U.S. dental schools have failed to make significant inroads in attracting and enrolling Black students over the past two decades, a fact that may be contributing to persistent oral health disparities among Black Americans, according to an article published in the Journal of Dental Education (JDE).

“Very little progress has been accomplished in growing the enrollment of BAA [Black and African American] applicants to dental school in 20 years,” wrote the authors. “As a profession, we also fail to grow interest among our graduates in careers that may support historically underrepresented and marginalized racial groups—public health, rural practice, population research, academic and health policy. This may be a contributing factor to the oral health disparities faced by Black Americans and have implications for dental education.”

The article—“Diversity, equity and inclusion interventions to support admissions have had little benefit to Black students over past 20 years”—was written by Romesh P. Nalliah, B.D.S., M.H.C.M., with the University of Michigan School of Dentistry; Peggy Timothé, D.D.S., M.P.H., with the Texas A&M College of Dentistry; and Michael S. Reddy, D.M.D., D.M.Sc., with the University of California, San Francisco, School of Dentistry. It was published in the April issue of the JDE, the peer-reviewed journal of the American Dental Education Association (ADEA), and the analysis was based on demographic data found on ADEA’s website.

The authors conclude that a look at raw numbers alone for dental school enrollees, which point to a significant rise for BAA students between 2000 and 2019, provides an incomplete, if not misleading, picture. Why? Because the gains (when they exist) for certain racial groups are far more modest when considered as a proportion of all dental school enrollees and when compared to overall growth in the U.S. population.

Perhaps more significantly, the authors argue that much of the increase in BAA enrollment can be attributed to the opening of new dental schools and larger class sizes in existing schools.

“True gains in recruitment and enrollment of BAA are limited,” they wrote.

To underscore their point, the authors highlight these three data points: “The percentage of enrollees who were BAA was 4.70% in 2000; in 2019, it was 5.78%. The percentage of BAA individuals in the U.S. population is 13.4%.”

Beyond looking at the aggregate data from all U.S. dental schools, the authors also examined data from specific schools in more detail. They found that in 2019, 10 schools still had no BAA enrollees, despite 236 applicants. They continued on to note that newer dental schools are performing worse in the enrollment of BAA students when compared with more established schools.

The authors called on such dental schools to review their admissions processes to consider “unconscious biases” and to partner with feeder schools to develop a better understanding as to why BAA applicants are unsuccessful at matriculating into their dental schools.

Noting that all U.S. dental schools compete over the relatively small pool of eligible applicants from underrepresented populations, the authors wrote, “What is truly necessary to impact the recruitment of underrepresented dental students is to grow the pool of eligible applicants through pathway programs in high school, middle school or even earlier.”

Dr. Nalliah, a native of Australia and the lead author of the article, said that the idea for the article came from his first experience as a teacher in the United States.

“I taught dental assisting to inner-city minority students at the corner of Adams and State in Chicago,” he said. “As I began to learn about the incredible barriers that my students faced in order to progress in life, I knew I had to help.”

About ADEA: The American Dental Education Association (ADEA) is The Voice of Dental Education. Our mission is to lead and support the health professions community in preparing future-ready oral health professionals. Our members include all 78 U.S. and Canadian dental schools, more than 800 allied and advanced dental education programs, more than 50 corporations and approximately 18,000 individuals. Our activities encompass a wide range of research, advocacy, faculty development, meetings and communications, including the esteemed Journal of Dental Education®, as well as the dental school application services ADEA AADSAS®, ADEA PASS®, ADEA DHCAS® and ADEA CAAPID®. For more information, visit adea.org.