By Shirley Gutkowski
At a recent gathering of dental professionals, primarily dental hygienists, we were treated to presentations by renowned speakers. Only two of the speakers were doctors (as in dentists, and both happened to be male) — the others were "PhD" doctors. Suddenly, it became a joke that there were only two dentists in the field of more than 80 attendees. Hygienists had them outnumbered. We laughed a little. We went to lunch.
Upon our return from the noon meal, it was announced that there were indeed three dentists at the gathering. Dr. Esther Wilkins was in attendance. To say that we were all mortified is an understatement. Suddenly, it wasn't funny anymore. Everyone at the gathering was deemed an opinion leader, and we were all caught with our unpolitically correct sexist pants down. It's not a situation we'll remember fondly. Dr. Wilkins, gracious as ever, didn't raise a fuss. She didn't need to. We were all ashamed.
Watch your language
Nurses will tell you that female physicians frequently get called nurse by co-workers and patients when name tags are not in view. Male nurses are automatically called doctor sans name tags. The same is true in the dentistry. A recent entry into the "Thinking Sharply" column dealt with tiering dental hygiene based on education. A male hygienist e-mailed me to say I referred to hygienists as "she" throughout the piece when the number of male hygienists is growing all the time. One hygienist I know thinks that having more men in the field will move our profession into more money, better working conditions, and will make legislators take hygienists more seriously. Must female hygienists go on men's coattails?
On another note, a hygienist was asked to run for president of a state hygiene association. Everyone thought her husband was the major breadwinner in that family. Being state president is a big job and the pay is not in legal tender — it is in gratitude. State presidents are volunteers, if elected. It's hard to buy groceries with gratitude, fanfare, and a title. To serve in this leadership role, a hygienist would miss a lot of work time if she practiced clinically. If a potential candidate has a spouse who is the major breadwinner, it's a lot easier. To put it another way, if a hygienist's wages are just "fun money" for the family then the sacrifices made by those who take on vital leadership roles are not as damaging to the family.
The implication was that, if the hygienist supports the family financially, it is possible for resentment to build because of the enormous amount of time required. And, to put it bluntly, the financially dependent hygienist may be a better choice than someone who is financially independent. To take on leadership roles in a female-dominated profession, women still have to rely on husbands to support them financially. Did reading that last sentence make your heart tighten like it did mine as I wrote it?
It isn't necessary to mention the little caveat that the majority of dentists, or hygienists' employers, are men. It may be important to point out that the people who make most of the laws are men. This is not to say that men are holding women down. It appears that women are progressing in their own way, and men are just, in their own minds, taking care of business.
Treatment planning issues
Another example of sexism is in dental treatment planning. My niece and nephew inherited their mother's and grandmother's dentition — very small maxilla, very large rotated teeth, severe crowding and crossbites. To my untrained eye, they each needed orthodontic intervention starting at a young age. My nephew, the older of the two siblings, was wearing a groove into the incisal edge of tooth number eight caused by its occlusion with tooth number 26. To put it another way, number eight was rotated 30 degrees, and was in an end-to-end relationship with the lower tooth to a point of damaging the upper central incisor.
I told my brother and his wife to take their son to the orthodontist. I showed them the damage being done to the upper tooth. They took him to their regular GP who said that he wanted to wait until the boy had more permanent teeth.
Two years later, my niece, exhibiting a similar condition at a similar age, was referred to the orthodontist at the tender age of nine. She's had an arch expander, and is now wearing full orthodontic brackets and bands. My nephew is now 13 and just had the remaining primary teeth extracted and will start orthodontic treatment. Every time I see these two kids I become enraged. It's obvious to me that their dentist is recommending treatment based not only on need but a "cute factor."
My nephew is already a little shy, and smiles don't come easy to him. Now, when he's developing in a number of psychosocial ways, he has to start orthodontic treatment!
If you think this column is an over-exaggeration of the situation at hand, go to Amazon.com and search books on sexism in language. Seventy-five titles come up. The words we use in society form society as much as the other way around.
A topic came up on one of the Internet lists that I belong to about commercials for oral care products. Many companies have ads where they refer to dentists recommending this or that home care product. They don't refer to the dental hygienist recommending this or that. One commercial in particular is distracting to the point that hygienists are willing to boycott recommending the products. The commercial starts out with the picture of a prophy handpiece, and angle with cup spinning wildly. The voiceover asks the viewer if they like the feeling of their teeth just after the dentist polishes them.
Hygienists all over this country are struggling to keep an identity. Hygienists are the ones in the office making purchasing decisions. The practice owner signs the checks, and often the practice owner is a dentist. The fact remains that hygienists make purchasing decisions, and make recommendations for oral care products to their patient/clients. Stiffing hygienists in print and commercial ads is not wise.
Escaping sexism starts with us, however. Watching our own attitudes and language is a good start. Hygienists must become aware of difficulty and discomfort when gender issues arise. Don't assume, and don't become angry when others assume. Instead, raise awareness, because it comes naturally to us.
Shirley Gutkowski, RDH, BSDH, has been a full time practicing dental hygienist in Madison, Wis., since 1986. Ms. Gutkowski is published in print and on Internet sites, and speaks to groups through Cross Links Presentations. She can be contacted at [email protected].