LAUSR

BACKGROUND Only twelve percent of dentists in 2020 self-identified as being Black, Latinx, or "Other," which includes American Indian. Moreover, the proportion of dentists from these groups profoundly fails to reflect the demographic composition of the U.S. overall. Evidence-based, ethically-grounded approaches are needed to successfully and continuously recruit and retain Black, Latinx, and American Indian dental students. We explored the barriers and opportunities to sustainable pathways to the dental profession. METHODS We conducted focus groups in 2021 with current Black, Latinx, and American Indian dental students and key informant interviews with dental school administrators using elicitation guides developed for this project. We completed a thematic analysis of data to identify and check findings to strengthen validity. RESULTS We identified the following successes, challenges, and opportunities for recruiting Black, Latinx, and American Indian dental students. Successes include institutional investment to build and sustain pathways, yet many of these practices are institution- or administrator-specific and may defy replication. Challenges are more widespread, and include weak accreditation standards; systemic bias and failure to consider candidates holistically in admissions decisions; costs associated with admissions test preparation and volunteer shadowing; transportation, geography, school culture and language/citizenship status. Opportunities include mentoring, scholarships, removing bias from admissions, institutional financial investment in pathway programs, and peer norming among programs. CONCLUSION Building sustainable pathways involve early support of students, removing systemic biases, and institutional commitments to equity to create a workforce to meet population needs.