Section I

Core Knowledge and Understanding

Draft prerequisites to achieving agreed Clinical Competences
(This has no formal status)

including

Consideration of Appropriate Methods of Evaluation of Outcome

Introduction

  1. Student Selection
  2. Length of Course
  3. Assessment of Students and Clinical Competences

Undergraduate Dental Curriculum

  1. Basic Biological and Medical Sciences
  2. Behavioural Sciences including Ethics and Jurisprudence
  3. Human Diseases
  4. Clinical Dentistry
  5. Medical Emergencies (Competence 5.1)
  6. Practice Management



***This document has not been finally agreed by the Working Party of the Advisory Committee on the Training of Dental Practitioners. However it provides useful background material for dental educators considering curriculum revision.***


Introduction and Background to this Core Knowledge Document

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The primary aim of dental education is to ensure that the new graduate is capable of carrying out independent dental practice without harm to patients using modern, appropriate, effective and currently accepted methods of treatment. The new graduate must also be capable of implementing suitable preventive programmes for individuals and groups in the context of community orientated programmes. In order to achieve that aim dental education must provide the student with a sound clinical training based on humanitarian, scientific and common sense principles. At the end of the undergraduate training programme the student must be capable of carrying out the Clinical Competences set out by the Advisory Committee on the Training of Dental Practitioners (XV/E/8316/8/93).

There is no one curriculum appropriate for Europe and the Advisory Committee on the Training of Dental Practitioners has specifically avoided imposing detailed regulations. Apart from the required clinical competences, no one subject or set of subjects should be independent of an overall educational philosophy in undergraduate education. Emphasis within subjects will vary from school to school nevertheless, care must be taken to avoid the dominance of certain subjects over others to the detriment of a comprehensive integrated curriculum.

It is essential that teaching staff and dental students, have clearly defined aims and objectives for each course taught. There must be a central educational philosophy with agreed overall educational goals which must be achieved by students and subjected to structured assessment methods.

The rapid expansion in knowledge required of dental students must be compensated for by reducing students' involvement in less relevant training programmes and ensuring that excessive or unnecessary detail is not expected of them in the course of their examinations and assessments. Dental students may need to be protected from courses which are more relevant to other disciplines.

The Advisory Committee endorses a process of international exchange and peer evaluation to promote convergence towards the highest possible standards in European dental education.

The existing directives need to be updated. At this time greater emphasis needs to be placed on outcome rather than content. The purpose of this document is to examine the essential core information, skills and knowledge required of a student in order to be competent in those procedures set out in document XV/E/8316/8/93.

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a) Student Selection

It is important to ensure that those school leavers who are intent on pursuing a career in dentistry are fully informed about the career and responsibilities of a dentist, whilst encouraging the most able to consider dentistry as their chosen career. There is no one universally accepted method or combination of methods for application in student selection procedures. However it is generally accepted that intelligence and integrity are two essential qualities.

Dentists require good physical health and acceptable eye sight. All dental students should be immunised where possible against those blood borne viruses which may be an occupational hazard to the dentist.

While Physics, Chemistry, Biology and Mathematics are desirable on matriculation from secondary education for the new dental student, it is also more desirable that their education should be broadly based and not confined to the sciences.

b) Length of Course

The undergraduate training programme must be extended over at least 5 academic years and preferably includes at least fifty per cent of a student's rostered time practising in a clinical training environment.

Emphasis should be changed where necessary from the passive acquisition of knowledge to researching the literature, problem-solving skills and clinical competence. No single course or group of courses should dominate or be independent of a cohesive integrated dental training programme. The Advisory Committee on the Training of Dental Practitioners does not wish to be prescriptive other than recommending as a basic minimum a sufficient understanding of the medical and biological sciences essential for understanding human diseases appropriate for a dentist. In the health sciences there is a continuous rapid expansion of knowledge and students should not be hindered with excessive detail in any subject to the detriment of a comprehensive training programme.

Dental students require a broadly based educational setting, ideally a university, combined with modern dental clinical facilities where emphasis on patient care is paramount. The clinical environment not only provides the dental student with appropriate training facilities but also exposure to the reality of patients' needs and demands as well as a full range of observations of secondary and tertiary oral/dental treatment procedures.

In addition it is desirable that dental students gain experience in other settings such as community dental clinics, private practices, general hospitals, accident and emergency departments, exchange programmes outside their own country, specialist departments, etc.

Integration with medical education is desirable but should not simply be to serve logistical exigencies by combining large groups of students for lectures in preclinical subjects where there is little integration in the context of shared clinical experiences. The object of integration with other disciplines in the health sciences particularly medicine, is to provide dental students with a better and broader understanding of human diseases.

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c) Assessment of Students and Clinical Competences

Assessment methods should be complimentary to the educational/learning experience of students. Assessment should be structured in order to determine whether students are achieving the stated educational objectives in didactic, practical laboratory and clinical courses. Assessments and examinations are too frequently considered by students to be end points in themselves. Assessments and examination methods are strongly influenced by the priorities of the member states competent authorities and the examination structures of each dental school's university or institute of learning. The most comprehensive approach is probably represented by a combination of continuous and end of course assessments. Examinations must not be used simply as a means of motivating students.

Assessment methods should support, reflect and act as a means of monitoring the teaching/learning in the subjects taught. Methods of evaluation range from traditional essays and multiple choice questions to computerised interactive assessment programmes, practical tests, clinical competence assessments and other innovative assessment methods. Whatever means is adopted the marking system must be transparent, known to the student, objective and constructive in its application to the educational process. Examination which results in high failure rates or excessively high marks being awarded must be seriously questioned.

The implementation of clinical competency tests should be integrated with the particular assessment system in operation in any dental school. Clinical Competence as defined in this document is more than the ability to complete a procedure with the aid of an instructor. It implies that a person is capable of carrying out the procedure safely and independently as in dental practice. It also implies appropriate understanding of the related theoretical knowledge. It is recommended that the gradual inclusion of competency testing should be accompanied by the exclusion of some existing assessments where there is overlap.

Insofar as possible, it is recommended that dental schools in Europe should develop their competency tests on the following basis:

  1. The scientific/biological basis for the clinical competence should be incorporated in the test/examination.
  2. The student must be able to explain the procedures to be adopted, including appropriate application of clinical principles in patient care.
  3. There should be formal certification and recording of successful completion of clinical/practical elements of the competence test.

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Undergraduate Dental Curriculum

The undergraduate curriculum should be seen as a whole. It may be broadly divided into:

  1. the Basic Biological and Medical Sciences; Chemistry, Physics, Biology (Biochemistry, Molecular Biology, Anatomy and Physiology)
  2. Behavioural Sciences (mainly Psychology and Sociology and also Ethics and Jurisprudence)
  3. Human Diseases; General Medicine and Surgery, Pathology, Microbiology and Pharmacology, appropriate to the needs of a dental practitioner
  4. Clinical Dentistry - patient care, prevention, diagnosis, treatment and rehabilitation of oral/dental diseases and their consequences. This includes the application of Biological, Medical Sciences and Human Diseases in the oral manifestation of systemic disease and the implication of oral and dental pathology and treatment complications in systemic disease

1 Basic Biological and Medical Sciences

The basic biological and medical sciences comprise macroscopic and microscopic anatomy, physiology, biochemistry, at a whole body as well as cellular and molecular levels. These should be learned to a standard appropriate for an understanding of oral biology and human diseases avoiding unnecessary detail. Also, they introduce students to the principles of scientific logic and argument including the critical appraisal of scientific design, statistics, biometry and published research.

General objectives of the course in basic medical sciences

On completion of their courses related to basic biological and medical sciences, in addition to being informed on recent research developments pertinent to human diseases in dentistry, students must have an understanding and knowledge of:

the principles of Chemistry and Physics appropriate to materials science, ionising radiation and the biological sciences.

Biochemistry
To a level of detail sufficient to understand molecular biology, physiology, microbiology, pharmacology, pathology and human diseases, cell structure, function and division.

Viruses
Immunology including antigens and antibodies, structure and function; complement system; T-cells, their subclasses and activation; cell interactions and the immune system.

Embryology
To include development of the embryo; differentiation of blastocytes, origin of tissues, and the development of the head and neck, particularly oral and dental tissues.

Anatomy
Sufficient to provide a detailed understanding of anatomy of particular relevance to the practising dentist combined with a general overview of human anatomy as necessary to understand the physiology and pathology of the systems of the body.

Physiology
including:
Structure and function and histology of tissues, particularly oral/dental; secretions with an emphasis on blood and blood forming elements; muscle, nerve, neuromuscular physiology, hormonal mechanisms, cardiovascular system, circulatory system, oxygen and carbon dioxide transport oral physiology, nutrition and metabolism, acid-base balance avoiding excessive detail but sufficient to understand human diseases and particular consideration of those conditions relevant in the practice of dentistry and holistic or comprehensive patient care for the needs of a practising dentist.

Histology
With particular reference to oral tissues

Assessment

There is a diverse approach throughout Europe in assessing the Biological Sciences. It is essential to avoid detail and irrelevant information to the understanding of the biological sciences as a basis for studying human diseases.

Wherever possible, the assessment of the biological sciences should also be incorporated into the clinical part of the programme in order to stress the relevance of the biological sciences.

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2. Behavioural Sciences including Ethics and Jurisprudence

Almost all decisions taken have some ethical dimension. The complex world in which the new dentist will practice demands a sensitivity towards not alone their ethical and professional responsibilities but also their wider social responsibilities both as health caring professionals as well as individual members of the community. For many, ethics has been relegated to the principles of jurisprudence and while there is a very complex relationship between the two it is important that our educational system should ensure students have an appreciation of a code of ethics that is not simply bound by jurisdiction.

It is important that students have a proper understanding of beneficence (doing the best one can), non-maleficence (first do no harm), respect for the views and rights of the individual patient, principles of social justice and an equitable distribution of the benefits of health care. In all respects students should be exposed to this learning process without prescription and free from any particular political dogma.

It goes without saying that students must also have an understanding of what is necessary in respect of record-keeping, patient confidentiality, informed consent for treatment and all that is necessary in order to avoid negligence in the care of patients.

This subject must be broadly based and is not narrowly focused. The area encroaches on the principles of the behavioural sciences in patient care and communication. Those disciplines lend themselves to a multi-disciplinary approach. Behavioural science and ethics require time for thinking and reflection, independent opinion and encouragement to articulate that opinion. These principles go back to four hundred years BC with the Hippocratic code of conduct for doctors and the Socratic approach to education.

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3. Human Diseases

General medicine and surgery and their allied subjects (pathology, microbiology and pharmacology) should be learned and experienced in appropriate clinical surroundings and integrated, insofar as is practical, throughout the students' training programme. It is essential that dentists be fully aware of the implications of general medicine and surgery as they apply to the practice of dentistry.

These subjects provide the basis for a dentist's comprehension of oral health and disease as one facet of general health and disease. In addition to gaining experience in general hospitals and observation in operating theatres, it is recommended that students be given the opportunity to observe and assist in more relevant settings to general dental practice such as general medical practice and community clinics. Generally a dentist must be able to assess signs and symptoms of relevant diseases from the medical history and extra oral signs visible in a fully clothed patient. In many dental schools experience and training is gained by incorporating dental students with groups of medical students in ward rounds and clinics. Often, however, insufficient attention is given to the needs of dental students with little opportunity to make maximum use of limited exposure to this critical part of their training programme. Without sufficient training in human diseases, comprehensive patient care, communication and awareness of the importance of lifestyle and stress related conditions, the dentist would be unable to provide a holistic approach to the care of his or her patients.

Practical classes on manikins in cardio-pulmonary resuscitation is essential for a modern training programme. Dental students also must be competent in First Aid.

Pathology
including:
Inflammation and repair; granulomatous response; thrombosis, embolism and infarction; oedema; shock; atrophy, hyperplasia, hypertrophy, metaplasia; neoplasia including its aetiology, progression, classification; atheroma; aneurysms and other vascular pathology; hypertension/failure; genetic, congenital and inborn errors in development; calcification; amyloid and pigmentation; rheumatic heart disease and infective endocarditis, cardiac pathology; specific pathology of the oral/dental tissues; pathology of other systems: nose, nasopharynx, larynx and trachea, respiratory and cardiovascular system, emphysema, asthma, pneumonia, gastro-intestinal system, immune system. endocrine system, blood and blood forming elements, vitamin deficiencies, bone, genito-urinary system, brain and CNS including trauma, strokes, tumours and other principles appropriate for a practising dentist.

Surgery
Principles of surgery; including differential diagnosis of swellings of the head and neck; principles governing management of malignancy of head and neck; principles of vascular surgery; management of acute trauma, haemorrhage, shock and interruption of breathing; principles of gastro-intestinal surgery; principles governing operation of an operating theatre; principles and implications of transplant surgery, including oral/dental complications.

Medicine
Ability to obtain a comprehensive medical history from a patient; recognition of the history, signs and symptoms of systemic disease relevant to patient care in a dental practice including the following:- hypertension, angina, myocardial infarction, rheumatic fever and other relevant endocardial pathology, vascular disease; bacterial endocarditis, heart valve disease, heart failure, congenital heart defects, pericarditis; respiratory failure, asthma, pneumonia; tuberculosis; carcinoma of the lung; sarcoiditis; alveolitis and other lung pathologies; oesophagitis, carcinoma of the oesophagus and stomach; malabsorption, liver and bile pathology; epilepsy; meningitis, cerebrovascular diseases; multiple sclerosis; peripheral neuropathy, acute subacute and chronic arthritis; cardiorespiratory arrest; anaphylactic shock; unconsciousness; acute asthmatic attack; inhalation of foreign body; diabetes and diabetic coma; disorders of the pituitary, adrenal, and thyroid glands; anaemia; bleeding disorders; leukaemia; lymphoma; skin and mucocutaneous disorders; infection; sexually transmitted diseases; psychiatric disorders, their implications and principles of care; drug induced diseases; including addiction; HIV; Hepatitis and other blood borne infections; carry out cardiorespiratory resuscitation; write prescriptions; administer drugs; carry out first aid including CPR; promotion of healthy lifestyle; tobacco related illnesses.

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Microbiology
Microbiology is central to a dental student's understanding of viral, bacterial, fungal and prion based infection and transmission of disease as well as sterilisation and cross infection control and anti microbial therapy. This should be learned in appropriate settings avoiding unnecessary detail and non-essential practical experience, concentrating on those essential features for modern dentistry. Microbiology should preferably be taught as an integrated part of Human Diseases with general pathology and immunology in a well structured co-ordinated course.

Students should have a knowledge and understanding of the principles involved in the pathogenesis, diagnosis, treatment and prevention of infectious diseases with particular emphasis on infections relevant to the practice of dentistry. Based on laboratory, practical, clinical and theoretical courses the new graduate must understand and be able to carry out and/or describe the following:- sterilisation and disinfection; the sources, portals and spread of infection; normal human microflora; pathogenic mechanisms of bacteria; infections of the mouth and perioral tissues; susceptibility and risk factors in infectious diseases; infections of bacteria, viruses, fungi, protozoa and prions appropriate to the dental patient; antimicrobial, antiviral, antifungal, antibiotic agents and their mode of action.

Pharmacology
including:
An appropriate understanding of pharmacology and therapeutics is required of a dentist for the safe practice of dentistry. Pharmacology and Therapeutics is a rapidly changing discipline. Dental graduates need to be aware of sources of information rather than learn excessive details and long lists of drugs. Dental students need to be aware of the indications, contra-indications, potential side effects, adverse reactions and interactions of therapeutic agents with other drugs and of those therapeutic agents used commonly in the dental surgery. .

The dental student should understand the principles of drug absorption, distribution, metabolism, excretion, and mode of action, particularly of those agents relevant to the practice of dentistry. Implicit in this is an understanding of the routes of administration, side effects, drug interactions, precautions with different age groups and their use in pregnancy.

Dental students must be capable of writing a prescription for those drugs commonly used in dental practice. It is essential that graduates have ease of access to reference material to update their information on pharmacology and therapeutics.

Assessment of Human Diseases

In addition to the assessment methods referred to in respect of the Biological Sciences it is essential to include practical clinical components to the assessment methods adopted in this part of the programme It may be difficult for some schools to provide access to general clinics and hospitals where patients with the particular conditions may be seen. Nevertheless, assessment of clinical competence is best carried out in real life situations rather than using simulation although the value of the latter is not questioned. Assessment of the human diseases lends itself to Objective Structured Clinical Examination (OSCE) and other innovative assessment techniques. It is important to ensure that the assessment methods are directly related to the educational objectives and that the information sought is at an appropriate level in the context of the knowledge and expertise required of a practising dentist. Students should not be subjected to assessment of excessively detailed or irrelevant knowledge

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4. Clinical Dentistry

Before graduation, dental students must demonstrate their ability to complete the clinical competences set out in XV/E/8316/8/93 which is included in section II of this document. The aim of training in clinical dentistry must be broader than the acquisition of specific clinical competences.

Clinical dentistry should be initiated as early as possible in the undergraduate curriculum.

Traditionally dental students in many dental schools acquire clinical skills using simulation such as mannikin heads and prosthetic laboratory exercises. Although useful, they can never be a substitute for clinical experience, biological orientation and experience in patient care and behavioural influences.

Patient care is of paramount importance in clinical dentistry and should never be relegated to a means of training students. Students must not be permitted to gain clinical skill or experience to the detriment of patient care. Holistic patient care should be exemplified in dental training institutions and students training should embrace that principle. The practice of clinical dentistry within dental schools should exemplify all the principles of ethical practice under safe, appropriate, hygienic and environmentally friendly clinical conditions

It is within these parameters that the clinical competences were established, not as separate entities, rather as segments within a comprehensive framework of patient care and health maintenance. In the following sections clinical competences are repeated from document XV/E/8316/8/93 using the numbers from the original (see also in part II of this document). Each set of related competences is followed by a set of skills and knowledge which are believed to be essential components if a student is to be considered competent.

Pre-requisite Knowledge and Core Understanding for Competences in Diagnosis and Treatment Planning

1.1 Taking a proper case history, including a medical history, carrying out an oral examination, recognising deviations from normal, diagnosing oral and dental diseases and formulating a long-term treatment plan and carrying out appropriate treatment or referral if necessary. This includes the craniomandibular joints.

1.2 Recognition and appropriate management and/or referral of patients who have oral manifestations of systemic disease.

1.3 Demonstrating an appreciation of the general health of the patient and the relationship between general health and disease of the oral cavity and the implications of general diseases on planning dental treatment.

1.4 Searching or screening for oral diseases including cancer.

1.5 Diagnosing and recording developmental anomalies and oral diseases using an internationally accepted classification.

1.6 Diagnosis and management and appropriate referral of patients with oro-facial, dental and cranio-mandibular related pain.

1.7 Diagnosis and management or appropriate referral of common oral and dental disease including cancer, mucosal lesions and bone pathology.

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Eliciting and/or recognising and understanding the significant and relevant details from:

When the full history, examination, case analysis and treatment plan have been established, the new dentist must be capable of:

Competences include the following:

1.1 Taking a proper case history, including a medical history, carrying out an oral examination, recognising deviations from normal, diagnosing oral and dental diseases and formulating a long-term treatment plan and carrying out appropriate treatment or referral if necessary. This includes the craniomandibular joints.

1.2 Recognition and appropriate management and/or referral of patients who have oral manifestations of systemic disease.

1.3 Demonstrating an appreciation of the general health of the patient and the relationship between general health and disease of the oral cavity and the implications of general diseases on planning dental treatment.

1.4 Searching or screening for oral diseases including cancer.

1.5 Diagnosing and recording developmental anomalies and oral diseases using an internationally accepted classification.

1.6 Diagnosis and management and appropriate referral of patients with oro-facial, dental and cranio-mandibular related pain.

1.7 Diagnosis and management or appropriate referral of common oral and dental disease including cancer, mucosal lesions and bone pathology.

Assessment of Competences in Diagnosis and Treatment Planning

Inevitably there will be a diversity in the methods of assessment in the clinical skills. However, if each student is to be deemed competent in competences 1.1 - 1.7 inclusive, it is necessary to design theoretical and clinical assessment methods which demonstrate the students' ability to competently carry out each section referred to under diagnosis and treatment planing. Such structured tests may be applied to a continuous or end of term examination basis or certified as complete on a log book system. Assessment methods should confirm to examiners that future dentists not alone are able to carry out properly patient examination, including appropriate medical and dental histology, recognition of deviations from normal, diagnosis, case analysis and treatment plan, but also to ensure that they have the theoretical clinical and scientific knowledge appropriate to carry out the clinical exercise. This applies in respect of all competences.

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Pre-requisite core knowledge for competences in radiography

In order to be competent in 1.8 and 1.9 the new graduate, in addition to those conditions set down in respect of competences 1.1 - 1.7 inclusive above, should also understand and be competent to apply where appropriate :-

Pre-requisites for Core Knowledge and Understanding for Competence in Medical Emergencies

It is essential that the dental student be competent to administer CPR and resuscitation for patients. In many schools separate courses in CPR and first aid are provided by outside agencies early in the course such as the Red Cross or St John's Ambulance Brigade. Where these exist they are to be encouraged. Competence in CPR requires hands-on practical courses on manikins or other simulated means.

5. Medical Emergencies (Competence 5.1)

5.1 Carrying out cardio-pulmonary resuscitation (CPR) and first aid.

Assessment

Demonstration of CPR on manikins

6. Practice Management

6.1 Working as a leader of a health care team using the full range of available dental auxiliary personnel.

In order to acquire competence in this area innovations are encouraged to help gain experience for students in general dental practice in order to give the student a realistic understanding of what is expected on graduation.

Consideration should be given in each region to provide their graduates with an appropriate understanding of:

The newly qualified or newly registered dentist must be capable of carrying out treatment as appropriate on adults, children, medically, physically and mentally compromised patients in the context of whole patient care appropriate to the expectations of a general dentist. These basic competences are not restrictive and should constitute only part of the educational and training objectives of a dental school's curriculum in the European Union. In their capacity as team leaders dental students should be exposed to this important facet of training which includes task analysis, scheduling and delegation of tasks, prescription and monitoring of results. It includes training in appropriate team work with dental laboratory technicians, hygienists, nurses and other auxiliaries.

Assessment

Continuous clinical assessment

General Prerequisites for competences

A dentist could not be considered clinically competent unless he or she is sufficiently well informed and is capable of carrying out the task within currently acceptable clinical parameters. The following prerequisites apply before a dentist can be considered competent.

  1. Having a sufficient understanding of the basic, biological, behavioural and medical sciences on which modern oral health care and maintenance of health is based.
  2. Practising the full range of general dentistry in the context of whole patient care without harm to the patient or the environment.
  3. An understanding of the dentist's moral and ethical responsibilities in patient care, as an individual and within the context of the community.
  4. Prioritising care according to need, and participating with others in setting attainable targets in reducing oral diseases within the community.
  5. Knowledge of the aetiology, principles of the molecular biological processes, pathogenesis, demographic features, prevention and treatment of oral and dental diseases.
  6. Being familiar with the pharmacology of drugs directly and indirectly related to the practice of dentistry and understanding the implications of drug therapy for systemic conditions in respect of dental treatment. This implies competency in safely prescribing appropriate drugs for dental patients.
  7. Knowledge of the biomaterial sciences as required for the practice of dentistry.
  8. Providing dental care within the ethical and medico-legal constraints of the member state in which the dentist practices.
  9. Controlling cross infection and preventing physical, chemical or microbiological contamination in the practice of dentistry.
  10. As appropriate to a dentist application of the full range of modern safe pain and anxiety control methods when carrying out dental treatment.
  11. Being aware of the importance of continuing professional development and education in order to keep abreast of relevant advances in all facets of dental practice.
  12. As a member of a health sciences discipline to participate in health promotion in the community with specific responsibility to promote oral and dental health.
  13. On graduation a new dentist must be capable of objectively judging the quality of care provided for patients under his or her care.

In addition the new dentist must be capable of carrying out comprehensive appropriate care and management of both adult and child patients including those with physical, medical and mental disabilities. Appropriate experience is desirable to develop the necessary skills in child management.

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Care of Child Patient (Paediatric Dentistry)

Although there are no specific competences described for paediatric dentistry they all apply to caring for the child patient. The newly qualified dentist must be capable of providing all facets of care, maintenance and prevention for the child patient. This requires appropriate training in behavioural psychology, management of children with special needs and an integrated approach in orthodontic treatment with paediatric dentistry and prevention and an understanding of growth and development. The social and psychological factors of ill-health, medically and socially disadvantaged children must be part of a modern dental curriculum. The development of child management skills is an essential component of a modern dental curriculum.

Prevention and Community Dentistry

Prevention is the dominant principle in all facets of dental care on an individual, group and community basis. It is essential that all programmes should have a basis in prevention and community care. Epidemiological principles, biostatistics and special group care programmes should be incorporated in each of the disciplines referred to within the context of required clinical competency. Specific community and preventive projects are to be encouraged.

Integrated or Comprehensive Patient Care

Integrated patient care is the guiding principle of modern dentistry reducing the segregated departmental approach. No one curriculum is appropriate for Europe. Innovations are to be encouraged provided they fulfil the essential requisite competences and are subject to objective analysis of the advantages and inevitable disadvantages inherent in all curricula. Clinical experience must always be set in a context of comprehensive holistic patient care.

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