Continuing Education is the Lifeblood of the Dental Profession
Dentistry is a profession founded on education. In the 17th and 18th centuries, quackery was rampant. The public had no way to figure out which practitioners were legitimate. As a result, the conscientious practitioners received the same bad reputation as the quacks. The only way conscientious practitioners could fight back was to organize. In the 1850’s they formed the “Society of Surgeon Dentists of the City and State of New York” , which led to the formation of the American Dental Association in 18591. One of the ADA’s first accomplishments was the passage of legislation requiring graduation from dental school as a prerequisite for dental practice.
At that time there was not a great deal of knowledge in the field of dentistry. Today, however, there is so much knowledge that the dental school curriculum can only provide students with a rudimentary foundation for dental practice. “The over-crowded curriculums of dental and medical schools”, explains Dr. Michael Heuer, Dean of Academic Affairs at Northwestern University, “precludes anything other than at best the attainment of “a baseline level of clinical competency at the time of graduation, even in the finest institutions”.2
G.V. Black, widely considered to be the founder of modern dentistry, strongly believed that for dentistry to truly be a ‘learned profession’, dentists had a moral obligation to become a body of continuous scholars. “A professional man”, he said, “has no right to be other than a continuous student3”. Why did he feel this way? Patients, he reasoned, are better served by professionals whose skills are up to date; and to keep current, dentists have to be perpetual students.
In today’s rapidly changing world, continuing education for practicing dentists is more critical than ever before. The pace of technological advancement has quickened to the point where some estimate that all available knowledge doubles every five years. The professional who does not keep up is left in the dust, and can only offer patients a comparatively lower level of care. Mortimer Adler, a famous educator once commented that, “a graduate [who] does not go on learning after school…might just as well not have gone through school at all! 4”
Often overlooked is the idea that continuing education instills in us the enthusiasm and confidence we need to succeed. “In any area of endeavor”, says Dr. John Kennedy5, an Albuquerque, New Mexico practitioner, the success rate goes up with a combination of advanced training and experience. This is a self-feeding circuit. Additional education brings more success, which gives confidence, which makes the person more enthusiastic, which makes more people accept his or her services, which leads to the desire for more knowledge—and the cycle continues”. Dr. Kennedy studied 13 successful practitioners and found that all 13 had a major trait in common–they were all perpetual students. All also reported that they enjoyed dentistry most when they were taking continuing education courses.
The majority of dental professionals agree that continuing education is important and most say that they want more continuing education. Paradoxically, attendance at courses seems to be declining. One reason may be the abundant opportunities for education that now exist. As a result of the internet and the popularity of Zoom that arose from the COVID lockdowns, a multitude of competing continuing education opportunities now exist online.
However, dentists cannot achieve a well-rounded education from online activities alone. Education from live continuing education courses provides personal experience, networking opportunities and the ability to exchange ideas with colleagues does not occur on videos or webinars. New worlds can open from live continuing education experiences that can never open up on the internet.
Unfortunately, many younger practitioners think all they need to know can be obtained from You-Tube videos. They don’t value the exchange of ideas and networking with experts and colleagues as important educational experiences. They don’t even value having experienced mentors who can vastly improve their clinical performance in a way that could NEVER happen from studying online or reading books!
Several trends are most likely responsible for this misconception:
- Society’s attitude toward education. “We have entered a phase in our society”, says
educator Vartan Gregorian6, “where education is valued for what it will give you rather than for what it will make out of ” As a result, many practitioners perceive the profession to be a means to an end–a comfortable lifestyle–rather than a quest for self-fulfillment and self-improvement. Teachers in this country are often looked down on because they don’t have what society considers important–wealth and status. For some the process of learning is associated with drudgery.
- Lack of Critical Thinking Skills. Society has also failed to teach students how to think.
Students learn to pass tests to spit back rote memorization. The entire educational system encourages learning for the achievement of grades, not for the desire to gain knowledge. After the tests are over, the learned material learned is often quickly forgotten. Students are essentially taught to seek the easy way out—and they are conditioned to seek cookbook solutions and instant gratification. This mode of thinking does not cut it in the real world. Dentists treat individuals, and there is no “one-size-fits-all.” They need to have out-of-the box thinking to arrive at the best treatment plan for each patient. They need to learn about new treatment options they can include in their armamentarium. As Dr. Jerome Groopman notes in his book How Doctors Think7:
“Clinical algorithms can be useful for run-of-the-mill diagnosis and treatment…But they quickly fall apart when a doctor needs to think outside their boxes…In such cases—the kinds of cases where we most need a discerning doctor—algorithms discourage physicians from thinking independently and creatively. Instead of expanding a doctor’s thinking, they can constrain it”.
A perfect example is the observation that most restorative dentists only have the implant treatment option to offer patients. Implants are lucrative and not as difficult as saving teeth with crown and bridgework in the majority of cases. This fact is one reason why there is an absolute epidemic of tooth extraction and implant placement. Many teeth that are being extracted can actually be saved but dentists don’t know how to save them. After a career of teaching and creating an extensive teaching website, it is my observation that most aren’t even interested in learning how! As a result, implants are being overused and used inappropriately. Implant suppliers and manufacturers are fueling this epidemic because they want to sell implants.
- Negative Dental School Experience. Almost all dentists have stories to tell about unpleasant experiences in dental schools. A common theme centers around teachers who exercise their frustrations on students. These teachers often encourage students to fulfill the minimum requirements in order to “just get by for the degree” rather than inspiring them to make the most of their education. “When people become adults psychologically”, explains Dr. Edward Barrett of the University of Detroit School of Dentistry,”8 they perceive themselves as being entirely self-directed. They resist learning in situations where they do not feel respected. Memories of unpleasant dental school experiences can discourage some dentists from becoming actively involved in continuing education activities.”
- Continuing education requires sacrifice. Unfortunately, the pursuit of continuing education always comes with a price–the price of the courses, the loss of income as a result of time spent away from the office, the sacrifice of free time spent with family or in the pursuit of other interests, and the self-discipline of studying and applying the learned material. Many new dentists graduate with enormous debts from educational loans. Instead of concentrating on building their knowledge and skills—which are rudimentary at best—they are forced to concentrate on earning money to pay back these debts. Paradoxically, these are the individuals who need continuing education the most. It is critically important to the future of the profession that graduating students understand that their real education begins on the day of graduation.
It is important for all dentists to re-examine their attitudes toward continuing education—particularly live continuing education courses. The purpose of continuing education is not just to obtain that piece of paper which confers eligibility for relicensure. Continuing Education allows dental professionals to improve the quality of care delivered to patients—and to gain exposure to what other practitioners have accomplished—whether or not there is agreement with what is being presented.
Attending Continuing Education courses provides us with the best opportunity to make the most of our potential–to become the best practitioners that we can possibly be. Striving to reach our potential is what gives life special meaning and makes it worth living. An investment in knowledge is ultimately an investment in ourselves. And, as Benjamin Franklin once remarked, “an investment in knowledge always pays the best interest”.
1Been, Dr. Valerie; “What the American Dental Association Can Do for You”; The Tenth Annual Practice Administration Seminar for Senior Dental Students; February 20, 1988.
2Heuer, Dr. Michael; ”Keeping Pace with Change: When the DDS is not Enough”; Journal of the American College of Dentists; Summer, 1988].
3Joseph R. The father of modern dentistry – Dr. Greene Vardiman Black (1836-[4] 1915). J Conserv Dent. 2005 8:5-6.
4Adler, Mortimer; “How to Read Great Books”; Wisdom Magazine, March, 1960
5Kennedy, Dr. John L.; “Enthusiasm and Confidence play a Major Role”; Dental Economics, August, 1989.
6Moyers, Bill; “Vartan Gregorian, Educator” [an interview]; A World of Ideas; Doubleday; 1989.
7Groopman, Jerome; How Doctors Think; Mariner Books , a division of Houghton Mifflin; New York; 2007; p 5.
8Barrett, Dr. Edward; “Androgogy: Taking an Adult Approach to Dental Continuing Education”; General Dentistry; March-April, 1984.
(c) 2024 Edward Feinberg DMD
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