UPFRONT

5. Alvarado-Omenat J J, Llamas-Ramos R, García-García D, combination of counselling, cognitive- a final-year dental student and two senior
Correyero-León M, Fonseca-Sánchez E, Llamas-Ramos
I. Effectiveness of virtual reality in cancer patients
behavioural treatments, provisional use nurses. After team introductions were made
undergoing chemotherapy. Systematic review. Int J of oral appliances, and pharmacological and local anaesthetic administered, it became
Cancer 2024; DOI: 10.1002/ijc.35258.
control of pain. Surgery may be needed apparent that the patient was unhappy. He
6. Lee J J. How precision cancer prevention can promote
health equity. 2022. Available at https://prevention. in a selected minority of cases. Dental expressed that he wanted a ‘real doctor’
cancer.gov/news-and-events/blog/how-precision- and/or surgical techniques to correct and refused treatment from ‘girls’. The male
cancer-prevention-can-promote-health-equity
(accessed 11 January 2025). occlusion and/or mandible position are supervising oral surgery consultant attended
7. Chow R, Drkulec H, Im J H B et al. The use of wearable not supported to diffuse the situation, and the patient
devices in oncology patients: A systematic review.
Oncologist 2024; DOI: 10.1093/oncolo/oyad305. • One statement on TMDs within the remarked ‘now the doctor has arrived’ he
8. Hawley S T, Haymart M R. The potential of wearable broader aspects of orofacial pain: cases of would have his treatment. The procedure was
devices in cancer care delivery. JAMA Oncol 2024; 10:
573–574. pain chronicity or presence of concurrent completed by the male consultant and the
https://doi.org/10.1038/s41415-025-8516-7 multiple pain conditions should be patient left happy with his care.
managed by expert practitioners and/or A BMA-backed project1 has some
Temporomandibular disorders referred to the proper specialist. striking findings that are relatable for many
women in dentistry. It found that 73.5%
TMD management standards These key points, in their simplicity, will of female doctors reported that they have
updated
assist general dental practitioners to advance been assumed to be in more junior roles
An open working group discussion was their understanding and prevent inappropriate in the workplace by patients, compared to
held at the IADR General Session in New treatment. They can be viewed as a guiding only 1.5% of male doctors. It is particularly
Orleans (March 2024), where members of template for other national and international prevalent for younger doctors, demonstrating
the INfORM network finalised the proposal associations to prepare guidelines and how gender stereotypes in medicine are still
of a list of ten key points for good clinical recommendations on management of very present. Likewise, a recent systematic
practice for the field of temporomandibular TMDs; those can be adapted to the different review found gender-based discrimination in
disorders (TMDs). These ten points represent cultural, social, educational, and healthcare surgery is prevalent but has evolved from an
a summary of the current standard of care for requirements in countries around the world. explicit to a more subtle attitude.2
TMD management.1 The key points and their D. Manfredini, Siena, Italy; S. D. Bender, Dallas, Women make up 52% of dentists in the
main contents mirror the recommendations USA; B. Häggman-Henrikson, Malmö, Sweden; UK, with 35% of specialist oral surgeons
recently released within England by NHS J. Durham, Newcastle upon Tyne, UK; C. S. being women.3 With an increasing number of
England’s GIRFT programme and the Royal Greene, Chicago, USA female dental students, we are seeing a huge
College of Surgeons of England for the TMD influx of women entering the profession,
Care Pathway,2 and include: References and potentially into surgical roles. As per
• One statement on general principles: 1. Manfredini D, Häggman-Henrikson B, Al Jaghsi A the Equality Act,4 the dental profession is
et al. International Network for Orofacial Pain and
patient-centred decision-making as well required to ensure that women are protected
Related Disorders Methodology. Temporomandibular
patient engagement and understanding disorders: INfORM/IADR key points for good clinical and challenge the damaging stereotype that
of expectations are critical aspects in the practice based on standard of care. Cranio 2024; DOI: women can’t be dentists or surgeons.
10.1080/08869634.2024.2405298.
management of TMDs 2. Beecroft E, Palmer J, Penlington C et al. Management Reflecting on this patient interaction, it begs
• Two statements on aetiology: TMDs of painful temporomandibular disorder in adults. the question of how should we be handling
NHS England Getting It Right First Time (GIRFT) and
are disorders of musculoskeletal origin Royal College of Surgeons’ Faculty of Dental Surgery. these situations? Patients have a right to choice
that occur within a biopsychosocial 2024. Available at https://www.rcseng.ac.uk/ in their care, but where do we draw the line
dental-faculties/fds/publications-guidelines/clinical-
framework and are precipitated by a guidelines/ (accessed November 2024). at blatant gender discrimination? It can be
multifactorial aetiology https://doi.org/10.1038/s41415-025-8515-8 difficult to know how to react at the time,
• Three statements on diagnosis: diagnosis and often these incidents can be put down
of TMDs should be based on a careful Sexism in healthcare to patient anxiety and overlooked to diffuse
and standardised oral history and clinical the situation. However, dental professionals
assessment. Imaging procedures should
Can I see the doctor please? deserve to work in an environment that does
be considered in all cases when that We write to raise a frustrating issue that not tolerate prejudice in any form, including
imaging (MRI for soft, CBCT for bone unfortunately is commonplace for many gender discrimination. All colleagues,
tissues) has the potential to impact the women in dentistry. A recent patient regardless of gender, need to play a more
treatment plan and outcome. Currently, interaction has highlighted how sexism active role in speaking up against sexism
the use of electronic devices for diagnosis from patients is still rife within healthcare and set a precedence that this behaviour is
is not supported and dentistry. In this interaction, a male not tolerated, to avoid reinforcing gender
• Three statements on treatment: outcomes patient attended secondary care for a simple discrimination as acceptable.
should be evaluated in terms of pain extraction. The team treating him were M. McCleary, J. Girdler, Manchester, UK
reduction and improved function as well six women, comprised of three qualified
as decrease of relapses and psychosocial dentists including a senior oral surgery References
impact. Primary approaches should be specialist registrar, a dental core trainee, and 1. British Medical Association. Sexism in medicine
report. 2024. Available at https://www.bma.org.uk/
conservative whenever possible, with a a postgraduate in oral surgery; as well as

BRITISH DENTAL JOURNAL | VOLUME 238 NO. 5 | March 14 2025 293

© The Author(s) under exclusive licence to the British Dental Association 2025.