Dental School Seniors Research Articles

Dentists of tomorrow 2023: An analysis of the results of the ADEA 2023 survey of U.S. Dental School Seniors.

This study examines the journey of U.S. dental schools' predoctoral senior class of 2023, from the influences on and their motivations to pursue careers in dentistry, the aspects of their dental school experiences, plans upon graduation, and the investment in their careers. This study is an analysis of the results of the American Dental Education Association (ADEA) survey of Dental School Seniors, 2023 Graduating Class. Forty-eight percent of senior students from 65 accredited U.S. dental schools in the 2022-2023 academic year responded to the ADEA survey. Whenever feasible, the class of 2023 survey respondents' answers were compared with those of their 2018 counterparts and with the responses of 2023 predoctoral senior students of historically underrepresented race and ethnicity (HURE) groups. The analysis revealed that 47% of the 2023 respondents decided to become a dentist before going to undergraduate college, more than the proportion of their 2018 colleagues (44%). When it comes to preparedness to practice dentistry, the responses indicated a high level of readiness to go into the profession. Ninety percent of respondents agreed and strongly agreed with the preparedness to practice statements indicated in the 2023 ADEA survey. Between 2018 and 2023, the share of survey respondents who planned to join a private practice immediately after graduation increased from 48% to 53%. More than one-third (34%) of the 2023 respondents and 40% of HURE participants who planned to go into private practice immediately upon graduation intended to join a dental service organization (DSO). When accounting for inflation, the average education debt for students graduating with debt who responded to ADEA 2023 survey was 12% lower than what the 2018 respondents reported. This study finds that some preferences changed between the 2018 and 2023 cohorts, the latter being more likely to decide to go to dental school before college and join a DSO private practice upon graduation. Senior students responding to the ADEA 2023 survey stated a high level of preparedness to practice dentistry.

Barriers in Sustainability of Dental Students Choosing Academic Career Path: Comparison between the United States and Japan

The purpose of this study is to investigate barriers experienced by dental students when choosing professional careers. An anonymous online survey with eight questions extracted from the annual American Dental Education Association Survey for U.S. dental school seniors (UDS) and two Japan-specific questions was given to Japanese dental school seniors (JDS) in 2019, 2020, and 2021. The results were compared to UDS data. This study was approved by the Institutional Review Board of Harvard Medical School and included 1053 respondents. The parental education and income levels of JDS were higher than UDS, and educational debt of JDS was lower than UDS. The top reason for choosing dentistry for JDS was influence and expectation from family members, while the top reason for UDS was service to others. Although both groups showed interest in teaching in academia, the majority chose to enter private practice immediately post-graduation, and would consider teaching during their mid or late career. Barriers for dental students staying in academia varied between the two countries. For JDS, the main barrier was an anxiety around stable income. For UDS, it was their educational debt. Dental educators and policymakers need to consider these barriers to improve the sustainability of dental students choosing an academic career path.

Dentists of tomorrow 2022: An analysis of the results of the ADEA 2022 Survey of U.S. Dental School Seniors.

This study examines the journey of US dental schools' predoctoral senior class of 2022, from the influences on and their motivations to pursue careers in dentistry, the aspects of their dental school experiences, plans upon graduation, and the investment in their careers. The study is an analysis of the results of the American Dental Education Association (ADEA) Survey of Dental School Seniors, 2022 Graduating Class. Each year, ADEA surveys senior predoctoral students from the accredited US dental schools. Whenever feasible, the answers of the survey respondents from the 2022 class were compared with their 2017 counterparts and with the responses of 2022 predoctoral senior students of historically underrepresented race and ethnicity groups. The analysis revealed that 47% of the 2022 respondents decided to become a dentist before going to undergraduate college, more than the proportion of their 2017 colleagues (44%). When it comes to preparedness to practice dentistry, the responses indicated a high level of readiness to go into the profession. Nineteen percent of survey participants reported that the COVID-19 pandemic affected their professional plans immediately after graduation. Between 2017 and 2022, the share of survey respondents who planned to join a private practice immediately after graduation increased from 48% to 53%. Almost a third of the 2022 respondents who planned to go into private practice immediately upon graduation intended to join a dental service organization. When accounting for inflation, the average education debt for students graduating with debt who responded to ADEA 2022 survey was 11% lower from what the 2017 respondents reported. This study finds that some preferences changed from the 2017 cohort to the 2022 cohort toward deciding to go to dental school before college and joining a private practice upon graduation. Senior students responding to the ADEA survey in 2022 stated a high level of preparedness to practice dentistry. US dental schools pursued consistently their mission to educate, train, and graduate oral health professionals fully prepared to go into the profession.

Introduction to this special issue.

Introduction to this special issue.

Editorial: Mentors, Mentees, and Mentoring

Daniel S. Budasoff, DDS: In October 2018, the American Dental Education Association (ADEA) published a policy brief from the Office of Policy, Research, and Diversity titled “Our Future Faculty—The Importance of Recruiting Students and Residents to Academic Dentistry.”¹ In this publication, the ADEA states that the dental faculty landscape is undergoing significant change due to the growing lack of educators. The report cites statistics that reflect this ever-shrinking pipeline of faculty: Only 0.4% of dental school seniors plan to teach upon graduation.¹ As the faculty continues to age and retire, recruiting younger candidates is paramount. Attracting students and residents is an even greater challenge today due to rising tuition and mounting student debt, often precluding those who wish to pursue an academic career. Additionally, many institutions tend to hire only fulltime instructors, exacerbating what will become a serious void in available faculty and, ultimately, a societal health problem. Mentoring thrives when the experienced mentor paves the way through sharing their lessons and knowledge learned through academics and life experience. We all claim to have had the best mentors; the mere gift of having had a caring mentor prepares the mentee to face the challenges ahead. It is incumbent on all of us to share our knowledge and experience in order to fill this deepening void. Academia needs our expertise and our commitment of time. This profession has provided us with a livelihood and great joy over our careers—Now is the time to fortify this critical component of our profession by facing its future. Mentorship is a two-way street. The mentor must be willing to give, and, just as important, the mentee must assume the responsibility to be an active participant in this exchange. In my 44 years in dentistry, I have had the honor of being both mentored and sponsored, and to this day I still turn to these individuals for guidance and wisdom. My affiliation with Columbia University reinforces the adage of “If you really want to master something, teach it.” The art of mentoring is an act of continuous learning. As G. V. Black, the father of modern dentistry, once said, “The professional person has no right to be other than a continuous student.”² Daniel S. Budasoff, DDS New York, New York, USA

Dentists of tomorrow 2020: An analysis of the results of the 2020 ADEA Survey of U.S. Dental School Seniors.

This study examines the journey of U.S. dental schools' predoctoral senior class of 2020, from the influences on and their motivations to pursue careers in dentistry, aspects of their dental school experiences, to plans upon graduation and the investment in their careers. The study is an analysis of the results of the ADEA Survey of Dental School Seniors, 2020 Graduating Class. Each year, ADEA surveys senior predoctoral students from the accredited U.S. dental schools. Whenever feasible, the answers of the survey respondents from the 2020 class were compared with their 2015 counterparts. The analysis revealed that 46% of the 2020 respondents decided to become a dentist before going to undergraduate college, more than the proportion of those deciding while in college (42%). When it comes to preparedness to practice dentistry, the responses indicated a high level of readiness to go into the profession. Seventy-seven percent of survey participants reported the COVID-19 pandemic did not affect their plans after graduation. Between 2015 and 2020, the share of survey respondents who planned to go into advanced dental education immediately after graduation increased from 35% to 40%. Almost a third of the 2020 respondents who planned to go into private practice immediately upon graduation intended to join a Dental Service Organization (DSO). Grants and scholarships represented a higher share of the average funding for dental education for the 2020 respondents than five years ago. The share of respondents expecting to graduate without any loans to finance their dental degrees and predental education (educational debt) increased significantly, from 12% in 2015 to 17% in 2020. This research shows that during these uncertain times, U.S. dental schools continued their mission to train and graduate oral health professionals fully prepared to go into the profession.

Practice management curricular changes may lead to enhanced preparedness for practice.

The 2018 American Dental Education Association Survey of Dental School Seniors showed that 62.5% of graduates felt prepared in practice administration compared to 49.5% in 2013. The aim of this study was to survey and Internet search U.S. Dental Schools' Practice Management curriculum (PMC) to assess if and what changes, made in the past 5 years, may account for the continued increase in dental graduates' perception of preparedness for practice METHODS: An electronic survey was emailed to 64 dental schools querying factors for changes in PMC, updates in instructors, instructional methods, technology, topics, hours, and content enhancements. In addition, if a dual degree in business administration was developed or planned in the future. Twenty-three schools responded for a 36.0% response rate. All participants (100.0%) indicated PMC changes, 73.9% responded that changes were motivated by student interest, and 60.9% planned future PMC improvements. All respondents (100.0%) updated subject matter and 52.2% had added technology, including Web-based business model and simulation courses. Two schools added dual degree MBA programs in 2017 due to student interest in entrepreneurship and administrative goals. The study showed that upgrades in topics and teaching methods with Web-based technology, dual degrees, and additional focus on PMC hours, sequence, and number of practice administration courses in D1 and D2 years may be contributory factors for the development of enhanced skills and enhanced attitudes of graduates for practice readiness. Future study is needed to assess if these PMC improvements and advanced business courses have been successful in practicing dentists' careers.

Development of a Dental School Strategic Plan to Inform Interprofessional Education.

Changes in U.S. health care delivery systems and Commission on Dental Accreditation standards provide impetus for interprofessional education (IPE) and collaborative practice, but roadmaps for engaging dental and dental hygiene faculty to incorporate IPE in a systematic manner are limited. The purpose of this report is to describe the process for creating a strategy and gathering a variety of baseline data to use for determining objectives and metrics and the subsequent development of an IPE strategic plan at the University of North Carolina (UNC) at Chapel Hill Adams School of Dentistry (SOD). SOD IPE committee members included representation from the UNC Schools of Dentistry, Medicine, Pharmacy, and Business. A three-phase framework was developed. Phase 1 (IPE assessment) was an internal environmental scan including a 2017 faculty survey, departmental mapping of IPE activities, comparison of UNC with national results on the IPE component of the American Dental Education Association (ADEA) survey of dental school seniors (2016 graduating class), identification of faculty joint/adjunct appointments at other UNC schools, and a strengths, weaknesses, opportunities, threats (SWOT) analysis. Phase 2 (visioning) consisted of development of IPE mission, vision, and priorities. In Phase 3 (implementation), priorities were developed. Data-gathering led to a strategic plan with three objectives: 1) increase faculty engagement and recognition, 2) develop predoctoral dentistry and dental hygiene IPE curricula, and 3) develop an infrastructure that supports IPE. Specific initiatives and activities, supporting metrics, and estimated costs were developed for each objective. The framework guided a systematic, transparent, and organized process for collecting and monitoring the evidence and directing activities. A three-year strategic plan for IPE was developed in 2017, and implementation is ongoing.

A Long-Term Follow-Up Study of Former Dental School Teaching Assistants: Are They Teaching After Graduation?

There has been growth in teaching opportunities for dental students over the past two decades, but little research on whether these experiences have led to actual positions in academia. The aims of this study were to determine whether former teaching assistants at New York University College of Dentistry continued in dental academia after graduation or intended to teach during their careers and to assess their reasons for or for not teaching. Of the 294 former teaching assistants who taught their peers from 2003 to 2014, 106 responded to a survey, for a response rate of 36%. Of the respondents, 28% reported having teaching appointments, with 7% (n=8) having full-time teaching appointments and 21% (n=22) having part-time teaching appointments in a dental school or hospital-based program at some point after graduation. The most common reasons given for teaching were "intellectual stimulation" and "enjoyment" followed by "interactions with students." The most reported reason for not teaching was "student loan debt," followed by "too busy building private practice," "limited teaching opportunities in area," and "family commitments." Significantly, 95% of these former teaching assistants either taught or intended to teach during their careers, and they were six times less likely to rule out future teaching than dental school seniors in national surveys. These findings suggest that participating in teaching opportunities in dental school plants the seed for future teaching. More follow-up studies should be undertaken to see which types of teaching assistant programs are more successful in creating long-term teaching commitments.

Annual ADEA Survey of Dental School Seniors: 2017 Graduating Class

This report summarizes the key findings of the American Dental Education Association (ADEA) Survey of Dental School Seniors for the graduating class of 2017. The survey covers a wide range of topics related to dental education, including students’ motivation to pursue dentistry, perceived preparation in different subject areas, debt incurred, and career plans. The response rate for the survey was 77.1% and included responses from students at all 65 U.S. dental schools with graduating classes that year. Some of the key findings include a near equal representation of males and females, but a skewed distribution by gender within race/ethnic groups. In general, minority students had a higher ratio of females, while White students had a higher ratio of males. Average educational debt fell slightly at public schools but rose by $40,000 to $287,405 at private schools. The two most common plans following graduation were to work in the private sector and to continue learning at an advanced dental education program. The majority of students planned at some point in their careers to teach and to work with underserved populations. Comparing the experiences and plans of seniors with different characteristics allows school administrators and policymakers to better understand these future dentists’ motivations and challenges.

An Interactive Online Approach to Teaching Evidence-Based Dentistry with Web 2.0 Technology.

At many dental schools, evidence-based dentistry (EBD) is taught in a traditional lecture format. To avoid the constraints of lectures, in 2012 the EBD unit was redesigned for online delivery at the Arthur A. Dugoni School of Dentistry at the University of the Pacific with a Web 2.0 tool called Voicethread. The aim of this study was to assess the impact of Voicethread-based online learning on students' perceptions of learning EBD, their participation and engagement, and their acceptance of this new online delivery approach. Students' perceptions were collected from two sources: a self-assessment quiz and a question on their self-reported preparedness in EBD from the 2014 American Dental Education Association (ADEA) Survey of Dental School Seniors. The Voicethread analytics tool provided data on students' participation and engagement. Students' responses to the survey questions on the self-assessment quiz provided data on their acceptance of Voicethread-based learning. The average score of the 124 students (91% of total) taking the quiz was 7.3 out of 8. The percentage of students who reported in the 2014 ADEA survey that they were "well prepared" in EBD was 45.2%, compared with the national average of 31.2%. Responses to this question for the Classes of 2013 and 2015, who received instruction in the traditional lecture format, were 35.2% and 34.6%, respectively. With Voicethread, students actively participated and interacted with their peers through questions and answers. They perceived Voicethread to be more effective than other delivery approaches and reported that it made learning more active and engaging. These findings suggest that Voicethread may be an effective tool for students to learn EBD since it adds interactivity to online learning.

Trends in Basic Sciences Education in Dental Schools, 1999-2016.

The purpose of this study was to examine data published over the past two decades to identify trends in the basic sciences curriculum in dental education, provide an analysis of those trends, and compare them with trends in the basic sciences curriculum in medical education. Data published from the American Dental Association (ADA) Surveys of Dental Education, American Dental Education Association (ADEA) Surveys of Dental School Seniors, and two additional surveys were examined. In large part, survey data collected focused on the structure, content, and instructional strategies used in dental education: what was taught and how. Great variability was noted in the total clock hours of instruction and the clock hours of basic sciences instruction reported by dental schools. Moreover, the participation of medical schools in the basic sciences education of dental students appears to have decreased dramatically over the past decade. Although modest progress has been made in implementing some of the curriculum changes recommended in the 1995 Institute of Medicine report such as integrated basic and clinical sciences curricula, adoption of active learning methods, and closer engagement with medical and other health professions education programs, educational effectiveness studies needed to generate data to support evidence-based approaches to curriculum reform are lacking. Overall, trends in the basic sciences curriculum in medical education were similar to those for dental education. Potential drivers of curriculum change were identified, as was recent work in other fields that should encourage reconsideration of dentistry's approach to basic sciences education. This article was written as part of the project "Advancing Dental Education in the 21st Century."

Practice ownership is declining

Practice ownership is declining

Annual ADEA Survey of Dental School Seniors: 2015 Graduating Class

This report summarizes and analyzes the results of the American Dental Education Association (ADEA) Survey of Dental School Seniors administered to seniors graduating in 2015. Data were collected from 60 of 61 U.S. dental schools with graduating seniors. The response rate was 83% (4,827 respondents). Where appropriate, results from prior years are included in this report to allow for comparisons over time. The survey asked students a range of questions concerning their motivations for attending dental school, experience while in dental school, educational debt incurred before and during dental school, and plans following graduation. The results provide insight into the future dental workforce and how well students perceive that schools are meeting their needs. Over the past 15 years, educational debt has nearly tripled at public schools and more than doubled at private schools. However, 12.4% of 2015 seniors reported graduating with no educational debt, an increase from 10.7% in 2014. Nearly half of the 2015 seniors planned to enter private practice dentistry (49.3%), and 34.3% planned to enter graduate school/residence/internship. Although very few seniors planned to teach immediately, the majority planned to teach later in their careers. Over half of American Indian/Alaska Native seniors planned to locate in rural areas or small towns, while over half of Black/African American seniors planned to work in mid‐sized cities or the urban fringe. A majority (53.7%) responded that they would definitely or probably work with underserved populations at some point after graduation. Together these, as well as other results from the survey, provide a window into the dental school experience as perceived by the graduating class of 2015.

Helping Dental Students Make Informed Decisions About Private Practice Employment Options in a Changing Landscape

According to the 2014 American Dental Education Association (ADEA) Survey of Dental School Seniors, 45.3% of new graduates planned to enter private practice immediately after graduation; of those, while 65% planned to become an associate dentist in a private practice, 28.3% intended to enter a corporate group practice-the only category that saw an increase over the previous year. Current trends indicate that the number of new graduates choosing to enter some form of private practice without further education will continue to remain high, due in large part to the need to repay educational debt. In light of these trends, the question that must be asked is whether dental schools are optimally preparing students to make informed decisions regarding future employment options in the changing dental practice landscape. This article argues that dental schools should review their curricula to ensure graduates are being prepared for this changing environment and the increased business pressures associated with dental practice. Important considerations in preparing dental students to be successful in the process of selecting a practice model are identified.

Annual ADEA Survey of Dental School Seniors: 2014 Graduating Class

This study presents the results of the annual American Dental Education Association (ADEA) Survey of Dental School Seniors for the graduating class of 2014. Where appropriate, data from past surveys are incorporated to show changes over time. The survey covers a range of topics, including students’ decisions to pursue a dental career, dental school experience, financing of dental education, planned activities after graduation, and perceived preparation to treat underserved groups. The survey response rate was 84% and included respondents from all 58 U.S. dental schools with graduating classes in 2014. The findings characterize who is entering the dental profession, how they will contribute to the dental workforce, and whether schools are meeting the perceived needs of students. Following graduation, these seniors reported primarily planning to enter private practice (45%) or advanced dental education (38%). Of those going into private practice, 65% planned to be an associate at a private dental practice. Nearly 11% had no educational debt, while the remaining respondents averaged $247,227 in total educational debt. Although few seniors intended to teach immediately after graduation, over half planned to teach at some point in the future. Finally, most of these seniors reported that their schools had generally met their perceived needs; agreed or strongly agreed that the time spent on most subject areas was appropriate; and agreed or strongly agreed that their school's curriculum had adequately prepared them to practice in settings with culturally and ethnically diverse patients. Among the demographic findings were that a quarter of the seniors were from lower income families. These students were more likely to have become interested in dentistry as a career prior to undergraduate studies than did the higher income students. These and other results from the survey provide a look into the experiences and perceptions of new dental professionals.

Annual ADEA Survey of Dental School Seniors: 2013 Graduating Class

The annual American Dental Education Association (ADEA) Survey of Dental School Seniors is conducted by ADEA to collect information on selected characteristics and opinions of seniors graduating from U.S. dental schools. The survey seeks information across a wide range of areas, including the

Educational debt and intended employment choice among dental school seniors

The authors examined the association between educational debt and dental school seniors' intended activity after graduation. The authors used multinomial logit regression analysis to estimate the relationship between dental educational debt and intended activity after graduation, controlling for potentially confounding variables. They used data from the 2004 through 2011 ADEA (American Dental Education Association) Survey of Dental School Seniors. Fourth-year dental school students with high levels of educational debt were more likely to express an interest in choosing to go into private practice, although the magnitude of this effect was relatively small. For each $10,000 increase in debt, the likelihood of choosing advanced education relative to private practice was 1.5 percent lower (relative risk ratio [RRR], 0.985 [95 percent confidence interval {CI}, 0.978-0.991]). For the same $10,000 increase in debt, the probability of choosing teaching, research and administration was 3.1 percent lower than that for choosing private practice (RRR, 0.969 [95 percent CI, 0.954-0.986]) and was 8.4 percent lower than that for choosing a government service position (RRR, 0.916 [95 percent CI, 0.908-0.924]). Although educational debt was statistically significant for predicting intended activity after graduation, the magnitude of influence of other variables such as sex, race and whether a parent is a dentist was substantially larger. Practical Implications Concerns regarding rising educational debt and its effect on the dental labor market may be misplaced. The characteristics of the dental school student body may be a more accurate predictor of employment choices that dental school seniors are making than are total educational debt levels.

Reforming dental workforce education and practice in the USA

The USA dental education programmes are facing challenges similar to those confronting countries around the globe, particularly amongst the industrialised nations. The purpose of this study was to evaluate the educational programmes of 15 USA dental schools to determine their impact on improving workforce diversity and oral health care access. The study investigates the predictors of public service plans of dental school seniors in Pipeline and non-Pipeline Program dental schools. We analysed baseline and post-intervention data collected in the American Dental Education Association (ADEA) Annual Survey of Dental School Seniors and a set of contextual variables. Public service plans (dependent variable) was predicted by four types of independent variables: intervention, contextual, community-based dental education (CBDE), and student characteristics. Findings from the study show that access to a state or federally sponsored loan repayment program was the most significant predictor of public service plans and that increasing educational debt was the most significant barrier. In the short-term we may be able to sustain the USA loan repayment programs to motivate senior dental students to provide public service to address the oral health care access crisis. However, in the long-term, a new workforce development initiative will be required to transform dental education and practice, modelled after the well-respected licensure programmes for Physician Assistants and/or Advanced Practice Registered Nurses, to expand oral health care access, particularly amongst vulnerable population subgroups, such as low-income children and families.

Altruism in Dental Students

Altruistic dentists play a central role in treating minority populations, the poor, the uninsured, and those living in underserved communities. This study examines factors associated with graduating dental students' altruistic attitudes. We use a nationally representative dataset, the 2007 American Dental Education Association Survey of Dental School Seniors (n=3,841), and a comprehensive framework to investigate individual, school, and community characteristics that may influence altruism. Student characteristics were the most significant predictors: women, African Americans, Hispanics, Asian/Pacific Islanders, and students with low socioeconomic status expressed greater altruism than their counterparts. These results inform dental educators and administrators to expand efforts to recruit underrepresented racial/ethnic and low-income students into dentistry. Additionally, we found that students with altruistic personalities attend schools where the social context is more accepting and respectful of diversity. This suggests that schools can promote altruism in their students by creating a positive culture and environment for diverse populations.