Supporting Ramadan observance in dental education and clinical care: a mixed-methods survey of staff and students
This mixed-methods study of a UK dental school reveals that while staff and students feel confident supporting Muslim individuals during Ramadan, they face significant uncertainty regarding clinical decisions and inclusive practices, highlighting a critical need for accessible institutional guidance and opportunities for open dialogue to foster psychological safety.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
In the world of dental care, the goal is always to treat the person sitting in the chair, not just the teeth. This means understanding the full context of a patient's life, including their health, their habits, and their beliefs. For many Muslims, the month of Ramadan is a time of deep spiritual significance, marked by fasting from dawn until sunset. During this period, individuals abstain from food and drink, which can change how their bodies feel, how they sleep, and how they care for their mouths. It also raises practical questions for dentists: Is it okay to use water sprays that might be swallowed? Can a patient take medication? How should a dentist schedule an appointment for someone who is tired from fasting? These are not just medical questions; they are questions of respect, trust, and clear communication. When a healthcare professional is unsure how to navigate these situations, patients may feel unheard, and the quality of care can suffer. The challenge lies in finding a balance between clinical rules and personal faith, ensuring that everyone feels safe and supported.
A team of researchers at a dental school in the United Kingdom set out to understand how well staff and students felt prepared to handle these specific moments. They wanted to know if the people working in the school felt confident discussing Ramadan with Muslim students and patients, or if they were holding back questions because they were afraid of saying the wrong thing. To find out, they asked 42 people—25 staff members and 17 students—to fill out a survey. The participants answered questions about their confidence levels and wrote freely about what they needed to know, what they had experienced, and what made them feel uncertain. The researchers then read through these written responses to find common patterns in how people thought about support, inclusion, and the rules of the dental school.
The results revealed a surprising mix of feelings. Most of the people who answered said they felt at least a little confident in supporting Muslims during Ramadan. However, this confidence did not mean they knew exactly what to do. Instead, it coexisted with a lot of uncertainty. Many staff and students admitted they were unsure about the clinical details, such as whether certain dental tools or materials might break a fast. They were also unsure about the social side of things. A major theme in the responses was a fear of causing offense. People worried that asking a patient if they were fasting, or asking what kind of support they needed, might sound rude or patronizing. They wanted to be respectful but did not know the right words to use. One staff member noted that they had picked up most of their knowledge informally over the years, rather than from official guidance, while another asked how to know what adjustments to make without sounding condescending.
The study also highlighted that the uncertainty was not limited to non-Muslims. Even Muslim students, who lived through the experience of fasting themselves, said they struggled with the same questions. They did not know if they should assume a patient was fasting based on their appearance, or how to ask for help without feeling like they were burdening others. They expressed a strong desire for clear, written rules from the university that would take the guesswork out of the situation. They wanted to know who had the authority to approve changes to schedules or to allow breaks for prayer. Currently, they felt that the responsibility often fell on them to educate their teachers and supervisors, which was an unfair burden. Some students reported that while some staff were very welcoming, others were unaware that they were fasting and expected the same level of energy and efficiency as on any other day.
Another layer of the problem was the confusion about what "fairness" actually meant in this context. While most people agreed that support was needed, one staff member suggested that giving special consideration to Ramadan might be unfair to other religions. The researchers noted that this view missed the point of equity, which is about giving people what they need to succeed, not treating everyone exactly the same. The study suggested that when people feel unsure about the rules, they often stay silent. This silence is not because they do not care, but because they are worried about making a mistake or being judged. The researchers described this as a lack of "psychological safety," a state where people feel comfortable asking questions without fear of negative consequences. Without clear guidance from the institution, this safety does not exist, and uncertainty remains unspoken.
Ultimately, the paper concludes that simply feeling confident is not enough. The dental school needs to provide clear, accessible information that covers both the medical facts and the social etiquette of supporting Ramadan. This includes creating a space where staff and students can ask questions without fear, and where the rules for adjustments are transparent and consistent. The goal is to move away from a situation where Muslim students and patients have to teach others how to support them, and toward a system where the institution takes responsibility for creating an inclusive environment. By doing this, the dental school can ensure that care is not just clinically sound, but also deeply respectful of the people receiving it.
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