Gender Segregation In Dentistry

Patterns of Declining and Persistent Inequality

Alexander V. Padalino University of Wisconsin Eau ClairePeter Hart-Brinson University of Wisconsin Eau Claire

Abstract

This project is an exploration of gender inequalities in the dental profession and how

occupational segregation, socialization, and culture affect the occupational environment.

Historically, dentistry has been a patriarchal profession, in that dentists were primarily men and

subordinate hygienists and assistants were almost exclusively women. After exploring the

literature, analyzing quantitative data on admissions to dental schools, and conducting interviews

with practicing dentists, hygienists, and assistants, a mixed trend emerged. Women’s status in

dentistry has improved in recent decades, both in dental practice and in admissions to dental

school. However, stereotypes persist: Women are still seen as primary caregivers and thus less

suited to be dentists because of the time needed away from work; some think other career paths,

such as hygiene, assisting, and dental therapy, are more favorable for women. Dental hygiene

and assisting remain almost exclusively female occupations. Qualitative interviews suggest that

men do not see these fields as long-term career options but rather as stepping stones to higher

positions. It is possible that men simply being in hygiene and assisting could serve as role

models for future generations, but further advocacy and persistence is needed to prevent the

gender revolution in dentistry from stalling.

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Introduction

Have you ever walked into a dental office and questioned the social environment you just

entered? For most people, that environment is one in which there is a sea of women reporting to

a lone male authority, the dentist. It is important to note that this “norm” is one that has been

around for decades and has gone unnoticed by most; but in reality it is quite peculiar. A dental

office is a place that, until the last few decades, has remained a largely patriarchal constant in an

ever-modernizing social environment. And the reason behind the dental office remaining

patriarchal has been largely due to gender norms and the effects that they have on the decisions

that we all make.

Gender is the self-identification of where one is located on the spectrum of masculine to

feminine. It is a pervasive identity framer that has played a significant role in each of our lives

and in the shaping of many professional organizations. It is a framer that, for a long time,

dictated what was socially acceptable for whom and what jobs were fit for which sex. Thus, due

to the nature of gender in the U.S., it resulted in a system in which higher prestige and higher

earning jobs were destined for men and lower status, less lucrative jobs were set aside for

women. A lot of progress has been made towards gender equality in the past few decades, with a

number of jobs becoming more acceptable for both genders and certain social stigmas about

women’s professions starting to dissipate. However, a definite separation still exists that is

preventing full gender equality in the professional world.

This is the atmosphere of the dental profession that existed for the life of the profession

until the last few decades. Dentistry has always been male-dominated, with women assuming

subordinate roles, such as hygienists or assistants. But things are starting to change as women

work to advance their status in society. This project explores the gender gap in dentistry, the

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ways in which it is both diminishing and persisting, and how these trends affect the profession

going forward.

Theories of Occupational Gender Segregation

Gender as Primary Frame

Gender has become one of the most prominent categorizing factors in our society. It is

something that everyone incorporates into their identity and shapes every interaction we have

ever had or will ever have with another human being. In her article “Framed Before We Know

It,” Cecilia Ridgeway defines gender as one of the main primary frames that people use in their

construction of self and interactions with others. In her writing, she describes gender as an

identifying factor that was developed and has been instilled throughout history as a means by

which to facilitate interpersonal interactions and relationships. One of the necessary elements of

successful communication amongst people is a common knowledge base. This has allowed

people to have some semblance of common ground with strangers in order to properly coordinate

behaviors with others. Gender becoming common knowledge also resulted in it becoming

cultural knowledge. It is one factor that helps people to characterize self vs. others and to act

accordingly. Characterization, or in this instance, categorization, relies upon differences.

Someone is a man because they are not a woman. Over time, the differences that dictate whether

one is a man or a woman were lumped together into a shared social-category system structured

around gender. The result of this system in real-time interactions was an oversimplified system

that caused gender to become a framing device, or in other words, one of the first mechanisms

used to define self and other (other primary framing devices are age and race). Therefore, gender

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has become a primary frame that all people use to categorize themselves and others, and it has

become so ingrained that we do it automatically. This means every interaction we have with

someone is initially framed and subsequently influenced by gender categorization.i

Discrimination and Stereotypes

The nature of this gender classification system relies on differences, and as such, it

inevitably follows that it can lead to discrimination and stereotypes. In the article, “What Gender

is Science?”, Maria Charles addresses this topic. Gender inequality is a social factor that has

decreased in many sectors of society since the 1960s, but it has persisted in the STEM fields

(Science, Technology, Engineering, and Math). Charles makes note that many times innate

gender differences are used as justification; however, she then goes on to explain that STEM

fields being masculine does not have historical precedence. In the 19th Century it was actually the

reverse situation: women were overrepresented in physics, chemistry, astronomy, and other

natural sciences. These fields were seen as prep for motherhood, and humanities were the fields

reserved for men. These fields only switched their gender demographics after STEM fields

became more lucrative and attractive to men. These occupational differences now have led to

perceptions that negatively bias attitudes and actions.ii

Title VII of the 1964 Civil Rights Act prohibited gender specific job ads, but gender

inequalities persist due to instilled biases. Previous perceptions about gender have caused there

to be a cognitive bias, which has resulted in gendered evaluations of task performance when no

real differences exist. People simply expect men and women to follow their perceived notions

about the nature of the two sexes. This cognitive bias is greatly impeding gender progress

because it reinforces existing patterns by making gender an intrinsic aspect of professions. The

result of such gendering can cause employers to perceive gender-conforming applicants as better

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qualified (eg. women to be perceived as capable for nurturing jobs and men for technical and

mechanical work), which inevitably substantiates the gendered ideas and perpetuates this cycle.iii

Furthermore, once these gendered stereotypes and perceptions become instilled in

people’s minds, the problem becomes compounded as the next generation of individuals

internalizes those perceptions and uses them in their own gender socialization. As individuals

develop, they observe same-sex role models, receive positive and negative sanctioning for

gender-conforming (or non-conforming) behavior, and assimilate to the cultural messages

pertaining to gender. During the 20th Century, math became something that girls were told they

should not like and were not good at. This caused girls seeking to affirm their femininity to avoid

math and sciences classes, thus drastically altering their life path and occupational potential due

to gender stereotypes. Behavior like this represents the concept of gender performativity, which

goes beyond socialization because people do not have to internalize these thoughts to act upon

them. Gendered stereotypes can become something that dictate people’s actions regardless of

whether or not they believe them simply because they know that the general public holds those

thoughts to be true.iv

Building on this idea, and again pulling from Cecilia Ridgeway, the gender stereotypes

that get handed down become what I earlier mentioned as being common, cultural knowledge.

These stereotypes become shared stereotypes that everyone knows are the way that typical

people view men and women. Thus, they guide public behavior on the basis of gender. As I

mentioned before, these stereotypes and the system they create are structured on differences, and

due to the nature of the creation of this system there is also inequality. Men created the

knowledge base and thus they held the power to shape the inequality and nature of the

differences between men and women. Men were given a position of higher status and labeled as

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more proactive and competent, while women were branded as lower, more reactive, and

emotionally expressive. Along with these differences, men were afforded social, political, and

occupational advantages, and since they were in a higher position, their interest was to protect

that position. Thus, the cultural knowledge of gendered positions has become hegemonic and

will stay that way because it is institutionalized in the media. Additionally, the gender beliefs of

most institutions represent the beliefs of the dominant group (males), because they are the group

who most powerfully shape those institutions. Likewise, these hegemonic, cultural rules act as

the default gender rules when people are interacting with strangers. So, inevitably, the gender

frames that are instilled in us prime our minds for gender stereotypes to bias our behaviors and

judgements.v

Effects of those Stereotypes

The stereotypes and perceptions about gender which have pervaded our society have led

to a large disparity in occupational outcomes with regard to gender. Occupations have become

gendered due to the intrinsic qualities they are thought to require, and in more developed

countries new avenues have been created to try to cater to these believed gender differences. In

the U.S., there have been many human-centered educational programs initiated that are believed

to align with feminine roles. There has also been a large expansion of liberal arts programs to

accommodate women and their believed distinct attributes. The result of this is that more affluent

countries provide alternative fields to STEM, which may be less lucrative but provide women a

means by which to affirm their femininity. This phenomenon is not observed in developing

countries though, where the economy is the main focus. In those countries there are STEM

shortages and their concern is filling those shortages, so women are encouraged to pursue STEM

fields.vi

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Therefore, it can be observed that men and women are not destined for distinctly different

paths based upon some innate differences, but that the stereotypes that persist and the

educational systems we have created around them are actually causing this gender gap to remain.

The large amount of freedom in the West seems to be permitting the construction of

stereotypically gendered selves because men and women both make career decisions that are

influenced around their cultural heritage. Consequently, since we live in a society in which

people strongly believe in, enact, and celebrate cultural stereotypes, the segregation remains even

without some outside force creating it.vii

Shelley Correll discusses this topic in her article, “Gender and the Career Choice Process:

The Role of Biased Self-Assessments.” The above mentioned systems that are in play in our

society create a breeding ground in which the cultural stereotypes can run wild and shape

people’s lives. Individuals’ thoughts are heavily shaped by the cultural knowledge that surrounds

them. Therefore, cultural depictions of STEM fields as masculine reduces girls’ interest in those

fields, but also decreases their perceived competencies at those fields. Since they feel they are

not competent, they avoid STEM fields and consequently, by their own free choices, perpetuate

the gender gap in STEM. If women are told from an early age that they are not meant for STEM

fields and they internalize those thoughts, the result is that when they are given the freedom in

the Western education system to follow their passions, rarely will their passions align with those

things they have culturally been taught are not for them. In her paper, Correll cites data that

shows that there no longer is any actual difference in mathematical performance between men

and women. All that remains is the cultural idea that a difference exists, that math is innately

masculine. This cultural thought can lead to women having decreased perceptions of their own

abilities, increased anxiety, and as a result of those self-assessments, decreased performance. The

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opposite holds for men. Society tells them that they are good at math, and as a result they feel

confident and overestimate their own abilities. The result of this social system is that it deters

girls from an early age, but encourages boys to follow STEM paths. Thus, without any actual

effort, the gender gap maintains itself and will continue to do so unless efforts are increased to

break down the cultural knowledge pertaining to gender and occupation.viii

The Gender Revolution

While there still is a gender gap and a lot of cultural stereotypes pertaining to gender and

the workplace, there has been some progress. The progress, though, is one-sided: women have

gained more access to mobility into male professions, but there has been little change in the

devaluation of traditionally female occupations. Thus, women have an incentive to move into

male occupations, but the reverse does not hold true. Predominately female jobs are devalued

and as a result are paid less. They do not hold a pay or prestige incentive for men to join and

therefore, they remain female-dominated professions. Men typically do not move into female-

dominated jobs, though nursing has become an occupation of interest in this regard. Women on

the other-hand have both economic and status incentives for moving into male-dominated

professions. It is more acceptable and celebrated in our society for women to do masculine things

than for men to do feminine things. Also, people naturally seek to maintain or move up in social

status and class. Therefore, the revolution has begun to stall. Women can move up, men rarely

move down, and thus an occupational gender gap persists. More jobs are becoming acceptable

for both genders, but female-dominated jobs, it seems, are remaining strictly for women.ix

Gender Segregation in Dentistry

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Many of the previously mentioned theories apply to the field of dentistry. This is a STEM

field that for many years was strictly male-dominated with a number of female-dominated,

subordinate positions (hygiene, assisting, receptionist, etc.) However, over the past few decades

there has been some progress with respect to gender in the field, mostly in the actual obtaining of

dental licensure, but also in the simple interest and admissions practices in the field. This

sections will be broken down into a number of subsections, each one dedicated to a different

aspect of the profession as a whole.

Dental Assisting and Dental Hygiene

Dental assisting and dental hygiene are both fields that have always been female-

dominated professions. Since their origins in the United States (hygiene in 1917 and assisting in

1885), assisting and hygiene have been subordinate positions to male dentists.x Their original

designations in the U.S. were as female auxiliary positions to help open up more of the male

dentist’s time.xi In Canada, only women could be dental hygienists until the legal wording of the

profession was changed in 1968.xii Thus, these professions were marked as female professions.

This, mixed with the patriarchal nature of gender relations in the U.S. throughout history, made

these occupations very unappealing to men because they are both a female-dominated field and

are directly subordinate to a man.

These facts lead to a strange situation with these professions, and a fact that works to

substantiate the claims made by Paula England in her article, “The Gender Revolution: Uneven

and Stalled:” these fields have remained strictly female despite the integration of most other

areas in society. In Tables 1 and 2 below, it can be seen that U.S. dental hygiene classes have

been ~ 97% female for the last decade and that percentage has not wavered much. Likewise,

dental assisting has been ~95% female for the same period.

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[Insert Tables 1 and 2 here]

This gender stagnation in hygiene and assisting becomes even more striking when

compared to the changes occurring in other female-dominated professions, such as nursing.

Nursing, which historically has also been very female-dominated has experienced a fair bit more

equalizing than dental hygiene or assisting. In 2014, the percentage of males enrolled in pre-

licensure RN programs was 15%.xiii This means that RN nursing programs are now only ~85%

female, compared to the hygiene and assisting figures of 91% and 95% respectively.xiv

These statistics suggest that there is something perpetuating these jobs as stereotypically

feminine. Of interest to this research was the question of the nature of the barriers to entry into

this field. We wanted to know if there are still barriers in place preventing men from being

admitted to these programs or hired by dentists after completion of their programs, or if men

simply are subconsciously avoiding these professions due to the social perception that they are

feminine professions. Historically, as noted before, there were actual legal barriers for men

entering these professions, but those were abolished decades ago. However, the fact that such

large segregation still exists suggests that the social stigma of men entering a doubly

subordinated job is a very larger deterrent for equalization. Hygiene and assisting are doubly

subordinated because they are both subordinate positions and historically female-oriented,

marking a man who is interested in these positions as “feminine.” Being a feminine man is a

social marker that, while it may be becoming more accepted, is still largely a taboo especially

among mainstream or normative culture. This double subordination makes these jobs very low

status for men. If a man is to assume one of these positions, he is in the broader cultural eye

choosing to be feminized and his status may be lower than that of a woman in the same position,

because his choice defies the gender norm whereas her choice simply perpetuates it. Therefore, it

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is likely that there is a large amount of self-selection of men to avoid these low status (for men,

not for women) jobs in favor of any other that may be less economically favorable, but that

provide a higher status than that of hygiene or assisting.

Dental Admission and Dental Practice

Unlike dental hygiene and dental assisting programs, dental school enrollment ratios have

become much more even over the last few decades. During its infancy, the dental profession was

exclusively for men. The first dentist came to the U.S. in 1760 from England and 106 years later,

in 1866, Lucy Hobbs became the first woman to earn a dental degree (at Ohio College of Dental

Surgery).xv Despite Lucy Hobb’s licensure in 1866, the field remained male-dominated for

decades. It wasn’t until recent years that the field has actually neared a 50/50 admissions rate.

Table 3 shows that the percentage of enrolled dental students who are women increased from

39% to 46% between 2000 and 2010. That increase in the number of women enrolled in dental

school is significant, especially compared to the stagnation seen in hygiene and assisting. In

2010, it appears the gender ratio still had not quite reached 50/50, but it is clearly on its way.

[Insert Table 3 here]

Furthermore, if an in-depth breakdown of the gender ratio at specific schools from 2009

is analyzed, it can be seen that at 20 schools, more women are being accepted than men. Thus,

some specific schools may be working to fight against the established gender disparity in

dentistry by admitting higher percentages of women. However, as seen in the statistics at the

bottom of the figure below, there still is a gender disparity present within admissions as a whole.

The p-value of <0.001 provides significant evidence to reject the null hypothesis (that acceptance

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and gender are independent of one another), and thus conclude that there is some correlation

between gender and acceptance to dental school still.

[Insert Table 4 here]

Thus, it can be seen that dental admissions are indeed working to make classes more

gender equal, but there still is some room for further change. Additionally, in 2009 the ADA

reported that among professionally active dentists, 77.8% were men and 22.2% were women. xvi

Therefore, we wanted to find out why this disparity persists. It is possible that there was such a

large gender gap already in existence that there is simply a time lag before the women entering

the workforce and men retiring will lead to a 50/50 gender ratio among practicing dentists.

However, it also could be possible that women were graduating from dental school, but then

having short careers thus recreating the gender gap. This path would suggest a struggle between

progressive ideas of dentistry being an equal opportunity profession and the more rigid societal

views of women being the primary caregivers in families and thus having their careers take a

backseat to their husband’s career. Additionally, it is also possible that women are outperforming

men and therefore, may be disproportionately represented in dental specialties. These were the

sorts of questions that we hoped to answer through our personal interviews.

Specialties and Advanced Dental Education

Dental specialties, like dentistry itself, were historically male dominated. However, in the

last few decades, the trend of women outperforming men has carried into the dental field as well.

In dentistry, the process of specializing is that students go through dental school and typically the

top 5 or so percent have the ability to further specialize in specific fields of dentistry. There are

currently 17 programs of higher dental education, with nine being recognized dental specialties:

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Dental Public Health, Endodontics, Oral and Maxillofacial Pathology, Oral and Maxillofacial

Radiology, Oral and Maxillofacial Surgery, Orthodontics and Dentofacial Orthopedics, Pediatric

Dentistry, Periodontics, and Prosthodontics. As it can be seen in Table 5 (below), four specialties

are majority women (Pediatric, Oral and Maxillofacial Pathology, Oral and Maxillofacial

Radiology, and Dental Public Health). However, in the other areas, they are disproportionately

underrepresented, which could be a cause for concern that maybe there are barriers in those areas

of study. Or, it could be that many women simply are not interested in those areas of dentistry.

We mainly were exploring specialties to see if this was a possible outlet where women who were

graduating were moving into rather than practicing general dentistry, thus contributing to the

continued gender gap in dentistry.

[Insert Table 5 here]

In order to understand what factors are contributing to these patterns of gender

differences in various occupations in the dental profession, we wanted to interview dentists,

hygienists, and assistants about their experiences in dental school and the profession, their

perceptions of what it is like being a man or woman in the dental profession, and how they see

gender currently having an influence in dentistry as a whole, but also in their home offices. There

are a lot of theories about gender and its role in career choices, and there is also a fair bit of

compiled data in the dental field to suggest that these two topics may be related. We decided that

interviews would be an essential addition to our project to provide insight and data from

individuals that work in this setting daily. It was the goal that interviews would shed light on the

mechanisms of inclusion/exclusion and how experiences in the dental field may influence

people’s career choice, either positively or negatively.

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Methods

The first author conducted qualitative personal interviews with individuals in the

occupations of dental assisting, dental hygiene, and dentistry. Interviews were done with the goal

of obtaining personal stories and opinions from individuals in a variety of dental professions

about the past and current state of the gender disparity in dentistry. The interview guide consisted

of a number of questions that explored interviewees’ education, the experiences they had while

at school, the sex ratios present in class sizes and faculty, the possibility of gender stereotyping

or bias in the education, and their overall opinions about the role that gender may have in the

dental profession. Interviews were done using the gender based questions mentioned above and

an audio recorder. The interviews lasted in duration from 5 minutes to 25 minutes (tending to be

longer for interviews with dentists vs. the other dental professions). After each interview, the

audio recording was transcribed and then the audio file was deleted. No additional notes were

taken during the actual interviews other than the transcripts from the recordings.

The interviews were done during the months of June 2015 – November 2015 in two

locations, Green Bay, WI and Eau Claire, WI. Interviewees were selected via personal contacts

and personal references. All interviewees in Green Bay, WI were personal contacts of the

researchers, while the Eau Claire, WI interviewees were contacted after referral from contacts at

the University of Wisconsin Eau Claire. Interviews were set up via phone call or email and then

all interviews were done in person.

In total, 11 individuals were interviewed, ranging in age from 22 – 54 years of age. The

gender and occupational breakdown of interviewees was 1 female dentist, 2 female hygienists, 1

female assistant, 1 male orthodontist, 4 male dentists, and 2 male assistants. Schools represented

in the education background of individuals included Northeast Wisconsin Technical College (1),

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Chippewa Valley Technical College (1) , UW-Eau Claire (1), Marquette University School of

Dentistry (3), University of Minnesota School of Dentistry (3), University of Michigan School of

Dentistry (1), and Weekend Dental Assistant School (1).

After all interviews were transcribed, they were analyzed and coded using QDA Minor

Lite. This software allows the interviews to be broken down into segments based upon the

analyst’s desired goal. For this project, there were 39 codes that were used to analyze the data.

The codes were created using a variety of methods. About 10-12 codes were simply the base

interview questions that were asked at every interview. The remaining codes were all specific

codes created based upon themes that appeared in the research, such as sexism, gender gap in

dentistry, gender gap in hygiene, a variety of codes for different personal stories, and then a few

codes about predictions of future trends in regard to gender in dentistry. After coding, the

different segments for each code were compiled in a segment report and printed off. The coded

sections were then grouped according to the areas of the research that they pertain to and were

then used to formulate the results and conclusions that will be presented in the following pages.

Results: Female Dentists: A Stubborn but Declining Gap

Perceptions of Women in the Profession Today

Despite the fact that dentistry was male-dominated for decades, there clearly is a change

occurring in the field. After speaking with a few male dentists and assistants, most seemed on the

same page about the fact that dentistry is in fact becoming more equal in regard to gender. When

asked about the gender gap in dentistry, most male professionals responded that they can

noticeably see more women entering the profession:

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It used to be a male dominated profession and I think that is definitely starting the

change, or at least it’s about 50/50 now. (male, dentist)

Women are pretty accepted. In dentistry I think it’s changed in the past 10 years that

women are very accepted in the field. (male, dentist)

These quotes are all from male dentists who are currently practicing and everyone interviewed

say the gap is decreasing and had no objections to women in the profession.

However, even though there were no objections, there still were some older perceptions

about women in dentistry that came to the surface during interviews, such as women as primary

caregivers and representing less stable providers in this field. These perceptions became evident

through statements like these:

I know what happens when a woman turns about 28. Her hormones hit, maternal

instincts, and all of a sudden they realize “Shoot, I have all this debt, can I afford to work

4-5 days and still have a family.” It’s a tough decision. And historically they have always

worked shorter careers. (male, dentist)

They have to decide if they can balance a family, and family is a big one for a lot of

women. It’s big for men too, but in our society women usually end up being the primary

caregivers and all that. (male, dentist)

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These statements show that male dentists do not see women as incapable of being dentists.

However, there definitely still remains a perception that women will indeed need to be the

primary caregivers, so dentistry may be too much of a financial and time commitment for

women. Despite these ideas though, more and more women are becoming dentists and defying

the societal idea of motherhood being a possible barrier. Overall, I would say that the perceptions

of men towards women have widened quite a bit. There are still some of the stereotypical ideas

about women being primary care-givers and that women are much more prevalent in hygiene,

but every dentist said that more women are indeed capable and are actively pursuing dentistry.

After talking with female dentists and hygienists, we also gained insight as to what

women’s current perceptions are about women in dentistry. Most women in the field share the

sentiment that the field is open to both genders and in some situations may be favorable for

women due to their perceptions as more nurturing to children. A few female hygienists said:

Sometime I’ll have a little kid say “I’ll open my mouth for you, but I don’t want that boy

to come in here” (female, hygienist)

Not that my boss isn’t nurturing when he gets in there, but for kids I think having a

female is more comforting. (female, hygienist)

However, women also stated the sentiment of money vs. time concerns and hygiene being more

favorable for women than actually practicing dentistry. A long practicing female hygienists

stated:

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I just want to go and do my job and help my patients. I have no interest in any business

part of it at all. It does not interest me. (female, hygienist)

This is a sentiment that was shared amongst other female hygienists, that hygiene is nice and that

they liked it, but that dentistry was a much more complicated profession, had a higher cost of

pursuing, and was not worth it to them to take that next step. One female dentist also claimed:

There still remains somewhat of an “Old Boy’s Club”, in the dental communities in

Wisconsin, but that with the increase of female dental groups this feeling is beginning to

lessen. (female, dentist)

Memories and Experiences from School

For the most part, gender seemed to be a factor that was not noticeably evident during

most male dentists’ education, or at least not something that they actively paid attention to or

noticed as a problem. However, there was a definite gradient among age and ratio of the sexes in

the dental class. When older dentists were asked about gender in their classes, they gave

responses such as these:

Out of a hundred 10-20 females. (male, dentist)

In 1996…there was 1 women in the class. (male, dentist)

But, most dentists that are currently practicing reported their classes to be much more equal,

making claims that their class was:

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50/50, I think we had maybe 3 or 4 more guys. (male, dentist)

47/53…but it may have been tipping slightly female over male at that time. It was very

close either way. (male, dentist)

As it can be seen, dentistry has become more modern and equalized from the perceptive of male

dentists. They also noted that their instructors have taken the same general trend:

Uhh, that [gender of instructor] was about 50/50 as well. I would say that it kind of goes

age-wise too. The older that the professor or doctor was the more males there were. But

as you start to get towards the younger professors coming in and younger group leaders

and dentists that were kind of teaching you, it seemed like there was more of a split

50/50. (male, dentist)

Good question…we had a number of really great female and male. I guess I never really

thought of that, if they were male or female. I’m guessing we had more men. (male,

dentist)

From these statements it can be seen that men didn’t really see a gender issue in their classes or

professors, or if they saw an issue they also saw it as a dynamic one that is currently in the

processes of being erased. However, this could also be due to the fact that men are in the

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majority and thus, they don’t pay attention to the disequilibrium that is present regarding gender

in the field because it is not something that would negatively impact or hinder them.

The women's perspectives here will be mostly for hygiene as there was only 1 female

dentist and then the rest of the women interviewed were in hygiene. From the female dentist’s

perspective there is also a “50/50” ratio for students in their dental class. However, they also

found their class to have an air of an “Old Boy’s Club” and a feeling that it was still sort of male-

biased, but that it was changing with the times. Hygiene, though, is definitely female-dominated

in terms of both class and instructors. When asked about their class, a few statements from

hygienists were:

All women. I have yet to meet a male hygienist. I know one graduated or worked

somewhere. I don’t know if it was from NWTC, but one did work in Wisconsin. (female,

hygienist)

For hygiene specifically we only had one male. (female, hygienist)

The quotes confirm the statistics found in the preliminary work that hygiene is largely female-

dominated. Hygiene instructors, likewise, were mostly women. When asked about their

instructors, hygienists responded:

Female. They were all female. (female, hygienist)

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Yes, for hygiene there was one male out of 15 instructors. And he was actually a master’s

student. So he was still going through the education part of things. And for dental

professors, it was pretty evenly split between females and males.”

From all of these statements and preliminary statistics it can be seen that women are making their

way into dentistry and are not facing any obvious obstacles in their schooling and that hygiene is

largely remaining a female-dominated field.

Allegations of Sexism

When asked about whether or not there was currently an issue with gender in regard to

dentistry, almost every professional interviewed said that they do not think that there is a

problem anymore. However, they would then go on later in the interview to point out gender

differences that they believe play a role in the profession and their own experiences, but they

wouldn’t overtly recognize them as sexist comments or gender differences. One example of this

was the idea that women are innately more nurturing, which was said in a number of different

ways such as:

Having a female is more comforting. (female, hygienist)

I think women just have more a natural caring. You know…whatever…than guys do.

(male, hygienist)

21

These comments were made by individuals who earlier on had said that there wasn’t a gender

issue or anything separating men and women in dentistry, but in reality they subconsciously still

adhere to stereotypes about the nature of men and women and how those natures relate to their

abilities as caregivers. Another example deals with women as primary care-givers and thus, less

fit for dentistry or destined to have a shorter career than a male dentist. This idea was seen

through statements such as:

I mean that’s the history. You go to class reunions and you find out a lot of them

[women] have retired in their 30s or 40s because they have the ability to or didn’t want to

work anymore. (male, dentist)

Historically they have always worked shorter careers, shorter hours, and most of them

like to be an employee vs. an employer. (male, dentist)

Another doctor made a statement about an incident during his time at school, in which a doctor

got in trouble for saying:

Maybe you should spend more time in the lab than getting your nails done. (male,

dentist)

These comments obviously show that there is still sexism and a difference in thought about the

nature of men and women than the careers over to people’s perception of each in the dental field.

22

Based upon the points and statements presented in the previous paragraph, we argue that

there is still a need for improvement in the dental field. People of both genders clearly hold

stereotypical attitudes about women, and these differences carry over into the workplace. Also,

there still is a gender gap that exists in the dental and associated fields. Despite changes in dental

education and society that make it easier for both genders to pursue whatever dental career path

they desire, there still is a division with more men being dentists and more women being

hygienists and assistants.

Results: Male Hygienists and Assistants: A Persistent Minority

In School

As discussed above, men are relatively scarce in hygiene and assisting, including in

education. When asked about instructors in these fields the remarks were as follows:

Female. They were all female. (female, hygienist)

Oh, yea. All women. (female, dentist)

It appears that gender segregation is a problem that persists throughout the hygiene and assisting

fields, from practitioners to educators. Likewise, the classes in school are made up predominately

of women. All the professionals that were presented with questions about the gender of their

hygiene/assisting classes responded along the same line, saying:

All women. I have yet to meet a male hygienist. (female, hygienist)

23

There were thirty-something people and only 4 men. (female, hygienist)

The observations made from the answers to the last two questions were consistent with the

remarks made by every individual that was from their own experiences or from people they

knew from the dental community. Thus, it became very evident from these remarks and from the

preliminary stats that were presented that men are indeed a rarity in these dental fields, both in

education and in the workforce.

In the Office

Despite the disparity of male hygienists and assistants, we were fortunate enough to find

three male assistants during the time that we were conducting this project to interview about their

experiences. Overall, they all had had positive office and educational experiences. One male

assistant remarked:

I mean I got treated great. Maybe it was because I was a guy that I got treated really nice.

Like reverse discrimination. (male, assistant)

The other two males were trained on the job, but they reported having positive experiences in the

office. A co-worker was also asked how it was to have male assistant and she responded:

It’s just normal, like it doesn’t seem like there is anything weird about it and he does

everything around here. (female, assistant)

24

It seems that at least in this particular instance, having a male assistant is not too weird and is

somewhat accepted by co-workers. When asked about how patients react to a male assistant, one

co-worker responded:

I feel like they love it. It doesn’t seem weird to them either. I don’t know if it’s just

because of their personalities…I don’t think people focus on the gender. (female,

assistant)

This statement is obviously very general, but it is positive to see that at least in this office, the

two male assistants are accepted and fit in with both their co-workers and patients. One of the

doctors commented:

Most patients seem to be pretty okay. I can’t speak to hygiene, but I think they are fine.

I’ve worker with Steve here for 5 months or so and no one has said anything about him

being a male assistant. I know my wife back in high school had a male assistant and

thought it was weird. But that’s because she was used to seeing females. So, it’s what you

are used to seeing and a lot of assistants have been in the field for a while…so, they are

just used to seeing that. But I don’t think there is a big issue with it. (male, dentist)

All of these experiences suggest that really it may not be anything on the work or patient side

that is preventing men from becoming hygienists or assistants. It may be that the only real barrier

preventing more men from being in these fields are career choices that men are making.

How Do People Talk About Male Hygienists and Assistants

25

From the interview experience, male hygienists and assistants are spoken about like

Bigfoot: everyone seems excited about the idea of them and a few have been reported sighted,

but they are mostly still spoken about like a myth. There were three main reactions, people spoke

about their rarity, how it wasn’t manly, or how they never really had thought about it before.

Informants spoke about male hygienists and assistants as a rarity in the dental world, and

that seems to be an issue that is not changing much over time. Two dentists made the following

remarks:

Hygiene you really don’t have many male hygienists that I have found. Or, male

assistants there are far fewer. A lot of times it may be someone who is interested in

pursuing dentistry and wants to get some experience. (male, dentist)

There is still a huge disparity. I mean, we put an ad in recently. We are doing some fires

for front desk and things like that and umm, the female demand…I don’t even know if

we had any male applicants…3 male [applicants] and I’ve gotten 260 [applicants]. So

less than 1%. (male, orthodontist)

These remarks make it clear that to some, men in these positions are just very uncommon and

that is that.

Other people cited gendered reasons for why men are not in this field, saying things like:

26

I think they look at it as it’s not a manly job…it’s probably just because it’s the gender

role. You know, people just assume that that’s a woman’s position. But, I’d hire a guy.

(female, dentist)

I think that if a male is interested in anything with the oral cavity, they will go into

dentistry. I just feel like oral hygiene is not where they want to be. (female, hygienist)

These comments go to show that gender is something people think plays a role. There is also the

stereotype of the man as the primary bread winner and the argument that there are not enough

male-role models in these positions:

I feel that since hygiene can be more part-time, in that relation most males are looking for

a full-time right away. So, that could be something that holds them back from applying.

(female, hygiene)

I think that a lot of men, if interested in dentistry at all, they are going to want to be a

dentist. That is just my first thought at it. And I don’t know if maybe they don’t.

Sometimes, if you don’t see an example of my dad was a dental assistant…or you know.

I would be that people don’t even think about that. (male, dentist)

Finally, there were the responses that showed that the lack of male hygienists/assistants

flies under people’s radar:

27

I honestly have never really thought about it really. (female, assistant)

I really don’t even know. I have no opinion on it at all. (female, assistant)

These responses show that to some people, the lack of men in the field isn’t really an issue and

most have just come to accept it. One professional commented:

I don’t think it’s an issue. The only potential issue that I see is that it may hinder people’s

own thoughts about what career choices and opportunities there are. (male, orthodontist)

This is a good way of putting the issue. The fact that there are not equal numbers of male and

female assistants and hygienists is not the issue; the issue is whether or not this disparity is

causing men to steer clear of these fields simply due to their fear of breaking the gender norm.

Conclusions

Looking at the data, it is clear that some big steps towards equality in dentistry have been

made over the last few decades. I am speaking strictly about actual dentists here. Sixty years ago

there was a huge gender divide in general dentistry, with women being relatively scarce. Today,

there is still a gender gap, but it is slowly, constantly diminishing. Some men still hold onto the

“Old Boy’s Club” attitude and see dentistry as a male field that women can break into if the right

conditions present themselves, but for the most part women are accepted in dentistry and are

actively performing in a way to carve out a large section of the job market for themselves. Over

28

the next few decades, I would not be surprised to see the gap shrink even further and hopefully

even disappear as women continue to enter and remain in the profession.

Hygiene and assisting, on the other hand, appear to be remaining female-dominated. The

interviews all lead to first-hand accounts being made of a lack of men in these fields and that the

status quo remains strong. However, this project did provide the opportunity to talk with a few

male assistants and gain some insight. For those men currently assisting, the welcome into the

dental field has been a warm one. None of them reported facing any opposition or stigma from

breaking the gender norm. However, it was interesting to see that the male assistants that we

talked to were not men that had desires to be in assisting long-term. They were men interested in

dentistry, with hopes of someday being a dentist. Therefore, from the interviews and stories that

were gathered, we conclude that there are not any professional barriers in dentistry right now

currently barring men from entering hygiene or assisting. There are, however, a number of social

barriers that still exist, such as gender stereotypes, the drive for men to be dentists and achieve

higher money and status, and the lack of male role models in those fields that indeed may be

working to perpetuate this lack of men in hygiene and assisting.

For the problems facing both men and women presented previously, there is a strong tie

back to the gender theory articles and data presented at the beginning of the paper. For women,

there has been a large advance in dental equality: the data show that admissions to dental school

are becoming more equal and therefore, more women are having the opportunity to become

dentists. New fields like dental therapy have also been created, targeted for women, that offer

more prestige and money than hygiene and assisting. However, the creation of dental therapy is

of questionable value and could either work to advance or stall the gender revolution in the

dental profession. On one side, it may present an in-between option for both men and women

29

that would serve as a position between dentist and hygienist, which could work down the line to

bridge the gender gap between the two. More men may be exposed to hygiene aspects that they

like while in this position, which could promote the movement or wider acceptance of men into

hygiene. At the same time, women entering this field may find the dentist aspect more appealing

and thus it may drive them to pursue further education and promote even more women to move

into dentistry. However, the flip-side is that it may serve as a stalling event in this revolution,

because it’s possible that it could become an outlet that is seen as female-oriented and thus,

divert more women from becoming dentists in favor of dental therapists. Therefore, at this point,

we can only speculate whether this change will work for or against the gender revolution in

dentistry.

The gender disparity for men presents a more puzzling case. In the introductory article it

was found that hygiene and assisting match with fields that represent a step down in status and

class for men because they have to be subordinate to another man and are put into a position that

for years has been equated to a women’s job. However, there now are slightly more men in these

fields than there were in the past and the fact that we were able to find a few speaks to the fact

that male hygienists and assistants do indeed exist. The men that we spoke to didn’t seem to feel

like that had lost any status or were put down by their occupations. Something of note though, is

that both of the male assistants that were interviewed did still hold a desire to further their dental

education to become either a hygienist or dentist. Even though these men reportedly felt no loss

of status, men are still not pursuing these fields, and something still drives the men in these fields

to further advance their careers. It is possible that because these men see these positions as

simply stepping stones, rather than their end game, that they do not feel any loss of status or

social stigma. It is a fairly normal practice for pre-dental students to join assisting after

30

undergraduate careers while applying to dental school. Therefore, I think that this is an area that

would require a much larger sample to be able to make any real claims or conclusions about how

being an assistant or hygienists socially impacts a man.

I also think it is important to note that there are other careers in dentistry that men are

pursuing in higher numbers than hygiene and assisting. The ability for men to move into a

technical lab job or business allows them to pursue a dental career that, while not being a dentist,

also avoids the social stigma of entering a female profession. Both technical jobs and sales are

positions that affirm the status quo for men and thus do not violate gender norms and protect

them from gaining the social stigma of assuming a feminine role. Thus, it is hard to say

conclusively from our data whether or not assisting actually represents a drop in status for men,

and we would need to conduct interviews with men who see that as their life career to more fully

understand this situation.

Thus, the gender theory arguments that were presented at the beginning of this paper are

valid and true for the dental profession. The fact that gender gaps have shifted as predicted

provides solid support for those arguments. Women have gained more access to the dental

profession as well as higher prestige jobs, while men have continued to avoid feminine

occupations in favor of dental fields that are seen as more manly.

Limitations and Future Research

The major limitations of this project were the number of interviews. With eleven

interviews, we just did not get a good enough feel for the dental atmosphere to make conclusive

arguments or statements about the current state of gender in dentistry. The fact that we were not

able to interview dental professionals from other regions also hindered the goals of the project.

31

Furthermore, the research could have been benefited more if we had gotten more interviews with

female dentists and if we had found a few male hygienists. Overall, the existing articles and data

for this topic exist, but a much larger pool of interviews would make this project stronger.

Additional interviews would provide more stories, more thoughts about possible barriers for men

and women in this profession, and also would provide a larger sample from which to draw

conclusions.

There are a number of issues that continue to persist seemingly because of the

subconscious thoughts that people still hold, as well as the social environment that we live in that

pressures people to go down certain avenues in order to preserve their status according to

gendered roles. Therefore, it would be beneficial for research in the future to explore this topic

again in a few decades. Gender segregation in occupations is a huge social issue that at its core

revolves around the concept of social norms and the breakdown of some of those norms in order

for certain jobs to become accepted for individuals of the opposite gender that those job

originally were viewed for. Thus, it is an issue that will require active effort and advocates if

more advances in gender equality are to be made.

It became clear through the interviews that both men and women still view women as the

primary care-givers. Consequently, it is also viewed that dentistry is more of a men’s profession

because women may have to take time away for the “mommy track.” Additionally, the creation

of new fields, such as dental therapy, may work to steer more women away from dentistry and

thus, perpetuate the patriarchy in dentistry. The interviews made it clear that there still is a

significant issue present. Women gaining power and relevance in dentistry is still an issue that

needs to be actively addressed to prevent the gender revolution from stalling. The problem lies in

people’s perceptions, and the gender issue will continue to persist until those perceptions change.

32

Women have indeed entered every area of this profession, but there is and will continue to be a

need for advocacy and for the creation of women-focused dental organizations to maintain and

further that position.

Additionally, a large issue lies with men and the acceptance of men into positions

previously viewed as women’s work. This is a situation for which nursing possibly offers a

model. Nursing used to be all women, but over time is has become more accepted for men to

enter this field. However, despite advancements, the field remains 85% women. Hygiene and

assisting are professions that, if they change, will most likely follow a similar pattern. It is not

likely for these fields to ever be male-dominated, but it is possible that at some point there will

be a consistent, even if low, number of men in this field. However, from the interviews that we

were able to obtain, it appears that some men may simply see these fields as stepping stones to

higher levels of dentistry. In this case, it is likely that the gender gap will never truly change,

because men will simply be transient members of these professions until moving onto the next

level of education. Another point to consider is that previously there have not been any male

role-models that would suggest to young men that hygiene or assisting are viable options for

them. However, once more men start to enter these fields, it is possible that they will become

more socially acceptable and seen as viable options for men. Consequently, an important task for

a future researcher would be to reexamine this topic in 20-30 years and see how the social

environment has changed, if at all.

33

Table 1

Student enrollment in U.S. dental hygiene programs, 2000 to 2010

Percentage by Race/Ethnicity

YearNumbe

rPercentage

WomenBlack

Hispanic

American Indian

Asian White

Unknown

2000–01

12,629

97% 4.19%

5.72% 0.55% 4.64%

88.28%

2.61%

2001–02

12,826

97% 3.73%

6.03% 0.76% 4.65%

83.26%

1.55%

2002–03

13,031

97% 4.01%

6.38% 0.69% 4.90%

82.33%

1.57%

2003–04

13,284

98% 4.09%

6.61% 0.71% 5.00%

81.62%

1.98%

2004–05

13,895

96% 4.21%

6.82% 0.76% 4.97%

79.90%

2.22%

2005–06

14,012

97% 3.95%

6.72% 0.71% 5.84%

80.20%

2.06%

2006–07

14,795

97% 4.18%

7.50% 0.75% 6.42%

79.27%

1.87%

2007–08

15,010

97% 4.34%

7.30% 0.85% 6.80%

78.99%

1.73%

2008–09

15,194

97% 4.41%

7.34% 0.61% 7.04%

78.65%

1.97%

2009–10

15,385

97% 4.35%

7.70% 0.79% 7.34%

77.87%

1.94%

Source: Dental Education: Evolving Student Trends.xvii

34

Table 2

Student enrollment in U.S. dental assistant programs, 2000 to 2010

Percentage by Race/Ethnicity

YearNumbe

rPercentage

Women BlackHispani

cAmerican Indian

Asian White

Unknown

2000–01

6,448 96% 12.53%

9.71% 1.66% 2.85%

68.38%

4.87%

2001–02

6,707 96% 13.69%

9.02% 1.24% 2.76%

67.03%

6.26%

2002–03

7,666 94% 14.54%

9.01% 1.54% 3.35%

66.18%

2.30%

2003–04

7,559 95% 13.63%

9.50% 1.72% 3.81%

66.78%

2.82%

2004–05

8,030 91% 11.17%

8.43% 0.81% 3.44%

62.85%

9.22%

2005–06

8,460 89% 12.84%

8.96% 1.06% 3.61%

58.38%

7.91%

2006–07

8,578 95% 14.70%

9.61% 1.63% 3.63%

59.98%

10.46%

2007–08

8,923 95% 13.76%

10.21% 1.00% 4.90%

62.75%

7.39%

2008–09

9,208 95% 15.13%

11.10% 1.23% 4.81%

60.17%

7.57%

2009–10

10,761

95% 17.14%

11.69% 1.13% 4.60%

55.72%

9.80%

Source: Dental Education: Evolving Student Trends.xviii

35

Table 3

Predoctoral students enrolled in U.S. dental schools, 1985 to 2010

Year Number Percentage Women

2000–01 17,354 39%

2001–02 17,498 42%

2002–03 17,688 43%

2003–04 17,978 44%

2004–05 18,313 42%

2005–06 18,617 44%

2006–07 19,050 43%

2007–08 19,292 43%

2008–09 19,701 44%

2009–10 20,055 47%

2010–11 20,346 46%

Source: History of Dentistry Timeline: ADA.xix

36

Table 4. Gender composition of applicants and enrollees by school, 2009

% of Enrollees

State School Name App Men Women

AL University of Alabama at Birmingham 361 49.1 50.9

AZ Arizona School of Dentistry and Oral Health 1,833 49.3 50.7

AZ Midwestern University-Arizona 1,405 52.3 47.7

CA Loma Linda University 1,252 68.0 32.0

CA University of California, San Francisco 946 59.3 40.7

CA University of Southern California 1,880 60.1 39.9

CA University of the Pacific Arthur A. Dugoni School of Dentistry 1,783 51.1 48.9

CA University of California, Los Angeles 1,030 46.5 53.5

CA Western University of Health Sciences 1,333 58.9 41.1

CO University of Colorado Denver 898 56.3 43.8

CT University of Connecticut 698 39.0 61.0

DC Howard University 1,297 45.2 54.8

FL Nova Southeastern University 1,818 45.4 54.6

FL University of Florida 707 46.3 53.7

GA Medical College of Georgia 137 55.4 44.6

IA University of Iowa 600 62.3 37.7

IL Southern Illinois University 524 61.2 38.8

IL University of Illinois at Chicago 792 47.8 52.2

IN Indiana University 1,029 63.0 37.0

KY University of Kentucky 850 44.6 55.4

KY University of Louisville 1,648 48.8 51.2

LA Louisiana State University 115 57.1 42.9

MA Boston University 2,469 51.8 48.2

MA Harvard School of Dental Medicine 527 37.1 62.9

MA Tufts University 2,425 45.1 54.9

MD University of Maryland 1,482 48.4 51.6

MI University of Detroit Mercy 953 55.7 44.3

37

MI University of Michigan 1,135 59.0 41.0

MN University of Minnesota 633 61.2 38.8

MO University of Missouri-Kansas City 486 39.8 60.2

MS University of Mississippi 57 50.0 50.0

NC University of North Carolina at Chapel Hill 678 53.8 46.3

NE Creighton University 1,802 55.2 44.8

NE University of Nebraska 555 57.1 42.9

NJ Univeristy of Medicine and Dentistry of New Jersey 1,063 42.0 58.0

NV University of Nevada, Las Vegas 1,605 59.0 41.0

NY Columbia University 1,257 54.7 45.3

NY New York University 2,655 60.0 40.0

NY Stony Brook University 727 57.5 42.5

NY University at Buffalo 1,240 50.6 49.4

OH Case School of Dental Medicine 1,770 58.8 41.2

OH The Ohio State University 643 60.4 39.6

OK University of Oklahoma 371 50.8 49.2

OR University of Oregon 654 66.2 33.8

PA Temple University 2,418 69.0 31.0

PA University of Pennsylvania 1,121 46.6 53.4

PA University of Pittsburgh 1,393 53.9 46.1

PR University of Puerto Rico 209 28.2 71.8

SC Medical University of South Carolina 387 51.7 48.3

TN Meharry Medical College 1,020 54.0 46.0

TN University of Tennessee 289 66.3 33.8

TX Baylor College of Dentistry 371 42.1 57.9

TX University of Texas Health Science Center at Houston 545 54.7 45.3

TX University of Texas Health Science Center at San Antonio 318 53.8 46.2

VA Virginia Commonwealth University 1,437 51.0 49.0

WA University of Washington 653 53.2 46.8

WI Marquette University 1,809 43.6 56.4

38

WV West Virginia University 876 48.0 52.0

60,969

Total Enrollment: 4,868

Percent Men 53.38948 53.39%

Percent Women 46.61052 46.61%

Male Female

Observed : 2,599 2,269

Expected: 2,434 2434

(O-E)/E: 11 11.18529

X2: 22

P-value: < 0.001

Null: Enrollment is independent of gender

Source: U.S. Dental School Applicants and Enrollees, 2009 Entering Class: ADEA Figure 3.xx

39

Table 5

Percentages of women enrolled in U.S. advanced dental education programs, 2007–08

Type of ProgramPercentage

WomenRank by Percentage of

Women

Oral medicine 67% 1

Pediatric dentistry 62% 2

Oral and maxillofacial radiology 61% 3

Dental public health 57% 4

Oral and maxillofacial pathology 55% 5

General practice residency 53% 6

Combine prosthodontics-maxillofacial prosthetics

50% 7.5

Combined specialty 50% 7.5

Maxillofacial prosthetics 46% 9

Advanced education in general dentistry 43% 10

Orthodontics and dentofacial orthopedics 38% 11

Periodontics 37% 12

Dental anesthesiology 36% 13

Prosthodontics 33% 14

Endodontics 26% 15

Clinical fellowship oral and maxillofacial surgery

14% 16

Oral and maxillofacial surgery 13% 17

Source: Workforce: Distribution of Dentists In the United States By Region and State, 2009.xxi

40

Endnotes

41

i Ridgeway, Cecilia L. 2009. “Framed Before We Know It.” Gender & Society 23 (2): 145 – 160. ii Charles, Marie. 2011. “What Gender is Science?” Contexts. https://contexts.org/articles/what-gender-is-science/iii Charles, Marie. 2011. “What Gender is Science?” Contexts. https://contexts.org/articles/what-gender-is-science/ iv Charles, Marie. 2011. “What Gender is Science?” Contexts. https://contexts.org/articles/what-gender-is-science/ v Ridgeway, Cecilia L. 2009. “Framed Before We Know It.” Gender & Society 23 (2): 145 – 160. vi Charles, Marie. 2011. “What Gender is Science?” Contexts. https://contexts.org/articles/what-gender-is-science/ vii Charles, Marie. 2011. “What Gender is Science?” Contexts. https://contexts.org/articles/what-gender-is-

science/ viii Cornell, Shelley. 2001. “Gender and the Career Choice Process: The Role of Biased Self-Assessments.” American

Journal of Sociology 106 (6): 1691 – 1730. ix England, Paula. 2010. “The Gender Revolution: Uneven and Stalled.” Gender & Society 24 (2): 149 – 166. x “History of Dentistry Timeline.” ADA: American Dental Association. http://www.ada.org/en/about-the-ada/ada-

history-and-presidents-of-the-ada/ada-history-of-dentistry-timelinexi Adams, Tracey L. 2003. “Professionalization, Gender and Female-dominated Professions: Dental Hygiene in

Ontario*.” CRSA/RCSA 40 (3): 267 – 289.xii Adams, Tracey L. 2003. “Professionalization, Gender and Female-dominated Professions: Dental Hygiene in

Ontario*.” CRSA/RCSA 40 (3): 267 – 289.xiii “Percentage of Students Enrolled in Pre-licensure RN Programs by Sex, 2014.” National League for Nursing.

http://www.nln.org/docs/default-source/newsroom/nursing-education-statistics/percentage-of-students-enrolled-in-pre-licensure-rn-programs-by-sex-2014.pdf?sfvrsn=0.

xiv “Percentage of Students Enrolled in Pre-licensure RN Programs by Sex, 2014.” National League for Nursing.http://www.nln.org/docs/default-source/newsroom/nursing-education-statistics/percentage-of-students-enrolled-in-pre-licensure-rn-programs-by-sex-2014.pdf?sfvrsn=0.

xv “History of Dentistry Timeline.” ADA: American Dental Association. http://www.ada.org/en/about-the-ada/ada-history-and-presidents-of-the-ada/ada-history-of-dentistry-timeline

xvi 2011. “Workforce: Distribution of Dentists in the United States by Region and State, 2009 .” ADA: American Dental Association.

http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/09_dod.ashxxvii Woolfolk, DDS., M.P.H., Marilyn W. and Shelia S. Price, DDS., Ed. D. 2012. “Dental Education: Evolving

Student Trends.” Journal of Dental Education 76 (1): 51 - 64xviii Woolfolk, DDS., M.P.H., Marilyn W. and Shelia S. Price, DDS., Ed. D. 2012. “Dental Education: Evolving

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