Insights and initiatives on sexual misconduct in dentistry: a clinical fellow's perspective

Introduction

One of my responsibilities as a clinical fellow at the GDC for one year was to explore the issue of sexual misconduct in dentistry and what can be done to address it.

Sexual misconduct encompasses a wide range of unwanted and harmful behaviours, which can have lasting negative impacts on those who experience and witness it. This can have serious implications for patient safety and the profession, because colleagues who feel frightened, unsafe or intimidated are likely to find it more difficult to work as part of a team and perform effectively.

The findings from the recently published research commissioned by the GDC bring to light what is known about sexual misconduct in dentistry and the gaps. It highlights the seriousness of the problem including the negative impacts it can have on those who experience or witness it, and some of the many barriers that contribute to under-reporting by victims and witnesses. The gaps include a lack of published literature in the UK with the majority published in the United States. There is also, a lack of literature on effective interventions. While these gaps make it difficult to draw strong conclusions, it provides a useful baseline to build on, and a clear call to action.

To better understand the context of sexual misconduct in the UK, we facilitated an online insights event to learn more about this issue, what is being done and how we as a sector can collaborate to address it. Experts working in dentistry, education, academia, claims resolution, law and regulation came together to share their insights and initiatives to prevent and address sexual misconduct.

Context and culture

There are lots of myths and misconceptions about sexual harassment and assault. Not least, that it happens in dark alleys between strangers. But we know that it happens in workplaces. And this of course includes dental practices and training environments – brightly lit surgeries, perpetrated by those we know and trust. Some of us might feel uncomfortable acknowledging this, because it goes against what we expect of our fellow professionals.

In exploring this sometimes uncomfortable subject, I looked at a range of data and information, including research findings, NHS resolution data, the Society of British Dental Nurses (SBDN) profession-wide survey, the National Education and Training Survey (NETS), NHS Staff Survey, Fitness to Practise cases and case law. This information all points to the fact that dental professionals, students and patients are victims, survivors, and witnesses of sexual misconduct, and that perpetrators include fellow professionals, particularly those in positions of power, and patients. While there is limited data on reporting of sexual misconduct in dentistry, feedback from stakeholders suggest it is under-reported. This indicates a culture of silence in dentistry. This must change. It is not safe for anyone to work, provide dental care or receive it in a culture of silence.

From silence to safety

To break this culture of silence, we need to foster a culture of safety in which incidents are reported, acted upon and ultimately prevented. We all know it’s our duty to safeguard our patients. But we need to apply the same duty to our colleagues. This involves working together, supporting colleagues to speak up early, calling out inappropriate behaviours to prevent them escalating, and listening to and acting on reports.

At the insights event, this duty to speak up for others and contribute to breaking the silence was described as an “upstander”. Similar to an active bystander, an upstander is one who takes proactive steps to uphold the standards expected of each other including calling out inappropriate behaviours early and supporting each other. As dental professionals and members of the dental team, we all play a role in advocating this behaviour to ensure safe environments and delivery of dental care for all. All employers also have a legal duty to prevent and address sexual misconduct in the workplace in line with The Worker Protection (Amendment of Equality Act 2010) Act 2023 introduced in October 2024. It is clear that we all have a duty to safeguard each other and our patients.

Commitment and collaboration

A real positive from the insights event was the shared commitment to address and prevent sexual misconduct in dentistry. This was reflected in the insights and initiatives shared, the quality of the discussion and questions raised. I have included links to these resources at the end of this piece.

As the professional regulator, the GDC plays a key role in making it clear that sexual misconduct is unacceptable and is doing all it can to eliminate it in dentistry. From my work at the GDC, I have seen this commitment from those working on this in the organisation from professionalism to fitness to practise and this commitment is explicitly set out in the corporate strategy. However, regulation alone is not enough. Preventing and addressing sexual misconduct requires a collective commitment across the dental sector, with regulators, education providers, employers, professional bodies, and leaders all playing their part. This is the work I am continuing beyond the fellowship in collaboration with these stakeholders.

While progress is being made, there is still much to learn and do together. By sharing insights, raising awareness, encouraging upstanders, and committing to action, we can embed safe, supportive environments for everyone working in and receiving dental care.

I want to thank those already committed and contributing to this important work and I look forward to continued collaboration in the months ahead, if I haven’t yet spoken to you, please reach out. To everyone else, I would like to ask you to reflect on the role you play in preventing and addressing sexual misconduct in dentistry – the standard we walk past is the standard we accept.

Resources:

• Freedom to Speak Up Guardian for anonymous support: The National Guardian's Office - Freedom to Speak Up
• GDC commissioned research: Sexual misconduct in dentistry
• Literature review: A review of sexual misconduct in dentistry | British Dental Journal
• NHS Education for Scotland Deanery Resources for those in health care including trainees: Sexual misconduct resources | Scotland Deanery
• NHS England Sexual Safety Charter, a national policy framework to address sexual misconduct in healthcare: NHS England » Sexual safety in healthcare – organisational charter
• NHS Practitioner performance advice: Practitioner Performance Advice (formerly NCAS) - NHS Resolution
• Society of British Dental Nurses Campaign: Speaking up and Listening UP – SBDN
• Training open to all professionals: Active Bystander Training for Tackling Sexual Misconduct in Healthcare | RCPSG
• University of surrey toolkit for Higher Education: Sexual misconduct case toolkit | University of Surrey