positions while maintaining holistic success in these fields. Within dental research and academia, we might observe trends toward a more balanced pipeline. However, women continue to face barriers in seeking leadership roles and achieving economic equity and scholarship recognition. In an effort to evaluate the status of women in dental research and academia, the authors examined the role of the International Association for Dental Research (IADR), a global research organization, which has improved awareness on gender inequality. The goal of this article is to review five crucial issues of gender inequality in oral health research and academics-workforce pipeline, economic inequality, workplace harassment, gender bias in scholarly productivity, and work-life balance-and to discuss proactive steps that the IADR has taken to promote gender equality. Providing networking and training opportunities through effective mentoring and coaching for women researchers, the IADR has developed a robust pipeline of women leaders while promoting gender equality for women in dental academia through a culture shift. As knowledge gaps remained on the levels of conscious and unconscious bias and sexist culture affecting women advancement in academics, as well as the intersectionality of gender with race, gender identity, ability status, sexual orientation, and cultural backgrounds, the IADR has recognized that further research is warranted.

Commentary: Challenges and Opportunities for Women in Dental Research

This commentary integrates and expands on the preceding articles in this issue that document and celebrate a century of women's achievements in the International Association for Dental Research (IADR). The increasing participation and leadership of women in dental and craniofacial research and within the IADR were viewed from the perspective of a changing culture of science. The steps that have been taken by the IADR to develop greater inclusiveness are acknowledged, and some of the challenges that remain are discussed in terms of obstacles that are most often social or cultural in origin. Comparisons are made across countries, and the social determinants that lead to differences in women's participation are described. Recommendations are made for developing strategies to change elements of our institutional cultures that have provided advantages to some groups of researchers more than to others. The unconscious biases and a lack of commitment to diversity, equity, and inclusion that limit the participation of members of some groups limit the progress and achievements of science in general.