Heavy but Hopeful: GSDM Faculty Development Day Discusses Discrimination in Oral Health

GSDM Faculty Development Director Dr. Neal Fleisher said the goal of this year’s Faculty Development Day was to feature internal GSDM speakers and prominent external speakers to provide attendees with a wide range of commentary and perspectives. Photo credit: Dan Bomba, GSDM

A record-setting number of GSDM faculty turned out to participate in thought-provoking discussions on racism and discrimination during a recent faculty development day.

Nearly 100 faculty members attended this year’s Faculty Development Day on “Race, Racism, Discrimination and Disparities in Oral Health in America.” According to GSDM Faculty Development Director Dr. Neal Fleisher, discrimination is an overarching issue that affects every aspect of society – including oral healthcare – and it is important for the school to foster safe platforms for diverse voices to articulate their experiences, so that all faculty can learn and grow.

“Race, racism, discrimination, that is a power-packed couple of words, and it’s often a difficult conversation…” Fleisher said in his opening remarks. “People become very offended by it. People become very defensive about it. And today, we’re going to try to tackle it a little bit. We’re going to be talking about things that are going to make people uncomfortable, everybody, to one extent or another. If we ever want to move forward, we have to at least put things on the table.”

In his opening remarks, Dean Cataldo Leone thanked everyone for attending and applauded the high attendance.

“Our Faculty Development Days are a wonderful opportunity to connect and grow together as a community,” Leone said. “I’m gratified by the record-setting turnout for this important session on disparities in oral healthcare. It gives me hope that we are taking the necessary steps – and doing the hard work – to make oral healthcare more accessible and inclusive for all our patients.”


Photo credit: Dan Bomba, GSDM

Fleisher received input from numerous colleagues to help shape the day’s agenda and to identify speakers. According to Fleisher, his goal was to feature both internal GSDM speakers as well prominent external speakers in order to provide attendees with a wide array of commentary and perspectives.

The lectures were:

  • Andrea Taylor, Boston University’s Senior Diversity Officer
  • Ana Zea, GSDM Clinical Associate Professor of General Dentistry and Director, Community-Based Education
  • Raul Garcia, Chair, Department of Health Policy & Health Services Research, and Director, GSDM Center for Research to Evaluate & Eliminate Dental Disparities
  • Paul Goulet, Boston University School of Public Health guest faculty member and former Director of the Consumer Office and Director of Community Engagement at the Massachusetts Department of Public Health
  • Darlene Sorrell, former Clinical Director of the Albuquerque Indian Health Service Dental Clinic, founding member and past president of Society of American Indian Dentists, and first Navajo member dentist

In Taylor’s lecture, “Bridging the Gap: Black Communities & the Healthcare System,” she discussed six persistent health issues that communities of color often face: maternal health, dental health, HIV/AIDS, water quality, pharmaceutical costs, and mental health. She said that health is a fundamental right, and people can’t function in society unless they have good dental health.

“Boston University is in a position to help the people who we are training to serve the community to be aware of these discrepancies and to be aware of the challenges and deficits in our community,” Taylor said. “Think about it as a holistic approach – if there are larger numbers of people suffering from a lack of care and a lack of access to care, then we are all diminished as a community.”

Zea explained in her presentation — “Health Disparities and Social Determinants of Health” — that social determinants, such as insurance coverage, the ability to understand health information, and cost-driven care, can greatly influence oral healthcare disparities. She said the dental field needs three key changes to enhance cultural awareness between dentist and patients: the field needs to support incoming dentists with diverse backgrounds, practicing dentists need more education on cultural awareness, and more dentists need to enter practice in underserved communities.

“If a patient can see somebody who shares their cultural beliefs or the same language, they may be able to communicate better,” Zea said. She continued, “By having students from different backgrounds be educated together, they can make each other more sensitive to their own culture, and their own values, and their own beliefs.”

Garcia explained the development and usage of race and ethnicity categories in the analysis of U.S. population data in his lecture, “Race, Racism, and Oral Health.” He also shared resources oral healthcare professionals can use to educate themselves on the effects of racism in healthcare and to identify how they can help combat these issues.

Building on Zea’s lecture, he said racism is an underlying factor to the social determinants of health, especially regarding access to care and clinical decision making.

“Shouldn’t we be living [in] a color-blind society? I mean, why are we labeling people? Why are we counting people still by race and ethnicity? Isn’t that somehow morally wrong?” Garcia asked. “I don’t know what the answer to that may be morally, but practically speaking, as you know from the [U.S. Office of Management and Budget]’s guidelines, they need to do this for very practical reasons and just for us to be sure that in fact the healthcare we’re providing is equally distributed.

Garcia continued, “We need to know research on differences. There’s a very practical reason why we still need to be counting people in this way.”

Both Goulet and Sorrell used their personal experiences to enhance their lectures. In Goulet’s lecture, “Breaking Barriers: HIV/AIDS and the Dental Patient,” he shared his story about living with HIV and the hardships he experienced in accessing dental care. When he was first diagnosed in the early 80s, he informed his dentist, and she refused to see him the day of his appointment. The following visit, she wore excessive protective gear; Goulet knew she was misinformed about HIV and never went back.

He said his experience was a common form of human rights violation. To protect patients’ rights, he said the dental community needs to take the time to build a safe and empathetic environment, including learning proper language to help prevent stigma and discrimination.

“I think language and the way we speak to a patient is very important,” Goulet said. “Language really helps us understand the world we live in, and language is helpful for us to tell our stories and describe who we are and how we connect with ourselves. Language can really inspire and build us up, but language also can really destroy.”

As the first Navajo member dentist, Sorrell has worked hard to promote dental health among the more than 500 American Indian/Alaska Native tribes (AI/AN) across the United States. During her presentation, “American Indian/Alaska Native Oral Health Disparities from the Perspective of an Indigenous Dentist,” she said both historical and cultural factors contribute to AI/AN oral health disparities. According to Sorrell, oral health isn’t always a priority in AI/AN communities, which can cause many health issues.

As a child, for example, she didn’t know until she was 10 years old that she needed to brush her teeth and clean her gums regularly, nor did her family take her to dental cleanings. Her entire family had bleeding gums, which she thought was normal.

Sorrell now works with the Society of American Indian Dentists to promote dental health in AI/AN communities and encourage AI/AN youth to pursue dentistry.

“When I talk like this in front of an audience, I am not really asking for sorrow or sympathy or anything like that,” Sorrell said. “I am asking for understanding, understanding there is another portion of the population in the United States out there that has no running water, has multiple families living in the same house at the same time…who don’t have toothbrushes.”

For the culminating panel, Zea, Garcia, Goulet, and Sorrell were joined by GSDM Assistant Dean for Diversity, Equity, Inclusion & Belonging Dr. Larry Dunham. The panel discussion was moderated by GSDM Assistant Professor of General Dentistry Dr. Matthew Mara.

The conversation was wide ranging, and covered everything from self-completion theory – the concept that by behaving in a certain way, one is symbolically proving oneself to be a certain kind of person – to the importance of modeling ideal behavior, to the power of proper communication.

Mara also asked all the panelists to provide two words to describe how they felt about the day’s topic. Together, they came up with: heavy, hopeful, challenges, opportunities, mindfulness, understanding, community, and inclusion.

Fleisher said he hopes faculty members came away from the day with an awareness of their bias and an increased understanding of how to talk about these topics.

“I think it’s a topic that needs more discussion,” Fleisher said. “And I don’t, in any way, think that I’ve fully accomplished it today or that we have accomplished it completely today; accomplished means to be able to say that there’s some concrete change that has occurred, but we need to start somewhere with it and do more than just superficial talk… We need to really delve into it. I think today was just breaking the surface, just starting to get in the direction that we need to go.”


By Rachel Grace Philipson