DR MICHÈLE AERDEN, the first female President of the FDI, recently visited Dublin to address the WiDEN group, and spoke to Ann-Marie Hardiman about her career, her views on women in dentistry and her work in developing countries.
‘From haute couture to President of the FDI’ was the intriguing title of Dr Michèle Aerden’s recent lecture to the Women in Dentistry Network and is, in fact, an accurate description of her fascinating career trajectory. After quitting her science degree to get married, Michèle started a successful fashion business in her native Brussels, before selling up to spend time with her children. It was only when she reached her 30s that she decided to return to her first love and embark on a more science-based career. Even then, she felt that dentistry had the potential to be an ideal career for a woman.
“I had a younger sister who became a dentist. I saw the flexibility of the job, and I like science so I decided to go for that. You can fit it with your schedule. You can decrease [your hours] when you have little children and increase when they grow up.”
She studied while the children were at school, and after graduation she joined a group practice, before setting up on her own. A GDP with an interest in aesthetic dentistry, she still practises, fitting a core group of loyal patients around her travels.
“I will never give it up because I think [it helps] you to keep contact with reality – keep your feet on the ground. And because I practise I have to do continuing education – otherwise I would lose my licence.”
Worried that, as a comparatively late starter, she needed to learn more about her new profession, Michèle got involved in her national scientific association almost immediately, attending CPD courses at every opportunity. This led to involvement at committee level in first the scientific, and then the national, association. Her commercial experience was a big part in her progression, and she became the first female President of the Belgian Dental Association. Her knowledge of languages, in turn, led to her being asked to represent the Association at the CED and FDI.
At the FDI, Michèle sat on the committees for ethics and for developing countries, and was eventually invited to apply for a place on the Council. Two Council terms made her eligible to run for President. However, her first attempt to be elected was unsuccessful. She persevered, running again two years later, and became the first female President in the 105-year history of the FDI in 2005. The FDI is a huge organisation, representing over one million dentists in 134 countries, and politics inevitably plays a major role at election time, so Michèle’s achievement as a woman from a small country with only one vote cannot be overstated. She relishes the challenges, however.
“I work very hard but I get results – and that gives you a lot of energy.”
A role model for women in dentistry
Michèle felt that her first defeat was related to her gender, and her determination to try again two years later was very much influenced by her conviction that women in dentistry must advance themselves in the profession.
“I felt that at least if I lost again it would make it harder for them to defeat another female candidate next time.”
A strong believer in the power of information, of “facts and figures”, Michèle’s conviction was based on research she had already carried out in 1996 into the growing feminisation of the dental profession. The results were telling: women, despite making up an increasing number of the profession, held a maximum of 12% of leadership positions, such as committee memberships, etc., within professional organisations. This led her to establish the Working Group on Women in Dentistry to try to address this deficit. The Working Group became Women Dentists Worldwide in 2001, and is now a full section of the FDI.
Michèle’s message is simple but powerful: “Only by taking a leadership position can you achieve sustainable change”.
She cites as an example the struggle she had as President of the Belgian Association to change the days when CPD was held. CPD was always held on Saturdays, and female dentists were not attending due to family commitments. Thanks to Michèle’s efforts, the association began to hold CPD on Thursdays, during school hours, to address this.
“This was a little thing that showed me that you have to be where decisions are made.”
These ‘little’ things made Michèle feel all the more strongly the need to run for President again.
“I had those facts and figures showing that you had no women at a decision-making level. That gave me more legitimacy to apply. I thought: ‘You have to do it’ – I felt I had a duty.”
Given that female members of the profession have the same education, and the same competence as their male colleagues, the question arises as to why more women do not take up these leadership positions. Michèle feels that lack of confidence is a huge part of this.
“In FDI I tried many times to encourage women [to join] committees (I was always the only woman), so I would call them and invite them to apply and they would always say ‘do you think that I can do it?’” Male colleagues, on the other hand, were always happy to accept immediately.
Asked how we solve this problem of lack of confidence, her answer is short and to the point: “Role models! Showing that we can do it. That is why I speak on these issues – it’s not about ego, or about social status – it’s a tool that you can use to change things”.
Having it all
Michèle also feels very strongly that the traditional barriers to women’s participation and progression in their careers – specifically time spent away while they have their families – should not prevent them from achieving great things.
“There’s no excuse for women not to be there. Take your time. Invest in your children, particularly for the first three years of their life. You can still do it. I began in my thirties and became President of the FDI. Women are organised, and you can do this!”
It is best not to have an association outside of your national association. Act as a section within the association; otherwise, you will never be part of the decision-making.”
The research carried out by Women Dentists Worldwide has also made some fascinating discoveries about the pay gap between male and female members of the profession. Despite having the same qualifications and opportunities, and working just as hard, women consistently earn 20-25% less than their male colleagues, and Michèle’s research had some interesting findings about this.
“When we did the surveys in Europe we saw that women have a different approach to care. We tend to do more conservative dentistry, and more paediatrics.”
This kind of care takes more time and involves fewer of the higher fee items such as implants or bridges. It’s more about caring and prevention, and Michèle feels that this is a fundamental difference of approach between the genders.
Michèle is very supportive of the WiDEN group, and has some words of advice for the members.
“It is best not to have an association outside of your national association. Act as a section within the association; otherwise, you will never be part of the decision-making. You need to be there to introduce sustainable change.”
Michèle’s involvement in the FDI’s Committee of Developing Countries made this an area in which she took a particular interest during her presidency.
“When I became President, there were seven projects in developing countries; when I left there were 42.”
One project, with which she is still very much involved, began as a pilot project in Manila in the Philippines with the aim of improving the health and educational attainment of young children. The President of FDI could attend meetings of the board of the World Health Organisation, and this project is a collaboration with the WHO’s public health arm, the OMS. Michèle explains: “We looked at what influenced the under-development of children under 10 years of age, and the three pillars we identified were: infection, such as diarrhoea and respiratory infection; oral disease – if a child has caries, or an abscess, he doesn’t eat, he doesn’t sleep, and he doesn’t go to school; and, terrible living conditions, which had led to chronic worm infections”.
The project has come up with a remarkable programme of simple, cheap and effective solutions. To combat infection, the children are taught to wash their hands before eating and after using the toilet. This small measure has led to a 40% reduction in diarrhoea and a 30% reduction in respiratory infections. The children also receive education about diet, and are supervised while brushing their teeth with fluoride toothpaste once a day at school. This measure has reduced the risk of cavities and oral infection by 30%. Finally, the children receive a twice-yearly dose of worm treatment, which has improved their general health.
Michèle is understandably delighted with the results: “Just with these measures, cognitive capacity increased by 30% – it’s unbelievable”.
And the cost of this intervention? 50c per child per year.
“It’s easy, low cost, and evidence based,” says Michèle. “The three-year evaluation was so good that the Philippines Government has taken over the scheme and it will now be rolled out to over eight million children.”
Michèle has taken this project to Africa, and the three-year evaluation phase of a pilot in Kinshasa in the Democratic Republic of Congo is about to come to an end.
“This year I will go with my facts and figures to the Government. We know it works – so do it!”
Michèle points out that she can achieve all of this because of the power of an organisation of the size and influence of the FDI, which gives her direct contact with the government, and with the national dental association, in each of 134 member countries.
“I have 134 telephone numbers, and all of these projects take place with the national association of each country. Whatever I obtain from governments, it is up to the national association to follow up – that is crucial.”
Michèle has always worked to use that influence – and her beloved facts and figures – as much as possible as a tool to create the sustainable change that is so important to her.
“Sometimes I come away from a country and think I haven’t done anything, but you are just the trigger. The national association does the work before and after, and the results are there. We are the spark, but they have to prepare and they have to continue after.”
A noble resolution
One of Michèle’s main priorities as FDI President was the integration of dental health with overall medical health, and one of her proudest achievements was to lobby successfully at the WHO General Assembly for a resolution to recognise this. The resolution, which was adopted on May 23, 2007, acknowledges the intrinsic link between oral health, general health and quality of life, and emphasises the need to incorporate programmes for the promotion of oral health and prevention of oral diseases into programmes for the integrated prevention and treatment of chronic diseases. Michele feels this is another tool in her armoury as she travels.
“I can say to the Ministers ‘you voted in Geneva – I am here now for the implementation’!”