CE Questions The answer sheet and further instructions are located on the tear-out card that appears on page 37, or take the test online at dimensionsofdentalhygiene.com. 1. Roughly how many adults in the United States identify their sexual and/or gender orientation as lesbian, gay, bisexual, or transgender? A. 5 million B. 10 million C. 20 million D. 30 million 2. Which of the following terms refers to the gender identity that conforms with sex assigned at birth? A. Nonbinary B. Cisgender C. Transgender D. All of the above 3. Sexual orientation refers to an individual’s physical, emotional, and/or romantic attraction to another person. True False 4. Which of the following terms describes the physical, emotional, and/or romantic attraction to all gender identities? A. Pansexual B. Homosexual C. Heterosexual D. Bisexual 5. Health conditions common to lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals include which of the following? A. Anxiety and depression B. Eating disorders C. Sexually transmitted diseases D. All of the above 6. The LGBTQ+ community is not targeted in public health tobacco cessation efforts. True False 7. Which of these substances is often abused among those in the LGBTQ+ community? A. Alcohol B. Heroin C. Opioids D. All of the above 8. Xerostomia is one of the most common side effects of anti-anxiety and anti-depressant medications. True False 9. Which of the following fosters a supportive practice culture for LGBTQ+ populations? A. Using gender-neutral language B. Using preferred pronouns C. Avoiding binary references D. All of the above 10. Which office emphasizes the need for culturally competent oral health professionals to increase access to care and enhance oral health, especially in minority groups such as LGBTQ+ individuals? A. Environmental Protection Agency B. Food and Drug Administration C. United States Surgeon General D. None of the above SECTION 1 SECTION 2 SECTION 3 extraoral examinations and refer to an oral surgeon or other specialist should a suspicious lesion be detected. During the medical history, the clinician should also discuss T-cell counts and neutrophil counts to determine immunosuppression if LGBTQ+ patients are HIV+. As prevention specialists, dental hygienists should be knowledgeable in educating LGBTQ+ populations who may present with STIs that affect the oral cavity.37 Oral signs of STIs include intraoral and extraoral lesions that may include white or red discoloration of the soft palate, tongue, or tonsils and swollen lymph nodes.36,37 Recommending at-home intra- and extraoral examinations between recare appoint- ments may also help LGBTQ+ patients recognize an oral issue early. Strategies for Support Using appropriate and safe language and developing a supportive practice culture in which all oral health professionals in the practice are culturally competent in regard to the LGBTQ+ population are important steps toward creating an inclusive environment. This may include learning and using gender-neutral language and preferred pronouns.38 Health documents and consent forms should include options for preferred name and preferred pronouns. However, many insurance companies and legal entities do not recognize a number of genders/sexes, so it is important the practice still has access to the legal name and sex for insurance, billing, and correspondence documents.38 Avoiding binary references when treating LGBTQ+ patients may facilitate a more comfortable and affirmative conversation. For example, oral health professionals can use the term “partner” instead of “husband or wife” when dis- cussing the patient’s spouse to avoid unnecessary assumptions. Oral health professionals may want to learn about resources that support LGBTQ+ individuals in their area. This provides the opportunity to build a trusting and safe patient and clinician rapport as well as an opening to offer referrals and resources beyond dentistry.12 Regular and frequent cultural competency training may assist in providing optimal oral care to this population. The US Surgeon General points to the need for culturally competent oral health professionals to increase access to care and enhance oral health, especially in minority groups such as LGBTQ+ individuals.39 In addition to cultural competency training, practices may consider simply displaying LGBTQ+ friendly stickers or flags to alert patients the practice is a safe environment. Providing inclusive rest- rooms for all genders may also make LGBTQ+ patients feel more comfortable in the dental office.40 Oral health professionals should also create an accountable environment by politely correcting colleagues if they make insensitive comments or use non-inclusive language.41 Practices that encourage and support LGBTQ+ inclusivity make a commitment to equitable care which may improve access to quality oral care. Conclusion Healthcare services, including dental hygiene care, should be delivered impartially regardless of gender, race, sex, ethnicity, religion, or culture. The American Dental Hygienists’ Association’s Code of Ethics also supports this ideal stating the dental hygienist must “serve all clients without discrimi- nation and avoid actions toward any individual or group that may be interpreted as discrimina- tory.”42 Oral health professionals should provide culturally competent and informed care to reduce the health and dental disparities among the LGBTQ+ population. The references that accompany this article appear with the web version at: dimensionsofdentalhygiene.com. D SECTION 3 ZAY NYI NYI/ ISTOCK / GETTY IMAGES PLUS dimensionsofdentalhygiene.com July/August 2023 • Dimensions OF DENTAL HYGIENE 41
