Review of the literature: Predoctoral removable prosthodontics education

Abstract

As the 21st century is approached, changes are occurring that directly relate to removable prosthodontics at the undergraduate level. Edentulism will continue to decline, although the need for complete dentures will diminish slowly because of the replacement needs for the existing edentulous population. In the short- to medium-term future, partial edentulism will increase in the older population at the expense of total edentulism. Therefore, the need for removable partial dentures will increase, but subsequently will decline. In the long-term, tooth loss, regardless of etiology, will be reduced. However, the replacement of lost teeth is unlikely to disappear completely as a needed dental service. 11 With 73% of dental schools reporting inadequate or marginal numbers of complete denture patients, Meskin and Entwistle 52 have identified a shortage of patients needing removable prostheses. On the other hand, 50% of the schools report a surplus of removable partial denture patients. Dental school curriculum time related to prosthodontics has declined significantly over the past 20 years. However, over the past 10 years it has risen slightly. Techniques that are taught in dental schools are frequently not being used in practice. Yet the practitioner's interest in removable prosthodontics as it relates to new techniques and materials remains high according to a 1988 survey of Academy of General Dentistry members. 53 Removable prosthodontics was rated first in regards to continuing education courses desired by its members. There are two basic objectives stated in the prologue of the Council on Dental Education Directive on Accreditation Standards. 54 First, faculties are ultimately responsible for the quality of care rendered to the patient population by students. Second, faculties are responsible for the assurance of clinical and didactic competence. Are dental school graduates competent and how is competence measured? Teaching methodologies that are both effective and efficient must be used. A redistribution of curriculum time may be necessary to accommodate the trends occurring with prosthodontics in the future. Implant dentistry, geriatric dentistry, and maxillofacial prosthetics are some of the subjects that will impact on the present prosthodontic curriculum. It is imperative that organized prosthodontics act rather than react to the changes in dental disease patterns and societal responsibilities.