Dental schools need to change their curriculum



DENTAL schools in Australia need to adjust their curriculum to better deal with tooth challenges for an ageing population, research says.

The University of Western Australia-led study says while experts have promoted addressing geriatrics within dental training since the 1970s, little has been done to put recommendations into practice.

“It is predicted that more than 25 per cent of the population in developed countries will be over the age of 65 by 2020,” School of Dentistry Professor Linda Slack-Smith says.

“The ageing of the population and increasing retention of teeth, often with complex restorations, is expected to increase the demand for dental care in older people.”

Knowing the unique dental-health issues of the elderly is vital.

Geriatric dentists are trained to recognise symptoms that present in the teeth and gums relating to general health issues.

They’re also skilled in working with dentures, which may have to be adjusted regularly due to changes in the jaw relating to the absence of teeth.

Poorly fitted dentures can lead to discomfort, loss of appetite and poor nutrition.

“For older people, oral health issues can be a combination of effects of exposures over a life time, including sugar, smoking, alcohol, and the accumulation of dental problems,” Prof Slack-Smith says.

Medication impacts on oral health

“Also, as the population ages, more people are taking medicines, which impact on oral health, often through decreasing saliva flow and quality.

“All of these distinct issues have to be considered in training.”

However, geriatric dentistry is not a dental specialty in Australia, with a limited number of qualified dental specialists able to meet expanding patient needs.

According to research 14.3 per cent of graduating dental students consider themselves well prepared to provide geriatric oral health care.

This is partly due to only a handful of courses offering placements in aged care facilities, which aren’t mandatory.

In the US, Canada and Europe most dental schools have aspects of geriatric dentistry integrated into their curricula.

Prof Slack-Smith says while the Federal Government has recognised the need to address new challenges facing an ageing population, including through the Living Longer Living Better program, this has not translated into funding support in dental training.

“It is time for academics, geriatric dental professional and policy makers to advocate for a world where social justice is valued, and promote geriatric dentistry education,” Dr Slack-Smith says.

Notes: The study involved UWA, Charles Sturt University and The University of Sydney.

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  1. The late, great Pat Shanahan was 50 years ahead of his time. May his vision of training and dental care for the aged, at long last, come to fruition

  2. If the government isn’t going to provide resources to support aged care why would it be a good idea to offer a specialty to students when the only real difference with aged care is increased focus on community care and oral hygiene (which auxillaries such as OHTs can provide). Dental schools already provide training in removable prosthetics and treat elderly patients with xerostomia, periodontal disease and polypharmacy.

    Dental universities today are struggling to provide the standard curriculum with so many new dental schools and retiring staff members the talent pool is becoming increasingly diluted.

    Our university is reverting to hiring new grads and grads who are a year or two out to train us in clinic as supervisors. We’ve lost one oral surgery professor, the undergraduate pros lecturer, two pros professors (although one is apparently returning) within the past 6 months.

    Even with a full staff the burgoning number of students has required more and more tutors with less discrimination of who is chosen. Even with a full staff of academics much of the course material we are provided with is “borrowed” and altered from established universities who publish their lecture notes freely for others to use.

    The Australian published an article last year about the concern of a lack of teaching expertise saying 6 of the country’s 10 dental schools were looking for a new head of school.

    The way our school has approached this problem is largely governed by the decisions of a delusional finance department who believes it is necessary to extract the most money out of their students for the least capital outlay, they want the prestige of having a dental school but don’t want to cover the losses of running one properly.

    Until dental schools reduce student numbers, focus on their core purpose of teaching and learning and create fair, standardised assessment practices the quality of graduates will continue to fall regardless of what topics are added to the curriculum.

  3. Dear ‘concerned student’- I am hearing you. At my University the majority of supervisors are overseas graduates with little or no Australian or University teaching experience- they have panicked and, in the process made some very ill-thought out decisions for a short term solution. The students are trained only in ‘socialized dentistry’ and, with only a remote chance of getting Govt. jobs, this makes no sense. With a saturated job market it is sad that the very Universities that are graduating large numbers of dentists exacerbate the problem by employing lots of foreign graduates who are not equipped to teach as they know they are unlikely to get employment in the private sector. Those that can do ,do and those who can’t teach! Dentistry as a career- I think not! Don’t hold your breath waiting for a curriculum change..

  4. There is a dental Specialty which trains dentists at Specialist level in Geriatric Dentistry. This is the Specialty of Special. Needs Dentistry.
    Greater support for Universities to train students ,and for students to enter postgraduate training programs in Special Needs Dentistry would be beneficial but to say that we don’t have a specialty which trains in Geriatric Dentistry is incorrect.

  5. Yes indeed . Pat Shannahan was an example of dedication and well grounded research, and an advocate for the ageing.
    It is indeed a concern to see the approaches we have been driven to take in response to government funding cuts, natural “attrition” as experienced academics and clinicians retire, with diminishing time to put in place a succession plan.
    As a society we are disinclined to invest in the short term pain for long term gain..
    However on a positive note there are groups e.g. ASSCID who are working together to educate and support Special Needs in Dentistry which is much larger than just working in Aging… We need to become global thinkers and look more deeply at what we have and how we can work as a unified profession to support each other.


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