“The Graduating European Dentist” specifically stresses the importance of Patient‐Centred Care. This approach is becoming increasingly prominent within the literature and within policy documents and is defined by the Institute of Medicine (2011) as “Providing care that is respectful of and responsive to individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions.”
In addition to treating individual patients, a Dentist must be able to focus on promoting health, monitoring interventions and implementing effective strategies of care at community and population levels. This necessarily involves understanding population demography and health trends, engaging with health policy and promoting health.
A Dentist must also understand population demography and health trends, in the context of the healthcare system, or systems, within which they work.
Recognising that most of dentistry is provided in a primary dental care setting, where Dentists practise as members of teams in healthcare systems, it is vitally important that Dentists:
- take account of the wider context within which they practise
- integrate effectively with society
- advocate for general and oral health, and system change
The undergraduate curriculum should reflect the importance of these principles and provide students with the opportunity to engage outside of dental settings. To understand populations and their health, new graduates must understand demographic changes and trends in oral/general health and society, which have major implications for their future patient base and care provision. Additionally, it is important to be aware of wider contextual influences: social, political, economic and environmental and their influence on populations and the health workforce. Dentists must be capable of promoting the general and oral health of their community, and that of the wider population.
This population health aspect of the dental undergraduate curriculum is often labelled “Community Dental Health,” “Dental Public Health” or “Preventive Dentistry.” This may, in turn, be delivered by a range of dental specialties such as (but not exclusively) Restorative Dentistry, Special Care Dentistry, Periodontics, Endodontics, Prosthodontics, Gerodontology, Paediatric Dentistry, Oral Medicine, Oral Surgery and Orthodontics.
Five competences have been identified by the GED that a graduating european dentsits must demonstrate.
Dental public health is concerned with the strategic aspects of dentistry at individual, community and population levels. It has been defined as “the science and art of preventing oral disease, promoting oral health and the quality of life through the organised efforts and informed choices of society; organisations, public and private; communities and individuals” (Gallagher 2005).
Four learning outcomes have been identified in this competence by the GED.
Health promotion not only addresses diseases and behaviours which take a common risk factor approach (Sheiham and Watt 2000) but also seeks to take into consideration the wider social determinants of health and, in doing so, uncovers the fundamental causes (Phelan et al. 2010). This recognises that health follows a social gradient, and better health often arises as a result of increased socio‐economic position (Graham 2007). Dental professionals should therefore be conscious that promoting oral health means identifying the contexts in which people live their lives, taking into account the health promotion action areas recommended by the World Health Organisation (WHO 1997). Addressing social inequalities in health means that interventions should be appropriate to reduce the gradient (Marmot 2010, Marmot and Bell 2011). The opportunity for students to participate in community oral health projects, either during their formal programme or as part of an elective study period, is therefore highly recommended. Eight learning outcomes have been identified that the graduating european dentist must demonstrate.
The graduate Dentist must have knowledge of the global burden of oral disease (Marcenes et al. 2013), population demographic, social, health, and oral health trends; and consider the implications for oral diseases and conditions and the practice of dentistry. Wider European and global perspectives will be important given Dentist and patient movement. The tools for assessing and monitoring oral health needs should be understood and the implications of findings.
The graduating european denist must demonstrate seven learning outcomes in this competence.
It is important to gain insight into public and private healthcare systems, the policies governing systems at national and European levels and how healthcare systems serve the population, particularly vulnerable groups.
Knowledge of national policies and those advocated by the World Health Organisation and the United Nations will be particularly important resources, including concepts of universal health coverage (World Health Organisation 2013, World Health Organisation 2016), human resources for health (World Health Organisation 2016) and the integration of oral health with wider general health assessment, to meet sustainable development goals.
Additionally, it will be important to explore how health systems are orientating towards prevention and managing risk, as well as defined disease, and examining patient experience and outcomes with an emerging emphasis on “value‐based healthcare”; this considers how treatments are distributed across a population, how effectively treatments meet the needs of the population, and individual patients.
The graduating European dentist must demonstrate seven learning outcomes have been achieved.
Describe the various mechanisms of delivering health care, including strategies that improve accessibility and sustainability such as remote consultations, digital workflows, and domiciliary/community visits
Just as Dentists plan care for individual patients, students should have the chance to explore strategic planning for the health of populations. This should draw on theory and the evidence base for community and population interventions. They should have the opportunity to consider different populations and the needs of different patient groups. Four learning outcomes have been identified witin this competence.