UK Dental Schools Research Articles

“You really shouldn’t be here”: using social identity theory to explore under-represented ethnic minority (UREM) students experiences of belonging in a UK dental school

There is tacit acknowledgment that the psycho-social and educational challenges experienced by under-represented ethnic minorities in medical school are likely to be similar to those experienced by ethnic minorities in dental school. However, dental scholarship is not as expansive or comprehensive by comparison to confirm if this is the case. This paper addresses this research gap by presenting the findings of a small-scale exploratory study into the experiences of nine dental undergraduates from a variety of ethnic backgrounds studying at one UK dental school. A social identity theoretical framework was applied to the analysis of semi-structured interview data. The study reveals that dental school is a racialised educational space, where whiteness and white privilege are the norm and students from ethnic minority backgrounds occupy ‘out-group’ status through a process of depersonalisation and stereotyping. Their experiences reveal the existence of a climate of everyday racism perpetuated by students and faculty alike. This research calls on dental schools, and the dental profession more generally to address the lack of inclusivity as a pressing concern requiring immediate action.

Exposure to and awareness of oral and maxillofacial surgery for first degree dental undergraduates in the United Kingdom

Evidence shows that the majority of OMFS trainees undertook dentistry as their first degree, however, an increasing number of undergraduates undertaking OMFS training have completed medicine first. It is vital that all undergraduates wanting to commit to another degree have adequate exposure to, and understanding of, the specialty. The aim of our study was to evaluate the perspectives of final-year dental students concerning their exposure to, and perceptions of, OMFS during their undergraduate teaching. This is a cross-sectional cohort study that used an online survey to collect data. All final-year dental students at a UK dental school who will graduate in 2024 were included. Regarding the exposure to OMFS, 122 (71.8%) respondents reported that they had been offered OMFS-related clinical placements from their respective dental schools, while 48 (28.2%) had not. Of the 122 who reported receiving placements, the placement lasted a mean of 3.78 days. Participants were then asked if they thought they had adequate experience and information to make an informed choice regarding OMFS as a career, to which 70 (41.2%) responded that they did have that knowledge and experience whilst 100 (58.8%) responded that they did not. Our study overall shows a better understanding of the scope of oral and maxillofacial surgery amongst final-year dental students in the UK compared with their medical student counterparts from previous literature. However, our results reflect areas in which knowledge, exposure to, and perception of, OMFS can be improved amongst dental undergraduates.

Are we practising what we preach and are we all singing from the same hymn sheet? An exploration of teaching in paediatric caries management across UK dental schools.

The evidence underpinning caries management for children has progressed dramatically over the past 20 years. Anecdotally, this is not reflected in the teaching provided to undergraduate dental students, with the ongoing teaching of outdated methods within some dental schools. To capture the current undergraduate teaching provision and clinical treatment experience requirement relative to caries management in paediatric dentistry in UK dental schools. Cross-sectional analysis of current teaching methods on paediatric caries management was obtained using a piloted online data collection form. Question content included current caries teaching methods, assessment of student exposure and competence. The results were analysed descriptively. Of the 16 UK dental schools, 14 participated. Discrepancy in teaching content was apparent. Many schools (n = 9) taught biological caries management through therapeutic fissure sealants, yet this was not reflected in assessment and clinical requirements. Some schools (n = 4) taught amalgam placement in children, and most (n = 12) operatively taught treatments that would no longer be routinely provided in general dental practice in the UK, including primary tooth pulpotomy. There is substantial variation in the paediatric caries management techniques that are taught across UK dental schools, demonstrating a need for a national consensus to address these disparities.

Environmental sustainability: the attitudes and experiences of UK students in the oral health care profession.

Objective This study aims to provide insight into the attitudes and perspectives of undergraduate dental students from UK dental schools regarding environmental sustainability in dentistry (ESD) and the manner and extent in which ESD is included in the current undergraduate oral health care curricula.Methods This study is a multi-centre, nationally representive study involving a cross-sectional online survey of undergraduate Bachelor of Dental Surgery and dental hygiene and therapy students in UK-based dental schools. Data analysis was conducted through descriptive statistics and thematic analysis.Results In total, 263 students from 13 UK schools completed the survey, resulting in a national school response rate of 68.4%. Key findings are: 97.3% of students believe that the dental profession should be more actively engaged in environmental sustainability but students currently have very little exposure to ESD at an undergraduate level; and 76.8% of students expressed that they are concerned about the impact that oral health care provision has on the environment, but only 23% of students have independently researched ESD.Conclusions Students identify that oral health care professionals should become more engaged in efforts to mitigate the negative impacts from our activities on the environment, principally via education at all levels. The data from this study provide insight into the current level of awareness and concerns for the environmental impacts of oral health care provision, and are a powerful driver for the inclusion of ESD into the undergraduate curriculum in UK based dental schools.

New dental graduates transition into UK professional practice; a longitudinal study of changes in perceptions and behaviours through the lens of evidence-based dentistry

BackgroundThis longitudinal study using qualitative methodology aims to investigate the perceptions, and implementation, of evidence-based guidelines into practice among new dental graduates (NDGs) during their transition from university into professional practice, by identifying factors that influence the adoption of evidence-based practice (EBP) in dental practice.MethodsThe study invited NDGs from one UK dental school (N = 66) and employed longitudinal, multiple qualitative methodologies for data collection, throughout the participants’ Vocational Dental Training (VDT) year. Initial interviews (Interview 1) conducted upon graduation and follow-up interviews (Interview 2) carried out between six and nine months into professional practice were combined with participants longitudinal audio diaries (LADs) recorded between the interviews. The study.ResultsA total of 12 NDGs agreed to participate. For Interview 1, twelve participants were interviewed, seven of whom agreed to participate in Interview 2 and six recorded the LADs. Interview 1 exposed diverse views among NDGs about EBP, acknowledging its significance but facing obstacles in implementation due to time and financial constraints. They intended to use evidence selectively, often aligning with trainers’ or NHS treatment options, while hesitating to fully embrace EBP in a busy dental practice. During VDT, LAD entries showed initial enthusiasm for EBP, but integrating evidence-based guidelines within the NHS system led to pragmatic treatment decisions, balancing gold-standard and cost-effective options. Over time, NDGs became more comfortable with alternative treatments, considering patients’ financial constraints, yet they expressed frustration with external pressures limiting their clinical decision-making autonomy. In Interview 2, after six to nine months in practice, NDGs exhibited mixed attitudes towards EBP. Some actively used dental guidelines like SDCEP, others associated EBP with hi-tech or expensive materials, while others would thought to rely on colleagues’ recommendations. None consistently sought direct evidence for treatment decisions.ConclusionNDGs’ attitudes towards EBP changed and became more negative over their first year in professional practice, leading to challenges in their applying it. It questions the assumption that teaching EBP during undergraduate education ensures its implementation. Further understanding the influences on the development of attitudinal challenges will help to devise effective strategies for fostering lifelong learning and supporting evidence-based practice in dentistry.

Exploring the declared and the formal and informal taught curricula at a UK dental school through the lens of pulp management.

Introduction This paper explores the declared and formal and informal taught endodontic curriculum within an undergraduate dental programme in the UK as part of a wider study, which also investigates the learned curriculum. Management of the dental pulp was chosen due to the availability of clear internationally recognised guidelines.Method The declared curriculum was identified through existing course guides and seminar and practical session plans. The formal taught curriculum was identified by cataloguing all lectures, practical teaching sessions, seminars and handouts available to dental students. Questionnaires using clinical vignettes were used to explore the informal taught curriculum.Results Valid responses to the questionnaire were received from 25/40 (62.5%) clinical supervisors. Disparities between national guidelines and the declared and taught curriculum were primarily due to broad learning objectives and disparate information from lectures and supervising clinicians. Although the majority of formal teaching aligned with national guidelines, the main deviation occurred within the informal taught curriculum.Conclusion This study highlights disparities between current evidence-based guidelines and the declared and taught curriculum in relation to pulp management in a UK dental school. Recommendations are that all policies, procedures and protocols are updated and aligned to a contemporaneous evidence base annually, plus engagement with clinical lecturers, to enable more standardised teaching.

Molar incisor hypomineralisation: Teaching and assessment across the undergraduate dental curricula in the UK.

No consensus exists on how molar incisor hypomineralisation (MIH) should be covered by the undergraduate dental curricula. To assess the current teaching and assessment of MIH in the UK. A piloted questionnaire regarding the teaching and assessment of MIH was disseminated to paediatric, restorative and orthodontic teaching leads in each UK dental school (n = 16). Data were analysed using descriptive statistics, chi-squared and Kruskal-Wallis tests. Response rates from paediatric, restorative and orthodontic teams were 75% (n = 12), 44% (n = 7) and 54% (n = 8), respectively. Prevention of caries, preformed metal crowns, anterior resin composites and vital bleaching were taught significantly more by paediatric teams (p = .006). Quality of life and resin infiltration were absent from restorative teaching. Orthodontic teaching focussed on the timing of first permanent molar extractions. Paediatric teams were mainly responsible for assessment. Risk factors, differential diagnoses for MIH and defining clinical features were more likely to be assessed by paediatric teams than by others (p = .006). All specialities reported that students were prepared to manage MIH. Molar incisor hypomineralisation is primarily taught and assessed by paediatric teams. No evidence of multidisciplinary or transitional teaching/assessment existed between specialities. Developing robust guidance regarding MIH learning in the UK undergraduate curricula may help improve consistency.

Assessing the assessors: investigating the process of marking essays.

Pressure for accountability, transparency, and consistency of the assessment process is increasing. For assessing complex cognitive achievements, essays are probably the most familiar method, but essay scoring is notoriously unreliable. To address issues of assessment process, accountability, and consistency, this study explores essay marking practice amongst examiners in a UK dental school using a qualitative approach. Think aloud interviews were used to gain insight into how examiners make judgements whilst engaged in marking essays. The issues were multifactorial. These interviews revealed differing interpretations of assessment and corresponding individualised practices which contributed to skewing the outcome when essays were marked. Common to all examiners was the tendency to rank essays rather than adhere to criterion-referencing. Whether examiners mark holistically or analytically, essay marking guides presented a problem to inexperienced examiners, who needed more guidance and seemed reluctant to make definitive judgements. The marking and re-marking of scripts revealed that only 1 of the 9 examiners achieved the same grade category. All examiners awarded different scores corresponding to at least one grade difference; the magnitude of the difference was unrelated to experience examining. This study concludes that in order to improve assessment, there needs to be a shared understanding of standards and of how criteria are to be used for the benefit of staff and students.

Engaging undergraduate medical and dental students with academic medicine: The Aberdeen INSPIRE summer school.

UK medical and dental school curricula limit opportunities for students to gain experience in research. This parallels a decline in the number of clinical academics. To address this at grass roots level, we organised and arranged a residential summer taster week; INSPIRE (Introducing New Skills to Promote Inspirational Research Experience)-Aberdeen). The purpose was to give first and second year medical and dental students who wished to explore a potential clinical academic career a taste of wet laboratory research and to gain experience in basic research skills. Seventeen students from eight different UK medical and dental schools attended this free residential course and were exposed to various laboratory techniques with clinical translation and application in diagnostic and therapeutic medicine. Students were given access to relevant online learning tools of the techniques being used beforehand and seminar style presentations were used to emphasise their clinical application. Students met daily with clinical academics from different specialities to give them a flavour of potential clinical academic career pathways and options. All students felt that the summer school helped them consider academic medicine as a career thus achieving our aim to inspire clinical academics of the future.

Exploring dental academics' perceptions of and experience with discrimination in the UK and Ireland: a qualitative study.

Introduction Diversity is known to be important but diversity of dental school academics in the UK and Ireland is low in comparison with the dental profession and the overall population. The aims were to explore whether UK and Ireland dental school academics are satisfied with their career progression, whether they believe that there are barriers to career progression in dental schools based on protected characteristics, and experience of discrimination at work.Methods An online survey, including four free-text questions related to the study aims, was circulated by the Dental Schools Council to dental academics at all UK and Ireland dental schools. Qualitative content analysis was used to analyse free-text comments.Results and discussion There were 192 responses from 20 dental schools. Five data categories were constructed which highlight the impact of discrimination in dental academia, the importance of opportunities and support, different perspectives of diversity and discrimination, and academic and institutional culture.Conclusion Staff perceived and experienced barriers to career progression. Many were satisfied with their career progression, but a proportion of staff expressed dissatisfaction and attributed this to discrimination based upon protected characteristics. The culture in dental schools is beginning to change to address factors contributing to inequality in dental academia.

Patient Safety Education in the Undergraduate Dental Curriculum: Evidence Base and Current Practice in UK Dental Schools.

International consensus advises patient safety education (PSE) for dental undergraduates. A previous systematic review found no articles describing PSE in dentistry. This article aimed to review the evidence base for, and the current practice of, PSE in UK dental schools. Literature search and surveys were sent via email to all 16 UK dental schools. Six articles describing PSE interventions were found: 2 small-scale studies for dental students and 4 interprofessional studies. Patient safety education is effective for undergraduate dental students with significant improvement in knowledge and interest. Interprofessional studies reported improved teamwork skills and more positive attitudes toward interprofessional working.The 2018 and 2021 surveys had response rates of 56% and 100%, respectively. An increase in integrated formal PSE and assessment in UK dental schools is demonstrated. No barriers to implementation were reported. Forty-six percent of schools deliver interprofessional PSE, 38% deliver human factors, 81% teach communication, 94% teach professionalism, and 31% of schools have a patient safety (PS) champion. Limited published literature on PSE in dentistry is available. However, the lack of published articles does not mean that PS is not being taught, as many UK dental schools were found to have formal PSE integrated and assessed within their curriculum. Further development is needed in terms of appointing PS champions for leadership and human factors training. Patient safety must form a part of an undergraduate student's core values.

Dental students' clinical and academic experience during placement in a UK tertiary care children's hospital.

There are well-recognized difficulties across UK dental schools in recruiting paediatric patients who are willing to attend, have manageable dental disease, and do not require the behaviour management skills of an experienced dentist. This presents a concern for the skill development of the future workforce. At the School of Dentistry in Liverpool, the challenge to enable students to develop these core skills is supported by attendance at a tertiary care children's hospital. The present study investigates whether attendance of final-year dental students at a children's hospital affects perceptions of their surgical experience, self-reported preparation for working independently as a dentist, and understanding of specialist care. A self-administered online survey was distributed to final-year dental students (2020-2021). Quantitative and qualitative data were gathered using mixed item formats for descriptive analysis. Questions addressed themes including experience of primary tooth exodontia, understanding of general anaesthetic dental care and multidisciplinary patient management. The response rate was 90% (n = 66). Attendance was beneficial to student learning and experience; responders reported increased surgical experience, self-confidence and understanding of multidisciplinary care. Students developed insight into future career pathways. The present study supports the use of external clinic rotations, known as outreach placements, for dental student training. The findings support existing literature demonstrating the value of outreach placements in providing an experience not available in dental school environments. Dental students' perceptions of their surgical experience, knowledge of specialist care, and preparedness for independent practice may be enhanced by attendance to outreach placements.

Demographic disparities in dental school selection: An analysis of current UK practices.

Specific social groups remain under-represented within dentistry. While the University Clinical Aptitude Test (UCAT) aims to widen participation in under-represented social groups, there is no evidence in dental education that this aim is being met. Data over two admission cycles (2012 and 2013), including 3246 applicants to 10 UK dental schools, were analysed. Applicant and selected pools were compared to the UK population. Multiple logistic regression was used to investigate the association between demographic variables and UCAT and receiving an offer of a place at dental school. Over-representation of Female, Asian, least deprived and grammar school groups were found in applicant and selected pools compared with the UK population. White ethnic applicants were significantly more selected than Black (OR 0.25), Asian (OR 0.57) and Mixed (OR 0.80) ethnicities, while least deprived applicants were significantly more selected than most deprived (OR 0.59). Grammar school education increased odds of selection by 1.8 when compared to state school. The addition of UCAT to the model for applicants reduced ethnic disparities but led to disparities between other groups. Current widening participation practices focus on attracting applicants from lower socio-economic groups. However, this study showed that ethnicity, sex and educational background biases also affect demographic diversity in dentistry. The UCAT shows promise in levelling the playing field; however, widening access measures will only succeed if selection committees radically change selection processes to address the systemic biases, enabling the dentists of tomorrow to represent the society they serve.

Should suicide risk assessment be embedded in undergraduate dental curricula?

Aims and objectives The aim of this Plan-Do-Study-Act cycle was to establish if undergraduate students believe they have a role to play in suicide risk assessment, and to discuss the implementation of suicide risk prevention into the undergraduate dental curriculum. Data gathered informed development of a subsequent suicide risk assessment educational workshop.Methodology An online questionnaire was disseminated to undergraduate students as part of a quality improvement service evaluation within a UK dental hospital and school. This sought to gain information on attitudes to suicide prevention, previous suicide awareness training, and the appetite and potential barriers to future training.Results A response rate of 23% (n = 30) was achieved. In total, 87% of undergraduate students responding reported having no experience or training in the identification of suicidal patients, 97% of respondents expressed a desire for training, and 80% stated not knowing what to do if a patient disclosed suicidal thoughts during an appointment.Conclusion The dental team have a role to play in suicide risk assessment and the signposting of at-risk patients to appropriate services. To embed this within daily practice, awareness and training must be introduced to undergraduate curricula.

Widening Access: what do dental school websites signal to prospective students?

Introduction Widening Access (WA) policies aim to ensure that a professional workforce reflects the community that it serves by facilitating the admission of applicants from under-represented demographics. WA has not been extensively studied in UK dental education. Website discourses are an important element in students' higher education choices and have the potential to engage those who might be under-represented.Methods Critical discourse analysis was used to investigate contents of the 16 UK dental school webpages in relation to WA, based on a previous study within medical education. Data were contextualised through identification of drivers and levers, as well as warrants of WA.Results Discourses emphasising social mobility, and the resultant advancement within social hierarchy of an individual, dominated the narrative rationalising WA as an initiative. WA was depicted as a mechanism to support applicants of high academic ability and exhibiting commitment to studying dentistry but who were unable to show their true potential due to their underprivileged backgrounds. This presentation portrayed dental schools as generous establishments, selectively granting career-advancement opportunities to disadvantaged students. Discourses on the benefits of WA for patient care and workforce diversification were largely absent.Conclusions Discourses representing WA on websites of UK dental schools are limited and do not portray applicants from deprived backgrounds or under-represented groups as individuals bringing unique positive benefits to dentistry and patient care. We encourage dental schools to consider alternate messages for attracting applicants from under-represented demographics.

Developing the Teaching Skills of Part-Time Dental Educators

Background: Well-conducted peer observation of teaching (POT) can be an effective tool in enhancing teaching quality and educator development in healthcare teaching including dentistry. Experience suggests that its effectiveness depends on the environment in which it is undertaken. A previous study investigated engagement with POT by a dental school faculty in the UK and identified barriers to its routine use for educator development. These barriers are particularly problematic for part-time educators who play an increasingly significant, but frequently underestimated role, in undergraduate dental teaching, complementing the teaching of full-time clinical academics. Owing to the part-time nature of their roles, opportunities for their teaching development are limited. This can lead to dissatisfaction and a lack of fulfillment, and ultimately their loss from teaching faculty. Aims: This study explores POT’s utility for the development of part-time dental educators’ (PTDEs). Specifically it (i) audited their engagement with POT, (ii) reviewed the design(s) employed, (iii) assessed participant’s perceived value of it and (iv) explored methods to maximize its utility for their teaching development. Method: Teaching roles and experience, current engagement and experience of POT of part-time educators employed in a UK dental school were explored using a mixed methodology survey. Free-text responses were subjected to thematic analysis and emerging themes were subsequently explored iteratively by undertaking observations of seven part-time educators in various dental teaching environments. A developmental POT approach was used to assess utility. Results: Of 44 surveys distributed, 27 (61%) completed surveys were returned. 24 (89%) respondents reported that POT was of some or high value and resulted in enhanced teaching quality. Respondents experienced difficulties undertaking POT annually with only 14 (52%) achieving this. Observer choice emerged as fundamental to its utility. Additionally, the study identified a number of barriers to its effective use.

Mental health and inclusivity support and education in a UK dental school: a cross-sectional survey

Aims To establish the current support and knowledge around mental health and equality, diversity and inclusion at a UK Dental School and make suggestions about improvements.Objectives Conduct a survey of dental undergraduate students at Newcastle Dental School to elicit responsesMethods Bachelor of Dental Surgery and Bachelor of Oral and Dental Health Science students at Newcastle University were invited to participate in this cross-sectional survey via email. Following electronic consent, an electronic questionnaire via an online form builder was distributed via email. Participants were asked questions on experiences and feelings towards wellbeing support, mental health and equality, diversity and inclusion topics, including improvements that could be made.Results In total, 89 students participated. The majority of participants were white, women and heterosexual. Wellbeing support was present and generally accessible. Students were aware of mental health conditions but unsure how to manage them in a clinical setting. Students were generally unaware of barriers to care faced by LGBT+ and racialised minority patients. Students were mainly uncomfortable disclosing personal issues with their personal tutor. Students responded positively to some suggested improvements in support and education surrounding mental health and inclusivity.Conclusion Our study highlighted the areas where Newcastle Dental School continues to provide high levels of support for students but also areas that may require attention through further study and focus groups, with an aim to increase diversity of respondents so that further exploration regarding the intersectionality of identity can be undertaken.

"I think that comes with experience": A thematic analysis exploring how dental students at a transitional stage of training understand and engage with reflection.

Reflection is an important skill for dentists but there is little consensus about how reflection can most usefully be integrated into dental education. The aim of this study was to conduct focus groups to explore how students at a transitional point of dental education in one UK dental school had experienced, and conceptualised reflection. Students at the beginning of their clinical studies were recruited by email and invited to attend a single focus group. Focus groups were co-facilitated by a team of staff and student researchers and analysed using thematic analysis. Students acted as research partners in planning a topic guide, recruiting students, conducting focus groups and considering the implications of research findings for the curriculum, and contributed their perspectives to other aspects of the research. Students primarily associated reflection with their clinical learning and valued the skill highly in this context. They were less familiar with the potential for reflection to support personal development and deeper learning. Themes were identified of learning, uncertainty, emotions and wellbeing, community and challenges and are discussed in detail. Reflection is highly valued within our dental education setting but many students may be missing out on using it to its' full potential. Changes to the undergraduate curriculum, including offering reflection from an early stage of education may be warranted.

NHS funding for dental undergraduate human disease teaching in the UK: a 20-year review

Introduction This study identifies funding of NHS services supporting dental students' teaching over the last 20 years, focusing on human disease (HD) teaching.Aims To identify NHS funding for education in UK dental schools following publication of the 1997 General Dental Council curriculum introducing specific funding for HD teaching and the years 2015/16 to 2019/20.Material and methods Searches of the medical literature, grey literature (government and regulatory authority reports, legislative articles) and freedom of information requests to hospitals helping to deliver teaching.Results There are few publications describing current funding of dental undergraduate teaching. Freedom of information requests gave data for NHS hospital allocations for teaching both clinical dentistry and HD. HD funding has dropped by £2 million in five years.Conclusions NHS Trusts linked to dental schools receive monies to deliver teaching and offset costs of accommodating students. Tracking these funds over 20 years has seen some schools lose up to £1 million of HD funding and some lose it all. Greater transparency regarding funding for HD delivery would help improve teaching. Increasing numbers of older patients, with a greater chronic disease burden who are retaining teeth into later life, need graduating dentists with good medical knowledge to deliver safe care.

Teaching of gerodontology to dental and dental hygiene therapy students in the UK

Introduction The demographic shift in the age profile of the UK is now well established. Older people have more complex requirements to maintain their oral health and appropriate training is required to provide good-quality oral and dental care. This research aimed to review the training in gerodontology currently being provided to undergraduate dental and dental hygiene therapy (DHT) students in the UK.Methods Quantitative data were generated through completion of an online questionnaire, emailed to the directors of dental education in each of the UK dental (n = 16) and DHT schools (n = 21). Data were analysed using IBM SPSS Statistics V26.Results There was a response rate of 37.5% from dental schools and 61.9% from DHT schools. Although gerodontology was being taught in every school that responded, it was only a standalone course in 16.7% of dental schools and 7.7% of DHT schools that responded. While all respondents reported a theoretical component, only 50% of dental schools and 53.8% of DHT schools reported providing clinical experience. Moreover, 33.3% of dental schools and 15.4% of DHT schools reported closely following the European curriculum guidelines in gerodontology.Conclusions The current training in gerodontology is not standardised across either dental or DHT schools in the UK and there seems to be a lack of awareness of the recommended European guidelines. The findings from this research demonstrate that future improvements in gerodontology training are still required for this to be achieved.