LGBTQ+ and dental education: Analyzing the present and recommendations for the future

Abstract

LGBTQ+ populations constitute increasing proportions of children, adolescents, and adults in the United States. Compared to their heterosexual counterparts, this group suffers from health inequities, including oral health. The report “Oral Health: Advances and Challenges” identified the LGBTQ+ community as an underserved population which faces significant barriers in accessing oral health care. Coverage of LGBTQ+ topics in formal education settings in both dental schools and dental hygiene programs is scarce, which contributes to inequities within this group. Increasing curriculum content related to LGBTQ+ populations is of utmost importance to promote optimal patient‐provider interactions while improving oral health outcomes. Ensuring equity in oral health care provision will require deliberate, consistent efforts on the part of all stakeholders. Dental and allied dental education programs have made important strides in enhancing equity and inclusion in their institutions by engaging campus groups that support LGBTQ+ populations, creating mentorship programs, and collaborating with non‐profit advocacy groups. Such efforts have successfully empowered LGBTQ+ patients, providers, and allies who are committed to further closing the knowledge gap. Most of the research regarding LGBTQ+ inclusion efforts have been done in the medical arena and there is a void in the data available from the dental profession. To fill this void, recommendations are offered that institutions can easily implement to expand LGBTQ+ diversity and inclusion visibility.

Cultural topics with clinical implications needed in the dental curriculum to develop intercultural competence: A systematic review

“…Recognition of microdiscrimination, racial bias, and exclusion: some articles emphasized the importance of deepening into these aspects to develop Inter-cultural Competence. 23,30,32,34,[36][37][38]44,51,56,57,59 In the others, situations were exposed that implicitly represented microdiscrimination. 21,24,40,43,46,47,52,53,55,58 b.…”

“…For example, differences reported in the articles were those related to gender, sexual orientation, disability status, religion, ethnic origin, and socioeconomic status of the patient. 23,26,37,38,39,56,57,59 Another inequality in care is attributed to social determinants, such as access barriers in remote areas, the lack of continuity in oral healthcare due to the high turnover of professionals, the absence of trained interpreters in clinical settings, and the prioritization of basic needs over oral care. 24,34,36,43,45,[47][48][49][51][52][53][54][55][56] It was also mentioned that there is a difference in criteria in the use of analgesic sedation, 30 which adds to the patient mistrust as a result of bad experiences in dental care, which translates into greater anxiety and fear when going to the dentist.…”

“…28,32,44,46 c. Respecting and understanding the patient's cultural patterns: 100% of the articles identified in this section emphasized the importance of respecting the patient's beliefs, customs, values, and autonomy. The educational articles that were analyzed did mention educational strategies such as roleplaying, 21,26,33,38,41,43,45,49,57,59 service learning/ experiential learning/simulation, 21,24,32,33,34,36,41,49,54 reflective diary or writing, 23,24,36,37,41,49 debate, 23,26,[36][37][38][39]43,45 clinical cases, 26,38,45,57 traditional lecture 26,38,54,57 and interprofessional education 21,54 to develop Intercultural Competence, where the development of respect and understanding for the other is implicit. d...…”

“…d. Establishing cultural inclusion in care: Overall, the articles mentioned the need to adjust the information to the needs and requirements of the patient. [24][25][26]35,37,38,44,48 Some emphasized that written materials, used for health promotion purposes, were more illustrative, in addition to paying attention to the cultural basis of the patient, especially regarding nutrition and oral hygiene. 22,25,29,35,48,52,54,55,60 Others pointed out the importance of informed consent being more explicit to contribute to better understanding.…”

“…d. Social, epidemiological and psychological determinants in minority groups: The articles considered it important to take into account the social aspects influencing clinical care, 24,[34][35][36]39,43,[45][46][47]51,52,56,60 to be aware of epidemiological differences of the country of origin 21,36,55 and the behavioral factors that affect the therapeutic relationship. 24,28,29,[34][35][36]38,40,42,46,[51][52][53]55,56,58 e. Adjustment of communication resources to patient needs: The articles emphasized the need for information channels used with patients to be more inclusive. For this, it was necessary to consider the culture, ethnicity, and religion of the population group, 24,37,38 use symbols that identify their cultural group (flags), 25,44 adapt the different types of forms for people with hearing and visual impairments 26 and understand the user's preferences for how they wish to receive information.…”