Supplementing Dental Student Education

Abstract

The Journal of Oral and Maxillofacial Surgery (JOMS) has 12 issues each year. In addition, the Journal publishes supplements. Over the years, supplements have been focused on a particular broad topic such as the Parameters of Care or specific clinical topics such as implant dentistry or bisphosphonates. Supplements also have been devoted to reporting the proceedings of conferences such as the annual supplement covering posters and oral abstracts presented at the annual meeting or special conferences such as the 2010 multidisciplinary third molar conference. American Association of Oral and Maxillofacial Surgeons (AAOMS) members and other subscribers receive JOMS supplements as part of the subscription. However, for the first time a supplement will not be distributed to subscribers; rather, a supplement has been designed for and is being distributed to nonsubscribers. These nonsubscribers are not oral-maxillofacial surgeons; they are not even dentists. So what individuals comprise this select group? Well, they are the future of our profession, namely dental students. What on earth were the JOMS and the AAOMS thinking when it was decided to create a JOMS supplement issue for dental students? The reasoning primarily relates to current realities in the curriculums of most US dental schools. The typical curriculum of dental schools begins with basic courses in human anatomy, development, physiology, and disease, as well as more specific dentally focused courses in oral anatomy, histology, tooth morphology, and occlusion. Faculty in pediatric dentistry and orthodontics usually conducts oral and cranial development courses, while endodontics focuses on pulpal biology. Early in the curriculum it is also common for courses to be provided in periodontal physiology and disease, and those continue for several terms. These courses are taught by periodontists. When does oral-maxillofacial surgery (OMS) enter the dental student's life? This usually does not begin until well into the second year of their education, if even that early. Certainly some schools include oral-maxillofacial surgeons in basic science courses for clinical correlations, but our role as surgeons is not emphasized in these courses. The next time OMS faculty usually appears in the curriculum is to teach local anesthesia and, sometimes, the management of the medically compromised patients and medical emergencies in the dental setting. Again, our surgical skills are not the focus of the material being presented. Although there are undoubtedly exceptions, oral surgery as a discipline does not appear in the curriculum until well into the second year, and more advanced topics in OMS may not be included in the curriculum until the final 2 years of 4-year curriculums. Therefore, although OMS faculty play a vital role in the preclinical didactic curriculum in dental schools, the total number of curriculum hours devoted to oral surgery is small, particularly in comparison to curriculum hours devoted to periodontology.1Survey of Dental Education Report 4: Curriculum from the 2010-11. Available from http://www.ada.org/en/science-research/health-policy-institute/data-center/dental-education. Accessed June 5, 2015.Google Scholar Sizable numbers of curriculum hours are also allocated to endodontology and prosthodontics. Most dental schools have curriculum committees that help determine the courses required to produce a competent general dentist. These committees also usually guide the number of curricular hours allocated to the various topics and sequencing. Thus, the positioning of oral surgery didactic and preclinical laboratory courses is usually not up to OMS faculty to determine. But placing oral surgery relatively late in the didactic curriculum results in dental students not being exposed to our role as surgeons until they are almost half done with their education. Meanwhile, in most schools, our colleagues in periodontology have had abundant time with the students. This continues into the clinical portion of dental school education, where in most schools periodontology plays a major role in clinical teaching and patient care. This gives that discipline a sizable platform to expose the role of periodontists as surgeons. An additional factor, beyond curriculum dynamics, is at play as well in dental education. In many schools the OMS faculty has substantial time commitments to residency education that often occur outside of the dental school in teaching hospitals. This pulls those faculty members away from being available to help teach dental students. This dilemma is difficult to resolve because most schools are unwilling to devote the resources needed to staff dental school clinics with oral-maxillofacial surgeons dedicated to dental student education on a full-time basis. Also, even the rare schools with the needed resources have difficulty finding surgeons willing to staff school clinics. So, what does this all have to do with a JOMS supplement being provided to dental students? The idea was that the JOMS could serve as a vehicle to help expose dental students to our role as surgeons and do so earlier in their curriculum. The supplement focuses on 2 topics: the supplement has a section on oral suturing and a section on the diagnostic evaluation of suspicious oral soft tissue lesions including biopsying. These are 2 topics squarely in the domain of oral surgery. The supplement is designed as a manual. Therefore, it is heavily illustrated providing details about sutures used for routine oral surgery and step-by-step guidance on common suturing techniques. The oral lesions section discusses the steps in evaluating oral soft tissue lesions, and then illustrates and discusses routine biopsy techniques and the management of biopsy specimens. AAOMS leadership will direct the distribution of this special dental student supplement to get it into the hands of dental students early in their dental education. It is envisioned that students will be thankful to have a manual they can use during preclinical courses and refer back to when preparing to treat patients. The suturing manual supplement makes it clear in its introduction and at other sites that the manual is designed to augment and complement the dental school faculty and is not designed to teach any aspect of oral surgery without expert faculty guidance. The AAOMS has a long tradition of interest in promoting excellence in dental school education. It is also dedicated to helping dental school faculty in their challenging task of preparing dental students become excellent general practitioners and making them aware of the important role oral-maxillofacial surgeons have in providing expert specialty care for their patients. The JOMS dental student suturing supplement will be made available on the AAOMS website and further distributions of hard copies of the manual are planned in coming years. The presence of the manual on the AAOMS website will help draw attention to the association and its many offerings and services. Although the regular readership of the JOMS is unlikely to see a hard copy of this special supplement because hard copies will be distributed only to dental students and their faculty, once you see the supplement online, hopefully you will appreciate this initiative to help promote our role as surgeons and help improve the education of today's dental students and our future dental colleagues.