Competencies for the New General Dentist
As approved by the ADEA House of Delegates on April 2, 2008
Preamble
The general dentist is the primary oral health care provider,
supported by dental specialists, allied dental professionals, and
other health care providers. The general dentist will address
health care issues beyond traditional oral health care and must be
able to independently and collaboratively practice evidence-based
comprehensive dentistry with the ultimate goal of improving the
health of society. The general dentist must have a broad biomedical
and clinical education and be able to demonstrate professional and
ethical behavior as well as effective communication and
interpersonal skills. In addition, he/she must have the ability to
evaluate and utilize emerging technologies, continuing professional
development opportunities and problem-solving and critical thinking
skills to effectively address current and future issues in health
care.
As used in this document, a competency is a complex behavior or
ability essential for the general dentist to begin independent,
unsupervised dental practice. Competency includes knowledge,
experience, critical thinking and problem-solving skills,
professionalism, ethical values, and technical and procedural
skills. These components become an integrated whole during the
delivery of patient care by the competent general dentist.
Competency assumes that all behaviors are performed with a degree
of quality consistent with patient well-being and that the general
dentist can self-evaluate treatment effectiveness. In
competency-based dental education, what students learn is based
upon clearly articulated competencies and further assumes that all
behaviors/abilities are supported by foundation knowledge and
psychomotor skills in biomedical, behavioral, ethical, clinical
dental science and informatics areas that are essential for
independent and unsupervised performance as an entry-level general
dentist. In creating curricula, dental faculty must consider the
competencies to be developed through the educational process, the
learning experiences that will lead to the development of these
competencies, and ways to assess or measure the attainment of
competencies.
The purpose of this document and the proposed foundation
knowledge concepts are to:
- Define the competencies necessary for entry into the dental
profession as a general dentist. Competencies must be relevant and
important to the patient care responsibilities of the general
dentist, directly linked to the oral health care needs of the
public, realistic, and understandable by other health care
professionals;
- Reflect (in contrast to the 1997 competencies) the 2002 IOM
core set of competencies for enhancing patient care quality and
safety, and illustrate current and emerging trends in the dental
practice environment; they are divided into domains, are broader
and less prescriptive in nature, are fewer in number, and most
importantly will be linked to requisite foundation knowledge and
skills;
- Serve as a central resource, both nationally for ADEA and
locally for individual dental schools, to promote change and
innovation in predoctoral dental school curricula;
- Inform and recommend to the Commission on Dental Accreditation
standards for predoctoral dental education;
- Provide a framework for the change, innovation, and
construction of national dental examinations, including those
provided through the Joint Commission on National Dental
Examinations and clinical testing agencies;
- Assist the development of curriculum guidelines, both
nationally for ADEA and locally for individual dental schools, for
both foundation knowledge and clinical instruction;
- Provide methods for assessing competencies for the general
dentist;
- Through periodic review and update, serve as a document for
benchmarking, best practice, and interprofessional collaboration
and additionally, as a mechanism to inform educators in other
health care professions about curricular priorities of dental
education and entry-level competencies of general dentists.
Domains
1. Critical Thinking
2. Professionalism
3. Communication and Interpersonal Skills
4. Health Promotion
5. Practice Management and Informatics
6. Patient Care
A. Assessment, Diagnosis, and Treatment Planning
B. Establishment and Maintenance of Oral Health
The statements below define the entry-level competencies for the
beginning general dentist:
1. Critical Thinking
Graduates must be competent to:
1.1 Evaluate and integrate emerging trends in health care as
appropriate.
1.2 Utilize critical thinking and problem-solving skills.
1.3 Evaluate and integrate best research outcomes with clinical
expertise and patient values for evidence-based practice.
2. Professionalism
Graduates must be competent to:
2.1 Apply ethical and legal standards in the provision of dental
care.
2.2 Practice within one's scope of competence and consult with
or refer to professional colleagues when indicated.
3. Communication and Interpersonal Skills
Graduates must be competent to:
3.1 Apply appropriate interpersonal and communication
skills.
3.2 Apply psychosocial and behavioral principles in
patient-centered health care.
3.3 Communicate effectively with individuals from diverse
populations.
4. Health Promotion
Graduates must be competent to:
4.1 Provide prevention, intervention, and educational
strategies.
4.2 Participate with dental team members and other health care
professionals in the management and health promotion for all
patients.
4.3 Recognize and appreciate the need to contribute to the
improvement of oral health beyond those served in traditional
practice settings.
5. Practice Management and Informatics
Graduates must be competent to:
5.1 Evaluate and apply contemporary and emerging information
including clinical and practice management technology
resources.
5.2 Evaluate and manage current models of oral health care
management and delivery.
5.3 Apply principles of risk management, including informed
consent and appropriate record keeping in patient care.
5.4 Demonstrate effective business, financial management, and
human resource skills.
5.5 Apply quality assurance, assessment, and improvement
concepts.
5.6 Comply with local, state and federal regulations including
OSHA and HIPAA.
5.7 Develop a catastrophe preparedness plan for the dental
practice.
6. Patient Care
A. Assessment, Diagnosis, and Treatment Planning
Graduates must be competent to:
6.1 Manage the oral health care of the infant, child,
adolescent, and adult, as well as the unique needs of women,
geriatric and special needs patients.
6.2 Prevent, identify, and manage trauma, oral diseases, and
other disorders.
6.3 Obtain and interpret patient / medical data, including a
thorough intra / extra oral examination, and use these findings to
accurately assess and manage all patients.
6.4 Select, obtain, and interpret diagnostic images for the
individual patient.
6.5 Recognize the manifestations of systemic disease and how the
disease and its management may affect the delivery of dental
care.
6.6 Formulate a comprehensive diagnosis, treatment, and/or
referral plan for the management of patients.
B. Establishment and Maintenance of Oral Health
Graduates must be competent to:
6.7 Utilize universal infection control guidelines for all
clinical procedures.
6.8 Prevent, diagnose, and manage pain and anxiety in the dental
patient.
6.9 Prevent, diagnose, and manage temporomandibular
disorders.
6.10 Prevent, diagnose, and manage periodontal diseases.
6.11 Develop and implement strategies for the clinical
assessment and management of caries.
6.12 Manage restorative procedures that preserve tooth
structure, replace missing or defective tooth structure, maintain
function, are esthetic, and promote soft and hard tissue
health.
6.13 Diagnose and manage developmental or acquired occlusal
abnormalities.
6.14 Manage the replacement of teeth for the partially or
completely edentulous patient.
6.15 Diagnose, identify, and manage pulpal and periradicular
diseases.
6.16 Diagnose and manage oral surgical treatment needs. .
6.17 Prevent, recognize, and manage medical and dental
emergencies.
6.18 Recognize and manage patient abuse and/or neglect.
6.19 Recognize and manage substance abuse.
6.20 Evaluate outcomes of comprehensive dental care.
6.21 Diagnose, identify, and manage oral mucosal and osseous
diseases.
APPENDIX A
GLOSSARY OF TERMS
Critical thinking: the process of assimilating and
analyzing information; this encompasses an interest in finding new
solutions, a curiosity with an ability to admit to a lack of
understanding, a willingness to examine beliefs and assumptions and
to search for evidence to support these beliefs and assumptions,
and the ability to distinguish between fact and opinion.
Competency: a complex behavior or ability essential for
the general dentist to begin independent, unsupervised dental
practice; it assumes that all behaviors and skills are performed
with a degree of quality consistent with patient well-being and
that the general dentist can self-evaluate treatment
effectiveness.
Curriculum guidelines (content): the relevant and
fundamental information that is taught for each category of
foundation knowledge; these are to be used as curriculum
development aids and should not be construed as recommendations for
restrictive requirements.
Domain: broad, critical category of activity for the
general dentist.
Emerging technologies: current and future technologies
used in patient care including technologies for biomedical
information storage and retrieval, clinical care information, and
technologies for use at the point of care.
Evidence-based dentistry: an approach to oral health
care that requires the judicious integration of systematic
assessments of clinically relevant scientific evidence relating to
the patient's oral and medical condition and history integrated
with the dentist's clinical expertise and the patient's treatment
needs and preferences.
Foundation knowledge and skills: the basic essential
knowledge and skills linked to and necessary to support a given
competency; these would serve to help guide curriculum in dental
schools, help assist educators in removing irrelevant, archaic
information from current curricula, aid in including important new
information, and help test construction committees develop
examinations based upon generally-accepted, contemporary
information.
General dentist: the primary dental care provider for
patients in all age groups who is responsible for the diagnosis,
treatment, management, and overall coordination of services related
to patients' oral health needs.
Health promotion: public health actions to protect or
improve oral health and promote oral well-being through behavioral,
educational and enabling socio-economic, legal, fiscal,
environmental, and social measures; it involves the process of
enabling individuals and communities to increase control over the
determinants of health and thereby improve their health; includes
education of the public to prevent chronic oral disease.
Informatics: applications associated with information
and technology used in health care delivery; the data and knowledge
needed for problem solving and decision making and the
administration and management of information and technology in
support of patient care, education, and research.
Interprofessional health care: the delivery of health
care by a variety of health care practitioners in a cooperative,
collaborative, and integrative manner to ensure care is continuous
and reliable.
Management: includes all actions performed by a health
care provider that are designed to alter the course of a patient's
condition; such actions may include providing education, advice,
treatment by the general dentist, treatment by the general dentist
after consultation with another health care professional, referral
of a patient to another health care professional, monitoring
treatment provided, and may also include providing no treatment or
observation.
Patient-centered care: the ability to identify,
respect, and care about patients' differences, values, preferences,
and expressed needs; relieve pain and suffering; coordinate
continuous care; listen to, clearly inform, communicate with, and
educate patients; share decision-making and management; and
continuously advocate disease prevention, wellness, and promotion
of healthy life styles, including a focus on population health.
Problem-solving: the process of answering a question or
achieving a goal when the path or answer is not immediately obvious
using an acceptable heuristic or strategy such as the scientific
method.
Special needs care: an approach to oral health
management tailored to the individual needs of people with a
variety of medical conditions or physical and mental limitations
that require more than routine delivery of oral care; special care
encompasses preventive, diagnostic, and treatment services.