Dental students, dental faculty members and practicing dentists recognize the need for an excellent dental education that can prepare them for the challenges and opportunities in dentistry. Each of us can recall rewarding and satisfying experiences during our dental education, but also instances when a better educational system could have lessened the strain and stress associated with that time in our lives.

In dissecting the good, the bad and the ugly of dental education, three topics come to mind: a relevant curriculum, the quantity of new information and topics that need to be accommodated within a four-year curriculum, and the lack of dental faculty.

The first two years of predoctoral dental education consist mainly of courses in which students are required to memorize facts. Unfortunately, there are several problems with the way in which most of these courses are being taught. And there are reasons why it is difficult to make any major changes to the approach traditionally used to introduce budding oral health care professionals to their chosen profession.

Most dental schools employ basic scientists to teach basic science courses. These faculty members teach for a couple of hours during a few weeks or months at some point during the academic year. The rest of their time is spent writing grants and conducting research, or they may be part of a health science faculty with duties in other professional schools. Most of these scientists lack the practical experience needed to translate their material into clinically relevant information. And unfortunately, at this point in their careers, students also lack the background needed to assess the importance and relevance of the information they are given.

Enhancing collaboration between clinical and basic science faculty and incorporating more clinical experiences into the curriculum for the first two years of dental school would greatly improve the dental school experience. However, instituting radical changes to the curriculum during these formative years is problematic. Much of the learning at this stage is meant to prepare students for the National Board Dental Examination (NBDE) Part I.

As NBDE scores are de facto used to rank dental schools and are an important part of a student’s portfolio when applying for postdoctoral dental programs, major changes in the curriculum during these years are not looked on kindly, when changes may jeopardize success on this national standardized test.

Dental curricula have remained essentially unaltered for decades. This is in contrast to the practice of dentistry, which has undergone dramatic transformations over the same period. Few dentists 30 years ago envisioned the emergence of spa dentistry, extreme makeovers, dental implants placed by general dentists and specialists alike, clear orthodontic aligners, facial bone distraction, computer-aided design/computer-aided manufacturing technology, posterior resin-based composites or oral fluid diagnostics.

These seminal changes have shaped today’s dentistry and brought to the forefront the importance of anticipating and incorporating timely and relevant modifications in our pre- and postdental curricula. But how do we, in just four years, provide all the information and training necessary for the dental student, while the knowledge and clinical skills required to become a dentist are evolving continuously?

Most dental schools do an excellent job of providing clinical knowledge and skills to their students. They also provide first-class didactic education. What is lacking is an emphasis on giving students the tools and skills that will enable them to assess and apply new knowledge independently. Reaching a level of proficiency to critique, assess and use new knowledge may be attained at the postdoctoral level, but it is rarely taught or required during pre-doctoral training. The selection criteria for gaining acceptance into dental school need to include the assessment of the potential predoctoral student’s aptitude to navigate a curriculum that requires independent evaluation of information in the literature.

It is a great challenge for one dental institution to sustain all the expertise necessary to answer the demands of a broadly based dental education. This also is a costly undertaking, as dental schools need to compete with the financial rewards of private practice (especially among dental specialists). They also must invest continuously in newer and better equipment and tools (such as simulation labs oratories) and give students wide-ranging experiences (exposing them to many different types of implant systems, for instance).

What is lacking is an emphasis on giving students the tools and skills that will enable them to assess and apply new knowledge independently.

Thanks to today’s technology, it is possible to share educational material and to participate in lectures and labs conducted at other institutions. Sharing of faculty members also is uncommon, but it could be accomplished. Doing so may require some state dental boards to change certain regulations to allow freer movement of dental faculty members between educational institutions and to enable recruitment of oral health care professionals from outside the United States.

Postdoctoral programs are the source of future educators. It would behoove them, therefore, to provide training on how to become an educator and to emphasize the importance and value of a career in dental education. If, however, turning dentists into educators is too difficult a task, perhaps we should start programs that turn educators into dentists.

Dental education must keep abreast of the evolving art and science of dentistry. A new blueprint that offers a flexible curriculum, provides context during all facets and stages of dental education, embraces the value of lifelong learning, and gives students better tools to understand and assimilate new knowledge should be created with input from and partnerships with all communities of interest.

This is a time when we need to embrace innovation and exhibit the courage and wisdom to implement changes that will define our profession for the next decades.