RPD teaching in the UK and Ireland

Key Points

• Enables readers to appreciate that while dental educational programmes in removable partial dentures are of high quality, there are areas of concern.

• Allows appreciation of the fact that ensuring student competence in removable prosthodontics is a challenging task.

• Gives an understanding of why it is necessary to further develop dental education programmes in removable partial denture prosthodontics to ensure that graduating dental students are best prepared for independent clinical practice.

Abstract

Aim

The aim of this paper is to investigate methods employed for teaching removable partial dentures in dental schools in Ireland and the United Kingdom.

Materials and methods

A questionnaire was distributed by email in May 2005 to each of the 15 dental schools with undergraduate dental degree programmes in Ireland and the UK. The questionnaire sought information relating to the preclinical and clinical teaching of removable partial dentures (both acrylic and cobalt-chromium based dentures).

Results

Eleven completed questionnaires were returned. The average duration of a preclinical course in removable partial dentures was 67 hours (range = 24-200 hours). This course was directed by a senior clinical academic alone in eight schools, by a senior clinical academic in collaboration with a dental technician in two schools, and solely by a dental instructor technician in one school. The median number of cobalt-chromium and acrylic removable partial dentures provided by undergraduate dental students was 3 (range = 2-5) and 2 (range = 0-3), respectively. Four schools reported that their patient pool is not entirely satisfactory for clinical teaching of undergraduate dental students.

Conclusion

Variations were noted between dental schools in both the amount and content of teaching programmes. Experience gained by undergraduate students in dental schools is limited, and appears to be hampered by limited access to patients suitable for undergraduate teaching.

Main

The teaching of removable partial dentures in Ireland and the United Kingdom C. D.Lynch and P. F.Allen British Dental Journal 2007; 203: E17

Editor's summary

This paper is the latest in a number of articles by these authors, who have been investigating the design and prescription of removable partial dentures (RPDs) in the UK and Ireland for some time. Their previous work has highlighted problems in this area and has suggested that educational factors may be a significant part of the problem. In this paper, they follow up this finding by investigating teaching methods for RPDs in dental schools in the UK and Ireland.

The results are revealing and show significant variations in the amount of teaching on RPDs between different dental schools and also in the content of the programmes taught. For example, the duration of preclinical teaching in RPDs ranged from 24 to 200 hours, with preclinical teaching in design and prescription of RPDs taking up as little as two hours in some schools. Given that such variations in teaching exist, the authors' previous findings are perhaps unsurprising.

The authors point out, and it is important to note, that all dental schools make efforts to try to ensure that their undergraduates are prepared as best as possible for future independent practice, and that the variations they have found are a reflection of the pressures on dental education today. However, two hours of teaching in RPD prescription and design is obviously unacceptable and the fact that undergraduates at one school did not routinely use a surveyor for RPD design is, as the authors say, bordering on negligence.

This paper should be a wake-up call to all involved in dental education: more must be done to ensure that dental students qualify fully prepared to meet the needs of their patients, whatever those needs may be.

The full paper can be accessed from the BDJ website ( http://www.bdj.co.uk ), under 'Research' in the table of contents for Volume 203 issue 8.

Rowena Milan, Journal Editor

Author questions and answers

1. Why did you undertake this research?

The authors undertook this work in an effort to establish the current situation in relation to teaching of removable partial dentures in Ireland and the UK. The last study of this kind was completed almost 30 years ago. Previous studies by the authors have demonstrated a high prevalence of failure on the part of general dental practitioners to comply with clinical guidelines in relation to prescription of RPDs. The authors have previously demonstrated that this 'under-performance' is related to a lack of confidence amongst practitioners, most likely related to their educational experiences. This seems to be borne out by the results of this study, which demonstrate that while dental educators strive to provide high-quality educational programmes, some areas of concern were noted.

2. What would you like to do next in this area to follow on from this work?

The next stages of this work are two-fold: 1) further elucidation and investigation of the attitudes and confidence of general dental practitioners when prescribing and designing removable partial dentures; 2) investigating the effectiveness of various methods to improve the confidence of general practitioners in this area.

Comment

The majority of clinical training time in undergraduate dental courses in the UK and Ireland is contained within the discipline of restorative dentistry, as this reflects the majority of treatment carried out in general dental practice. The General Dental Council (GDC) has identified seven competencies within restorative dentistry which dental graduates should possess on graduation; two of these relate to competence at completing a range of clinical procedures, included in which are complete and partial dentures, plus competence at completing a range of procedures including partial and complete dentures. Clearly, and with regard to removable partial dentures (RPDs), dental schools are required to educate their students to attain acceptable levels of clinical and prescriptive skills to satisfy GDC expectations.

This study by Lynch and Allen reports on a questionnaire sent to 15 (undergraduate) dental schools in Ireland and the UK. Eleven centres replied, but the results of the questionnaire are of great importance as they raise concerns over the teaching of RPDs. These results demonstrate significant variations in the duration of courses (ranges 24 to 200 hours) and the staff:student ratios (range from 1:8 to 1:22).

All parties interested in dental education ought to be concerned at the results of this research as they reflect current pressures on the diminishing numbers of teachers of restorative dentistry in Ireland and the UK.