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Have you ever been unsure how to treat someone whose background was different than yours?

Have you had trouble communicating with a patient of a different culture?

As populations in Canada and the U.S. become more diverse, these kinds of challenges are increasingly prevalent in the dental profession.

Throughout a dentist's career, they are bound to encounter patients and colleagues from many different cultures. Not only is this true in private practice, but also in public health, academia, and research.

This is why cultural competence — the ability to communicate with people from different cultural backgrounds — is key to providing effective, appropriate dental care.

What’s more, in the aftermath of the COVID-19 pandemic, it has never been important for dental professionals to understand diversity and inclusion. As Dr. Cathy Hung highlights in her piece on dental professionals and cultural competency, a rise in xenophobia and racism has been an unfortunate side effect of society’s pandemic-induced anxiety.

The topic of cultural competency goes far beyond the scope of a single article. We encourage you to dig deeper in the subject via the sources linked throughout this post.

Let's talk about cultural competency in dentistry.

What Cultural Competency Means in Dentistry

The word culture generally refers to beliefs, values, attitudes and behaviours shared by a group. Cultural traits can be passed down through generations, or arise in response to things happening in the present.

We often think of culture as norms and traditions rooted in a person’s country of origin. While geography does play a role, sex, gender, sexual orientation, and age are also relevent in providing culturally competent care. People with different cultural backgrounds also tend to have different religious and philosophical beliefs, as well as differences in education and economic status. Each of these factors could impact how a patient is assessed and treated, as well as their health literacy. 

Cultural competency is the ability to connect and communicate with people from different cultural backgrounds. To put it another way, a culturally competent dentist, dental hygienist or dental assistant is one who accepts cultural differences and responds with appropriate attitudes and behaviours to allow for effective treatment and communication.

Cultural competency also involves a degree of cultural sensitivity, making an effort to understand the cultures of your patients and colleagues.

Being a culturally competent dental professional enhances your ability to:

• Grow your patient base by offering culturally sensitive care to a larger, more diverse patient population
• Provide better oral health care while respecting your patients' cultural beliefs and practices
• Reduce errors caused by miscommunications and differences in oral health literacy
• Help lessen the disparities in oral health care that exist based on race and ethnicity

Becoming a Culturally Competent Dental Professional

As a dental professional, diversity is a part of everyday life: your friends and family, colleagues, and of course, your patients. Cultural competency is vital if you are going to meet the diverse needs of a changing demographic.

However, it’s not something you can learn overnight. Developing cultural competency is a continuous process of self-reflection, education, and learning.

Fortunately, there are a number of resources available to dental assistants, hygienists and dentists to assist them with cultural competency. For example, the U.S. The Department of Health and Human Services offers an e-learning program to provide dental professionals with basic skills and knowledge related to cultural and linguistic competency.

You don’t need to hit the books to improve your cultural competency right away. As Dr. Hung recommends, you can spark change within your own dental practice day-to-day.

• Get to know the people in the area you serve. If you practice in an area that's home to many people of a different cultural background, get to know their cultural beliefs and religious practices.
• Ask questions instead of making assumptions. For example, if you don’t know how to pronounce a patient’s name, the best thing to do is just ask them how. If they prefer to go by a name that's not on their ID, respect that. It’s always better to ask than to guess.
• Make small talk to build rapport. Building positive relationships with your patients will ensure they receive culturally sensitive and effective care. The more you know about their culture, the faster you can establish rapport with them.
• Pay close attention to nonverbal communication. People communicate in a variety of ways. A big part of communication relies on body language, including facial expressions.  Many nonverbal clues are still universal, even when translation is needed; but others differ greatly across different cultures.
• Be mindful of personal distance. Letting a dentist or dental hygienist get right up close to examine your mouth might not be a big deal to you, but for someone else, it could be very uncomfortable. Many Asian, Southeast Asian and Middle Eastern cultures have a greater value on physical distance than in Western cultures, especially between men and women. Always ask for permission before you examine a patient, especially if you are a male practitioner working on a female patient, and explain what you are doing and why.
• Acknowledge other values systems. Many dentists get frustrated when patients try to negotiate a lower fee or say they’ll seek treatment in their home country. What you may not realize is that cultural differences can produce very different views of the North American health care systems. For example, dental implants are usually offered at a significantly lower cost by dentists in Mexico and India. Instead of getting frustrated, try to educate these patients on the value of your care and the importance of continuity of care.

Remember: Culture goes beyond race or ethnicity! Although you may practice in a more ethnically homogenous area, there will always be cultural concerns to consider.

Becoming a culturally competent care is key to improving communication, broadening your patient base, and providing the best possible oral health care to patients of all cultural backgrounds.