Tipping the Balance

Mary Beth Aichelmann-Reidy, DDS, a past-president of the American Association of Women Dentists, had similar expectations when she began practicing 25 years ago. But each time she attended a dental meeting with her husband, who is not a dentist, manufacturing representatives would explain their products to him and ignore her. So she stopped bringing him. His absence alleviated some of the confusion, but not all. “The most annoying and last thing I want when attending a dental meeting is someone slathering me with hand lotion,” says the vice-chair of periodontics and director of post-graduate periodontics at the University of Maryland. “Furthermore, I’m not more interested in a product because it’s pink.”

Just six months out of dental school, 28-years-old and in private practice with two other women, Brittany Bergeron, DDS is incredulous that such misconceptions about women dentists still occur. After all, about half of her dental school classmates were female. “At dental meetings, attendees will often ask me for directions,” says Dr. Bergeron, who recognizes the unconscious stereotyping. “I can’t help but feel a little bit embarrassed for them.”

These three dental professionals are representative of the wave of women graduating from today’s dental schools and opening up private practices across the country. In 2010, women made up a record 46% of first-time, first-year enrollees in dental schools, according to American Dental Education Association findings, with 15 of 58 schools reporting 51% or more women entering that class.

For laboratory owners, the tipping balance from a male- to female-dominated profession may require reexamining any long-held notions about women in practice. Those who are out of touch with women’s current professional objectives or insensitive to their sometimes distinctive approaches and requirements will lose the client demographic poised to dominate the profession. So who is this new rising dental demographic and what are their professional needs, challenges, and goals?

Despite the equal opportunity advances made in the 20th century, hard-wired gender roles, biases, and stereotypes persist. In the early ‘90s, when Robin Edwards, DDS was a new dentist, she would occasionally be insulted by comments from first-time patients, such as, “I didn’t know you were a woman,” or “Are you strong enough to pull my teeth?” However, she quickly realized such remarks were not intended to be offensive. “Patients were responding to a new and unexpected situation,” said the Kinston, North Carolina general practice dentist. “They assumed that only men were dentists because their mindset was molded by the era in which they grew up—when all dentists were men.”

Women entering the dental technology field have not been immune to similar gender biasing. Kim Ravdin, CDT, owner of Champlain Dental Laboratory, a 20-employee laboratory in Burlington, Vermont, began working as a dental laboratory technician at about the same time, when few women were in the field of dental laboratory technology. Her male colleagues often asked if she needed help or guidance. The overtures didn’t bother her because she sensed they were well-intentioned, but an initial bias about her abilities was apparent. She explains, “Nobody assumed the men needed help.”

Elizabeth Curran, CDT, RDT, an associate professor at A.T. Still University, Arizona School of Dentistry and Oral Health, has managed a private laboratory at the dental school for nine years and started in the business in 1974—when few women were in either the laboratory or the operatory. “Despite good technical mechanics, women technologists still often hear, ‘you’re really good with color,’” says Curran.

She notes that the gender shift in the dental laboratory profession isn’t occurring as rapidly as it is in dentistry. National Association of Dental Laboratories research shows female ownership of large laboratories (greater than 25 employees) was 24% in 2013, up significantly from 11% in 2011. Female ownership of medium-sized laboratories (10-25 employees) was 17% in 2013 and 25% in 2011. Only 22% of small laboratories owners (1-9 employees) are women.

“It’s clear that many young women dentists will be working with predominantly older male technicians for a long time. It’s going to be interesting,” Curran predicts. “Judging from what I overhear, old attitudes are still out there. If a male dentist sends a bad impression, it’s because he’s inept or has had poor training. If a female does, it’s because she’s a woman.”

Such innuendos are the exception rather than the rule, says Dean Mersky, DDS, founder of Opt-In Dental Laboratory Cooperative, a group of member dental laboratories. Mersky practiced dentistry for more than 25 years and was a frequent speaker prior to serving as director in the dental implant department of a large laboratory. He says although it is now well-understood that women dentists are as clinically competent as men, the disconnect that hampers much technician/dentist communications may be exacerbated when technicians speak with female dentists. “Some laboratory technicians have a different manner of communication with each other that unsuitably overlaps into their communication with dentists,” he says.

But beyond curtailing any well-intentioned but personal vernacular, controlling dialogue is a skill that can and should be learned, says Mersky, who provides training in communication skills to dental laboratory technicians working in member laboratories. “Dialogue has to be controlled if it’s going to be as effective as it needs to be to help the client. It’s the responsibility of the laboratory to find the best way to communicate with individual dentists, whether they’re male or female.”

Senior executives working with women in the highest ranks say professionally successful women are no different from successful men—they have “a results orientation coupled with the ability to grow and take risks.” The research, conducted by McKinsey and Company, included interviews with 200 women executives and the help of 60 corporations, almost all Fortune 500 or of similar size. Study authors of the ensuing report, “Unlocking the full potential of women at work,” said, “We were struck by the very observation that these women did not stand apart from their male counterparts.”

Yet there were differences. About half of the women surveyed were both primary breadwinners and primary caregivers, whereas most of the men surveyed who were primary breadwinners were not also primary caregivers. Although it stands to reason that such family circumstances are affecting dentists just as frequently as those in other professions, it is not well-acknowledged, some say.

“I still hear comments referring to a husband’s earnings used as justification for paying women less,” says Aichelmann-Reidy, who perceives a glass ceiling for women administrators in academia overall. “Women in private practice are in a different situation.”

A long-held belief that the majority of women dentists will work many fewer hours than men with an expectation of providing a secondary income isn’t coming to fruition. According to American Dental Education Association research on 2013 seniors’ immediate plans after graduation, only 3.3% of females expecting to work in private practice were planning a part-time schedule, vs. 1% of males (48.4% of females and 52.7% of males planned to immediately enter private practice after graduation). Such minimal differences don’t come as a surprise to Aichelmann-Reidy, who rarely meets female dental students who aren’t planning to work full-time.

“They wouldn’t incur the current dental school debt load if they weren’t planning to work full-time,” she says. In fact, the primary difference she observes in young women today when compared with her contemporaries is their unwillingness to allow their personal life and care-giving roles to derail their professional drives.

Edwards agrees this perspective has changed the way female dentists work more than any other factor. “A lot of the women dentists I knew stopped working to raise their children,” says Edwards. “Some returned to practice, but some did not. I don’t know any male dentists who did this.” She says that although women may still balance family with career in ways that men do not, more women are planning families and dental careers simultaneously.

“Women don’t worry about it the way they used to,” observes Aichelman-Reidy. “Many women are doing residencies or starting out as an associate, but down the road they want their own practices. They know it’s more lucrative and they’ll have more control.”

Many female dentists no longer find the need to limit their practice hours but seek to control their schedules to balance their roles as care-givers and dental professionals. They say it’s one of the primary gratifications of working in private practice.

Even with two young children, Marron-Tarrazzi practices four full days per week, usually exceeding 30 hours. She doesn’t have any contemporaries who took long breaks or significantly cut back their schedules after starting their families. “Women don’t feel that having a family is a barrier to having a full career anymore,” she says.

Bergeron is in private practice with two other women—one of whom has owned the practice for 20 years. The arrangement enables her to use a day per week to provide help to her 85-year-old grandparents, while maintaining the number of hours she wants to work. “It was always my goal to work in private practice with other women. I just didn’t anticipate it happening so quickly for me,” she comments.

The 2012 American Dental Association Survey of Dental Practice data reports female dentists work an average of 33.2 hours per week versus an average of 35 hours per week for males. Among new dentists (graduated within the last 10 years), 76.8% of owners are male dentists and 59.5% are female. Overall, 90.6% of male dentists and 76.9% of female dentists are owners (sole proprietors or partners) in their practices.

Marron-Tarrazzi highly values the opportunity to explain to a dental laboratory technician exactly what she wants, rather than having someone dictate the treatment to her, or later say, “I thought that’s what you wanted.”

She was especially impressed when a large laboratory in her area offered her a tour of their facilities, “showing a spirit of collaboration and an effort to establish a relationship,” she says. She likes to meet her dental laboratory partners so she can feel familiar with them when speaking on the phone.

Champlain Dental Laboratory’s Ravdin, says the biggest change she has observed in working with women, particularly younger women, is their tendency to offer feedback.

“It’s great,” says Ravdin. “We’ll often get a call or a quality card back about how well a case went. That’s something new for dental laboratory owners. We’re accustomed to not hearing anything when things go well.”

Women dentists sense they spend more time communicating with laboratories overall than their male counterparts and some laboratory managers agree.

“I noticed it tended to be more time-consuming to get through the challenges when we were working with female dentists, but I wouldn’t say it was more difficult or that they were more resistant to guidance from the laboratory,” says Mersky. “It may be that in these cases the dentists took the situations more seriously or that there needed to be better laboratory-to-dentist communication.”

Harold Burdette owns Burdette Dental Laboratories, a 71-employee operation in Birmingham, Alabama that was opened by his family in 1950 and employed just 12 people when he joined the business in 1970. He says accessibility is crucial to meeting the needs of the laboratory’s female dentists because they often practice together and have fluctuating or rotating hours and coverage responsibilities.

“Our female clients do want to communicate more with the dental laboratory because everything has to go right the first time around,” Burdette says. “If it doesn’t, the delays are much more significant because each dentist isn’t typically in the practice every day of the week.”

Bergeron says women naturally have a greater sensitivity to some patient concerns, which may be more time-consuming for dental laboratories. “When the laboratory didn’t understand why a denture case had to be rushed, I knew I was making a demand they were unaccustomed to, one more likely to be made by a woman.”

“Overall, women tend to be more people oriented and empathetic and that comes across in all of their communications,” says Liz Cascaden. The director of Education and Marketing at Expertec Dental Laboratory in Westland, Michigan, says the majority of the laboratory’s female dentist clients are in private practice. Cascaden oversees an annual conference for women in dental professions, including dental team members. The topics are wide-ranging and include practice management and clinical programs, ergonomics, and team building. “We’ve learned that men who work well with women appreciate their abilities and don’t talk down to them because of differences in communication styles.”

Women dentists may not always model the same behaviors as their male counterparts. Ascertaining their distinctive goals and challenges will be an increasingly worthwhile endeavor for dental laboratory managers as a new wave of women enters the profession and eventually forms its powerbase.