Talking About Racism Will and Should Make You Uncomfortable, and that’s OK

Keisha Ray, PhD

As a professional philosopher, the philosophical absurdity of our Fellows Forum at the 2022 meeting of the American College of Dentists is not lost on me. Including myself, we were five racially, ethnically, and gender diverse scholars speaking in a hotel ballroom in Houston, Texas, one of the most diverse cities in the United States of America, talking about, among other topics, racial discrimination in dentistry. Yet, if the audience questions and looks on their faces were any indication, what we thought was a simple fact was met with suspicion and, at times, anger. When we said oral healthcare in America has roots in racism and contemporary dentistry can exacerbate racial disparities in oral health, we thought this would be a starting point to discuss how dental professionals can do better by their patients and colleagues. But it seems like the audience heard something entirely different – they heard us calling them racist. And perhaps that’s fair. After all they are in a profession that we said maintains racism and other forms of discrimination like classism. Because of this communication barrier we only got a chance to briefly discuss the specifics of what dentistry can do to offset its past and current contributions, whether systemic or individual, to racial disparities in oral health.

Talking about racism makes some people uncomfortable. And for many, once that discomfort sets in, all other information is filtered through the discomfort, contorting the message and ultimately ending potentially useful discourse. Additionally, this discomfort can affect how we educate and prevent learners from understanding their future patients in a more meaningful way that is conducive to socially informed care. But it does not have to be this way. Discomfort can be motivating, if only we could get comfortable with the uncomfortable.

The dentists and dental educators who attended our session on ethical and social issues in dentistry and dental education came face to face with dentistry’s past and current relation - ship with marginalized people. Accepting that theprofession has a racist history can be difficult for some people. But typically, not too difficult. People tend to abstract themselves from their profession’s past since after all, it’s not like they specifically committed any misdeed. They take comfort in believing that they are not racist, nor do they condone racism. They remind themselves that they are not their profession’s past. Acknowledging that you are continuing your profession’s racist past with your own patients, however, is much harder for some people to grasp. But our session asked the audience to do the opposite. We asked them to grapple with the racist history to understand dentistry’s role in keeping that history alive. We asked them to think about the ways that history repeats itself through repackaging; specifically how blatantly racist and inhumane acts like using teeth from enslaved African and African Americans to make dentures for White people can turn into contemporary acts like dentists being more likely to recommend tooth extraction rather than tooth restoration for Black Americans.

Similarly, we asked audience members to ponder why topics related to racism such as its impact on access to the social, political, and commercial determinants of oral health for racially marginalized people are not more prevalent in dental education. If Black, Latinx, and Indigenous people face known structural barriers to oral health, why isn’t this a central part of dental education? Why is it only sometimes relegated to an elective topic? What we teach and how we teach it demonstrate values. And if the social determinants of oral health and the influence of different forms of discrimination on who has access to those determinants of oral health are not prioritized in dental education then it says that dentistry does not value the full lives of racially marginalized people. Furthermore, it conveys to learners that this view should also be unimportant to them while they are at a crucial and influential time in their professional development. As learners, they are looking to their profession, institutions, and individual educators for guidance. If the guidance does not include understanding their future patients’ social lives, how those lives contribute to poor oral health, and what they can do as professionals to mitigate these effects on their oral health then their education is incomplete because it’s missing value formation.

But dental educators cannot be in a position to help learners in this way if they themselves cannot embrace the discomfort that may come with talking about racism and other forms of discrimination. Talking about these topics can be difficult and some people may even feel personally called out. But as the common saying in Black communities, goes, we are not calling you out, we are calling you in. As our session tried to do, we are calling dentists in and asking them to have the hard conversations and to examine their discomfort and more importantly, the eagerness to get rid of that discomfort. Change only happens on the other side of this eagerness to rid ourself of something we should embrace as normal.

I challenge readers to embrace the discomfort that can come when we acknowledge that we are a part of a historically racist institution. It can be uncomfortable to acknowledge that we can knowingly and unknowingly contribute to our institution’s contemporary racist behaviors, in all of its subtle and blatantly obvious forms. Instead of using it to shut down conversations, let us use it to create the conversations necessary to educate ourselves and future dental professionals. Let’s use the discomfort to change our values for the sake of the people who have to live with racial discrimination and its effects on their every day lives.