I’ve been a subscriber to Spear Online for more than 10 years. I’ve generally been impressed with the quality of the content on Spear Online, but today I’m writing in response to two articles recently published by Spear Education in Spear Digest. The first is titled ‘Providing LGBTQ-friendly Dental Care for Patients: Overcoming Dental Phobias’. The second article is titled ‘Supporting LGBTQ Health Equity in Dentistry’. Both articles are authored by ‘Spear Team’. Since these articles are published by Spear Education and authored by ‘Spear Team’, it seems reasonable to conclude that they reflect the opinion and values of Spear Education, not just the opinion of a single anonymous author.

I’m going to confine my comments specifically in response to the article ‘Providing LGBTQ-friendly Dental Care for Patients: Overcoming Dental Phobias’ (hereafter referred to as ‘the article’) since it covers pretty much the same topics as the second article ‘Supporting LGBTQ Health Equity in Dentistry’.

The article presents unsupported assertions as facts. For example…

“…over one-quarter of gender non-conforming individuals have been denied needed care.” The citation in the article is linked to www.lambdalegal.org, a LBGTQ+ legal advocacy organization - hardly the place to find high quality, unbiased, evidence-based information. There’s no evidence presented that sexual orientation or identity is the reason LGBTQ individuals are reporting that they were ‘denied’ care. It seems possible that sexual preference or sexual identity could be a co-incident factor, but not the primary reason LGBTQ patients are not getting needed care. I suppose that some of my patients (both LGBTQ and otherwise) might report that they were denied needed care by my office, but it could be that the patient was 45 minutes late to a 60-minute appointment. Or it might be because the patient wasn’t willing to pay for the needed treatment.
The article implies that that dental practices are saying to LGBTQ patients “We don’t serve your kind here.” While that might be common and widespread, I highly doubt it. Dentists are about the nicest bunch of people I’ve ever encountered and it’s hard for me to believe that dentists are like that – it just doesn’t match up with my experience. There isn’t any evidence presented that discrimination and/or hostility directed by dentists and dental offices towards LGBTQ individuals is common or widespread.
“If your practice is following correct hygiene procedures, there should be zero risk of transmission from any patients, regardless of the sexual orientation.” I’d like to see Spear present some evidence to support this assertion. I assume the writer is speaking of blood and/or saliva borne pathogens (i.e. HPV, HIV, etc.). I was taught that universal precautions are measures we take to mitigate risk, but that the risk is never ZERO.
The article asserts that the barriers to care for LGBTQ patients’ is a “systemic issue” but provides no supporting evidence. An alternative explanation is that the barriers to care experienced by LGBTQ individuals might be the same barriers that exist for everyone else – fear and anxiety, unable (or unwilling) to pay, difficulty scheduling appointments outside of normal business hours, no dental insurance coverage, placing a low priority on dental care, etc.

The article asserts that the “…entire dental community needs to work together to solve…” LBGTQ barriers to care and that I “…must learn to adjust my way of speaking and treating patients.” [bold and italics added] These are strong statements! It’s the sort of language used by social activists, not dentists. I don’t recall Spear faculty such as Bob Winters or Ricardo Mitrani writing in their Spear Digest articles that I must follow their clinical recommendations. Why is Spear using absolute language here?

The article suggests that to create an inclusive environment in my practice, I should display “pro-LGBTQ material” that feature LGBTQ icons or symbols such as the rainbow flag to show “…that the provider is welcoming to LGBTQ patients and creates a safe and affirming environment.”

I don’t display the Democrat donkey, nor do I display the Republican elephant in my office. I don’t display a Jewish star of David, a Christian cross, the Hindu Aum, or the crescent and star of Islam either. This doesn’t mean that I’m hostile to any of these groups. On the contrary, I treat every patient with kindness and respect regardless of their race, gender, religion, sexual orientation, or political affiliation.

If I start displaying symbols or flags to demonstrate that my office is a ‘safe and affirming environment’ for every cause and special interest, where does it end? If I don’t display symbols for all the popular causes, how do I choose one group over another? What is it about the LGBTQ ‘cause’ that makes it more important or special than any other group or cause?

To me, being inclusive means treating everyone with kindness and respect, but not advocating for any political party, religion, group, or social cause in my office. Endorsing ‘group A’ or ‘cause B’ may offend or alienate supporters of ‘group C’ or ‘cause D’ that may have opposing views and that wouldn’t be inclusive.

I’d like to see Spear Education stay in their lane and stay focused on teaching dentists to provide excellent dental care and leave the social activism out of the curriculum. I don’t want or need Spear to preach tolerance and inclusivity. If I’m looking for someone to preach to me, I can go to church.

Articles like these are below the standard of writing that I have come to expect from Spear Education.

I realize that my views might not sit well with everyone, but that should be OK. I hope we can have an honest, respectful, and open dialog about these articles rather than resort to canceling or disparaging anyone who has opposing views.

I hope Frank Spear or Spear Education CEO, Kaleim Manji will respond and contribute to the discussion.

Ronald Jarvis, DDS

Kalispell, MT