Dental education in Europe: the challenges of variety

Dental education varies considerably across Europe, with differing traditions of stomatology (dentistry as a specialty of medicine) and odontology (single autonomous discipline). Dental curricula within the European Union (EU) are governed by European law expressed in directives that are binding on all EU member states. The Dental Directives (78/686/EC) base the curriculum on the odontological model, but compliance by individual schools is often poor. The differences within the EU will likely intensify with the accession of Eastern/Central European countries where the stomatological tradition is strong. Moreover, current proposals within the EU will reduce even the limited existing effectiveness of the Dental Directives. The DentEd Thematic Network Project, which aims to promote convergence of European curricula through voluntary self-assessment and outside peer review, has involved about 25 percent of European schools. Its effectiveness in inducing changes in individual schools is unknown. It is not an accreditation system, and there is no intention to establish a European-wide common curriculum. Dentists' vocational training, here defined as "the organised education of the newly qualified dentist in supervised practice," is present in various models in many European countries, but is compulsory in only a few. Continuing dental education (CDE) is encouraged in most countries, but CDE-dependent licensure is required in only two.     

Perspectives on dental education in the Nordic countries

The object of this review is to discuss the state of dental education and describe current developments at dental schools in the Nordic countries. The main focus is the undergraduate dental education; however, the postgraduate system will also be addressed. The curriculum model for undergraduate dental education in the Nordic countries is based upon the odontological tradition. The influence of biomedicine on dental education is increasing at present due to scientific and medico-technological developments and the altered disease profiles of oral and systemic diseases. These circumstances create new possibilities for dental education, but at the same time they raise some problems. In the long-term, the strong biomedical influence on dental education will be an advantage to future dentists' function and tasks in health care systems in the Nordic countries. In the short term, it may result in an identity crisis for dental schools, students, and our profession, as we experience the evolution from the traditional odontological curriculum model to one significantly influenced by ongoing changes in the biomedical field. Continuing professional education and advanced training in clinical specialties are likely to play important roles in this evolution.     

Analysis of the extent and efficiency of the partnership and collaboration between the dental faculties and National Dental Associations within the FDI–ERO zone: a dental faculties' perspective

Background and aim: As National Dental Associations and dental faculties can be considered as the two major institutions representing national organised dentistry, their further extended collaboration is crucial in responding to the many global oral health matters and issues. The main aim of the present study is to analyse the nature and extent of the partnership between the dental faculties and NDAs. Methods: A questionnaire was developed focusing on the relationship between National Dental Associations and the dental faculties within the World Dental Federation–European Regional Organisation zone regarding their major professional activities such as dental education, workforce issues, improvement of national oral health, science and knowledge transfer. The questionnaire was sent to 173 dental faculties within the countries in the European Regional Organisation zone. Results: Response rate was 62/173 (35.8%). Major activities of dental faculties were listed as implementation of new technologies into practice (72%), followed by improvement of national oral health (65%), while the least involved activity was dental workforce issues (42%). The dental faculties perceived their relationship with the National Dental Associations as quite satisfactory in the field of continuing education and science and knowledge transfer. However, their relationship was suggested to need significant improvement when dealing with undergraduate dental education curriculum, dental workforce issues and negotiations with the authorities regarding professional matters/issues. Discussion and conclusions: Despite the fact that there are differences between the perceived competences and responsibilities of the two bodies, the presence of so many potential areas of collaboration, the increasing expectations from the individual dentists/dental profession and the new challenges of the dental profession give this relationship significant importance. Communication, regular contacts, more joint activities and improved collaboration is needed between dental faculties and National Dental Associations to overcome such professional matters and issues.     

Scandinavian Fellowship for Oral Pathology and Oral Medicine: statement on oral pathology and oral medicine in the European Dental Curriculum

J Oral Pathol Med (2010) 39 : 800–e1 Background: For many years, dentists have migrated between the Scandinavian countries without an intentionally harmonized dental education. The free movement of the workforce in the European Union has clarified that a certain degree of standardization or harmonization of the European higher education acts, including the dental education, is required. As a result of the Bologna process, the Association for Dental Education in Europe and the thematic network DentEd have generated guidelines in the document ‘Profile and Competences for the European Dentist’ (PCD). This document is meant to act as the leading source in revisions of dental curricula throughout Europe converging towards a European Dental Curriculum. In order to render the best conditions for future curriculum revisions providing the best quality dentist we feel obliged to analyse and comment the outlines of oral pathology and oral medicine in the PCD. Methods: The representatives agreed upon definitions of oral pathology and oral medicine, and competences in oral pathology and oral medicine that a contemporary European dentist should master. The competences directly related to oral pathology and oral medicine were identified, within the PCD. Results: The subject representatives suggested eighteen additions and two rewordings of the PCD, which all were substantiated by thorough argumentation. Perspectives: Hopefully, this contribution will find support in future revisions of the PCD in order to secure the best quality dental education.     

Dental education in India and Japan: implications for U.S. dental programs for foreign-trained dentists

An understanding of international dental education systems is critical for the education of foreign-trained dentists in U.S. dental programs. However, there is little information on this topic. This article provides information regarding 1) dental history, 2) dental school system, 3) curriculum/examination at dental school, and 4) dental licensure in India and Japan. There are 185 dental schools in India and twenty-nine in Japan. The number of first-year dental students is 12,872 and 2,647 in India and Japan, respectively. A five-year dental education, which includes 4,035 curriculum hours, leads to the B.D.S. degree in India, whereas a six-year dental education program, which includes 5,060 curriculum hours, leads to the D.D.S. degree in Japan. No undergraduate predental study is needed prior to entry into dental school in both countries. In India, the entrance examination is extremely competitive; however, there is no nationwide licensure examination. In Japan, dental schools use more sophisticated dental materials and equipment in the clinical phases of the curriculum than in India, but there is no clinical examination at the time of graduation. Several implications for U.S. dental programs for foreign-trained dentists with respect to screening applicants and curriculum development are discussed.     

Basic sciences education in the dental curriculum in Southern Europe

A survey was conducted to determine the current status of the basic sciences education in Southern European dental schools. Responses were collected from schools in Malta, Greece, Portugal, Italy, France and Spain. The results show that there is some uniformity across Southern Europe, even if there are some variations among dental schools both within one country and among the different countries. The links with Medicine seem to be strong. Most basic sciences dental educators have a medical degree and usually have their main appointment in a medical school. The only exception to this is found in France, where the faculty, who are mostly dentists, have their main appointment in a dental school. In half of the countries, courses are given jointly to both dental and medical students. There is, in general, poor coordination between the basic science subjects and other subjects in the dental curriculum. All the surveyed schools maintain traditional curricula and teaching methodologies. However, there is an increased movement towards self-directed learning, computer-assisted learning and improved coordination with clinical subjects.     

中国口腔急诊建设现状的调查分析

目的    了解并分析我国口腔急诊规范化建设、口腔医护人员应急处置能力以及口腔急诊医学课程等情况。方法    于2022年6月采用线上问卷调查方式对全国708家口腔医疗机构的1638名口腔医护人员进行调查。结果    80.9%的医疗机构开设了口腔急诊业务;37.5%开设口腔急诊业务的医疗机构设有急救诊室,其中有66家是口腔专科医院,占所有口腔专科医院（115家）半数以上;57.5%的医疗机构有绿色通道和转诊流程,口腔专科医院中占比为78.3%（90/115）;配备椅旁救治所需基本药物和生命支持设备齐全的医疗机构分别占所调查医疗机构的6.6%和5.6%;口腔急诊常见疾病是急性牙髓炎（57.3%）,其次是口腔颌面外伤（28.2%）和牙外伤（9.3%）,晕厥、低血糖和高血压急症是较常见的3种口腔临床伴发急性全身性病症;所调查的医护人员中完全能够处置常见口腔临床伴发急性全身性病症者仅有39.7%,76.3%的医护人员认为开设口腔急诊课程非常必要,80.4%的医护人员认为应将口腔急诊课程设置为必修课程,但仅有21.6%医学院校开设口腔急诊医学课程。结论    口腔急诊的规范化建设亟待加强;口腔急诊急救培训工作发展迅速,但口腔医护人员的急诊急救处置能力仍需提高;口腔急诊医学教育是目前口腔急诊医学发展的瓶颈和短板,需要加快教材建设与教学普及。     

Tobacco use cessation curricula in the U.S. dental schools and dental hygiene programs

Tobacco-related health problems are the most preventable forms of illness in the United States. By assuming proactive tobacco use cessation counseling roles, dentists and dental hygienists can help reduce the number of people who currently use tobacco. The literature reports that many oral health professionals feel unprepared to assume such roles. To help combat the problem of tobacco-related illness and to help prepare dentists and dental hygienists to assume tobacco use cessation counseling roles, dental schools and dental hygiene programs need to develop appropriate didactic and clinical tobacco use cessation curriculum content. To date, there are limited national data addressing the extent of tobacco use cessation education in dental schools and dental hygiene programs. Studies of medical schools have revealed a need for increased curriculum content on tobacco use prevention and cessation. Further, tobacco use cessation training programs for medical students, practicing dentists, and dental hygienists have resulted in increased student and provider confidence when tobacco use cessation counseling roles were assumed. This study surveyed all dental schools and dental hygiene programs in the U.S. to determine if tobacco-related curriculum content exists, and if so, to what extent. Variables addressed included allocated hours, subject content, scope, department responsible, workplace smoking policy, importance, and future curricular directions. Questionnaires were mailed to all dental hygiene program directors and dental school academic deans. Study findings suggest that dental and dental hygiene students receive limited tobacco use cessation education, and respondent schools have no immediate plans for curriculum change in this area.(ABSTRACT TRUNCATED AT 250 WORDS)     

Teaching ethics in dentistry

This paper describes a curriculum project designed to help dental students identify, reason about, and adequately resolve ethical problems in their chosen profession. The project involved application of a theoretical approach to the study of ethical development that had not been applied previously in professional education. Tests were designed to measure the abilities defined by the theory and used to evaluate the program and to monitor student progress. To date, studies of student abilities and attitudes clearly indicate that the curriculum is needed. Learning activities, created to promote the abilities, are based on studies of the real-life ethical problems confronting dentists and dental students. A program of research and development has been established to study the influence of this curriculum on the abilities defined, and to link them to clinical performance. Half of the dental schools in the United States have requested these materials. Suggestions are made to professional schools considering expanding the teaching of ethics.     

Undergraduate training in the European Union Convergence or divergence?

A survey of dental schools in the European Union was carried out for two main reasons. Firstly to promote the exchange of information in respect of curriculum objectives in the different countries and secondly to ascertain the differences in the interpretation of the 1978 EU sectoral directives for dental education and training. Out of 127 schools, only 30 responded, yet the information provided is of considerable importance. It demonstrates wide divergence in the interpretation of the 1978 Directives and methods of assessment of clinical competence. There is a considerable difference throughout Europe in hours devoted to the various subjects included in the Dental Directives. There is little evidence of convergence in methods of assessment or quality assurance. The survey demonstrates the difference in resources, levels of staff, availability of clinical training places, output in research and patient treatments throughout the European Union. The results question the effectiveness of the 1978 Dental Directives in promoting convergence of standards. As there is free movement of dentists throughout the European Union, it is concluded that a different approach may be necessary to ensure that all European Union dental graduates achieve comparable standards in their education and training.     

Comparison of dental education and professional development between mainland China and North America

Different educational and professional developments within the dental field create different sets of missions, norms, and practices regarding dental diseases and their appropriate treatment. This review has addressed differences in dental education and professional development between mainland China and North America. Many factors influence the choice of model and it is very difficult to predict which model will become predominant. However, there is growing sentiment that the independent faculty model in North America is logical and superior to the model, which ‘integrates’ dental and medical education in mainland China. Many North America dental schools place a high priority on preclinical and clinical training in the curriculum in order to expose students to patient oral health needs and systemic dental problems much earlier than in mainland China. North America dental schools promote and embrace students self‐learning skills by the use of PBL, CRL, and TRAD education methodologies and new e‐based technologies and approaches whereby students learn rather than are taught. In mainland China, the traditional lecture‐based format is still employed in the majority of dental schools; however, strategies to enhance students self‐learning skills is increasingly utilised in most well‐known Chinese dental schools. The Chinese dental education model, which treats dentistry as a sub‐specialty of medicine, has brought about fundamental differences, with the dentist functioning essentially as a stomatologist. For example, China has built up a large oral and maxillofacial surgery society, and craniofacial surgery is performed to a much broader extent by Chinese dentists than by most North American counterparts. In North America, dentists engage in full‐time work, attend continuing training/education programmes, belong to an association, gain legal status, and construct a code of ethics emphasising the quality of care delivered to the public. Currently, continuing dental education in North America is available through a variety of venues involving licensing authorities, universities and private programmes. The concept of professional development in mainland China is relatively new and is still considered primarily in the context of promotion or achieving a higher professional title. Mandatory continuing dental professional education requirements do not guarantee the competence of members of the profession. Today, the Chinese government and society place increasing emphasis upon the accountability of self‐regulating professions. Rather than attempting to summarise the current scope of dental education and professional development between mainland China and North America, this paper hopes to enhance mutual understanding, and promote greater academic exchanges in dental education.     

The Baltic dental programme at The Faculty of Dentistry of The Karolinska Institute: first evaluation

In 1992, The Faculty of Dentistry of The Karolinska Institute (KI) introduced a dental undergraduate programme specifically for Baltic students. Initiative for this programme came from both the Ministries of Health in Estonia and Latvia and a Member's Bill in the Swedish Committee for Foreign Affairs. The first 10 students were admitted in January 1992, and in 1994, a further 8 students were accepted. The main objective is to train Baltic students according to the Scandinavian model of dental education, in order to facilitate a positive development in dentistry in these countries. Candidates for the programme, dental students in Latvia or Estonia who had completed several preclinical years, were interviewed and tested in their home countries by a Swedish Admissions Committee. The curriculum comprises 7 semesters at the School of Dentistry, and includes complementary courses in basic science, preventive dentistry, and theoretical and practical courses in all fields of clinical dentistry. The students work with Increasing independence, treating patients with a great variety of oral diseases and from different age groups. A course in Informatics is central and forms a base for a research-based assignment in collaboration with the respective home universities. The Baltic Programme is the first time KI has designed and implemented a specially tailored dental undergraduate curriculum in English for a selected group of foreign undergraduates. The students have proved to be ambitious and industrious, with very high academic standards. Their results in the written examinations were equal to or better than those of the home students. Of the 9 students who to date have completed the course, all are working as dentists In their respective countries and 6 are associated with their university.     

Attitudes and perceptions of medical and dental students on the implementation of non-surgical facial aesthetics in their curricula

There is an accelerated demand for non-surgical facial aesthetics (NSFA) encompassing the use of botulinum toxin and dermal fillers. Healthcare professionals may either treat NSFA-related complications in the public sector or practise in the private sector. Currently, there is no standardised undergraduate teaching in the UK to educate healthcare professionals on NSFA. The aim of our study was to compare medical and dental undergraduate students’ perceptions and awareness of NSFA, and to understand its role if implemented in each curriculum in the UK. An online questionnaire was devised and distributed via social media platforms to medical and dental students across the UK. Student responses were anonymised and collated as quantitative data, and subsequently analysed. Of the 146 respondents, 89% had no previous teaching on NSFA. Ninety-three per cent of medics and 75% of dentists agreed or strongly agreed that non-surgical aestheticians require dental or medical knowledge to deliver NSFA, and 66% of medics and 75% of dentists agreed or strongly agreed that NSFA should be incorporated into the undergraduate curriculum. Only 7% of medics and 8% of dentists were aware of the steps required to practise NSFA. Incoming doctors and dentists are showing interest in the field yet have no formal teaching in the area. Requiring healthcare professionals to have some baseline understanding of NSFA and its associated complications means that implementing formal education on the subject in the medical and dental curricula is an important consideration.     

Paradigm shifts in medical and dental education: behavioural sciences and behavioural medicine

Psychosomatic and behavioural medicine have a long tradition in Hungary. In this paper, we highlight the possibilities of teaching behavioural medicine and behavioural science in the medical and dental curricula, particularly in the field of health promotion and prevention. There are a number of possibilities for dentists in the fields of behavioural science in both research and health policy. There is a need for closer integration of teaching, research and health policy in both general medicine and dentistry, and both doctors and dentists must approach their patients in a holistic way.     

Scandinavian Fellowship for Oral Pathology and Oral Medicine: guidelines for oral pathology and oral medicine in the dental curriculum

In Scandinavia, as in many European countries, most patients consult their general dentist once a year or more. This gives the dentist a unique opportunity and an obligation to make an early diagnosis of oral diseases, which is beneficial for both the patient and the society. Thus, the dentist must have knowledge of clinical symptoms, local and systemic signs and clinical differential diagnoses to make an accurate diagnosis. The dentist must be competent in selecting appropriate diagnostic tests, for example, tissue biopsy and microbiological samples, and conducting them correctly, as well as in interpreting test results and taking appropriate action accordingly. Furthermore, the dentist must be aware of diseases demanding multidisciplinary cooperation and be able to recognise his/her professional limitation, and to refer to other specialists when required. The dental curriculum changes over time as new approaches, treatments and diagnostic possibilities develop. Likewise, the role of the dentist in the community changes and may vary in different countries. As members of the Scandinavian Fellowship for Oral Pathology and Oral Medicine and subject representatives of oral pathology and oral medicine, we feel obliged to contribute to the discussion of how the guidelines of the dental curriculum support the highest possible standards of dental education. This article is meant to delineate a reasonable standard of oral pathology and oral medicine in the European dental curriculum and to guide subject representatives in curriculum development and planning. We have created an advisory topic list in oral pathology and oral medicine.     

Perceived relevance of oral biology by dental students

Objectives: This study investigated the perception that dental students have regarding the relevance of oral biology (OB) to dental education and dentistry in general. Moreover, this study analysed students’ attitude towards OB learning approaches and resources. Methods: A questionnaire based on a Likert scale was used to survey pre‐clinical/second (BDS2)‐ and final/fifth (BDS5)‐year dental students at the School of Dentistry of the University of Birmingham (United Kingdom). In comparison, a small group of postgraduate specialist registrars were surveyed to evaluate the attitudes of practising dentists. Results: The results show that all study groups expressed a high level of perceived relevance of OB to dentistry. Students’ perception of OB for dental education, clinical training and practice also scored high. More than 40% of undergraduate students and about 55% of the postgraduates indicated a perceived change in their attitude towards OB with time characterised by increased appreciation of the subject. Lectures were considered as the most important teaching approach, whereas ‘group poster projects’ ranked lowest. Of the different study resources, lecture handouts received the overall highest importance score. Conclusions: The results indicate that dental students considered OB relevant for dental education and dentistry and suggest a positive attitude towards the subject. This study also suggested that dental students prefer teacher‐centred/led teaching rather than student‐directed learning of OB. The article addresses the role of OB and science‐related research projects within the dental curriculum and discusses that close integration of basic sciences with dental education may enrich dental education and overall learning experience.     

Educational practices regarding anticoagulation and dental procedures in U.S. dental schools

Evidence suggests that stopping oral anticoagulation with warfarin is not necessary in patients requiring low-risk dental procedures and may actually increase thrombosis risk. However, widespread belief remains among dentists that stopping oral anticoagulation for dental procedures is necessary. The purpose of this study was to investigate the teaching practice of U.S. dental faculty responsible for providing education to dental students about anticoagulation. Surveys were mailed in 2003 and 2004 to fifty-five U.S. dental faculties to assess their teaching practice regarding anticoagulation and dental procedures. Twenty-eight (50.9 percent) of the schools returned surveys. Contrary to evidence indicating anticoagulation does not need to be altered, many dental faculty responded that they teach dental students to discuss with medical providers/patients about altering warfarin therapy for several routine procedures: 21.4 percent (cleaning), 14.3 percent (restorative treatment), 46.4 percent (single simple extraction), 64.3 percent (multiple simple extractions), and 17.9 percent (root canal). However, 67.9 percent stated an International Normalized Ratio (INR) of 2.0-3.0 would be acceptable prior to dental procedures. A discrepancy was also found between the number of faculty recommending altering warfarin in intermediate- to high-risk individuals compared to those recommending heparin bridging for the same patients. Overall, this study identified inconsistencies between teaching practices in U.S. dental schools and medical evidence. Dental faculty should consider comparing their teaching material with evidence regarding anticoagulation and dental procedures. Continuing education may be necessary for practicing dentists regarding this topic.     

A new dental curriculum for chinese research universities

The current dental curriculum in China was developed from the system in the Soviet Union in the 1950s. This curriculum is outdated and must be reformed to keep pace with the developments of modern dental education. The new dental educational system should be customized to China's needs: care for a large population with poor overall oral health, operating within a government-owned, centralized health care delivery system. Chinese research universities have a mission to produce competent dentists who will also be educators and researchers. To efficiently train academic dentists who can also meet the clinical needs of today's Chinese population, a new dental curriculum was developed at the Institute and Hospital of Dentistry, Nanjing University Medical School. This curriculum has four main features: 1) a two-year general higher education plus five-year dental education ("2+5") model; 2) improved integration of didactic and practical learning; 3) improved integration of dental education with research training; and 4) improved overall sequencing of the entire curriculum. This article describes the details of this new dental curriculum.