Competencies for Predoctoral Periodontics

Recommended competencies are based on a review of available literature and the needs of the periodontal patient.

Published by the American Academy of Periodontology – August 2000

Background Information

Several documents currently exist related to competencies for the graduating dentist. Relevant information from these documents is summarized below.

  1. AAP Statement on Periodontal Examination for Initial Dental Licensure

This document recommends a written or interactive examination of a candidate's ability to “identify, diagnose, treat and manage various periodontal conditions.” The statement also recommends, as a minimum, a clinical performance examination testing candidates ability to “gather diagnostic records and develop a diagnostic statement regarding the patient's periodontal condition, removal of the identified calculus, and proper management of soft tissues during the treatment.”

  1. ADEA Competencies for the New Dentist

This document lists 63 skills that must be within the ability of the graduating dentist. Many of these skills are general skills such as ethics and practice management. Those related specifically to periodontal patient management fall under the headings of diagnosis, treatment planning, and treatment summarized below. Within the context of the ADEA document it should be noted that the term “manage” is used in instances “when the new dentist may perform some treatment, but is more likely to oversee treatment or to refer.”

  • Diagnosis – These twelve statements are very general in nature and do not specifically mention periodontal disease or any other specific oral disease. The items describe those skills necessary to gather and collect data, obtain medical or dental consults, recognized etiologic factors, diagnose, establish a prognosis, monitor outcomes and reevaluate and modify initial diagnoses or therapy.
  • Treatment Planning – The statements describe the ability to integrate multiple disciplines into an individual, comprehensive sequenced treatment plan, discuss etiologies, treatment alternatives and prognosis with the patient and obtain informed consent.
  • Treatment – In this section specific mention is made of skills related to the periodontal management of the patient. Some relevant selected statements are listed as follows:
    • Provide patient education to maximize oral health
    • Manage preventive oral health procedures
    • Perform therapies to eliminate local etiologic factors to control caries, periodontal disease and other oral diseases
    • Manage patients with advanced periodontal diseases and conditions
    • Manage patients requiring modification of oral tissues to optimize restoration of form, function, and esthetics
    • Manage a comprehensive maintenance plan following the active phase of periodontal treatment
    • Manage patients with oral esthetic needs
  1. ADA Accreditation Standards for Dental Education Programs

The accreditation standards produced by the ADA Commission on Dental Accreditation are very broad and specifically leave it to the schools to define the “scope of general dentistry.” The standard related to clinical sciences is found in section 2-26. At a minimum, graduates must be competent in providing oral health care within the scope of general dentistry, as defined by the school, for the child, adolescent, adult, geriatric and medically compromised patient, including:

  • patient assessment and diagnosis
  • comprehensive treatment planning
  • health promotion and disease prevention
  • informed consent
  • anesthesia, sedation and pain and anxiety control
  • restoration of teeth
  • replacement of teeth
  • periodontal therapy
  • pulpal therapy
  • oral mucosal disorders
  • hard and soft tissue surgery
  • dental emergencies
  • malocclusion and space management
  • evaluation of the outcomes of treatment
  1. Outcomes Assessment

The ADA Commission on Dental Accreditation outlines the recommended process of outcomes assessment. The single most important recommendation for consideration in this document is found in section I.2: “ …The development of procedures for evaluating the extent to which the competencies contained in the appropriate discipline-specific accreditation standards are achieved…” In the development of suitable useful competencies it is important to remember that the outcomes must be measurable. 

Competencies in Periodontics for Graduating Dental Students

Based on review of the documents summarized above and an understanding of the needs of the periodontal patient, the following are recommended competencies for the graduating predoctoral dental student. The graduating dentist must be able to:

  1. Demonstrate an understanding of the nature and etiology of periodontal diseases.
  2. Conduct and accurately record the findings of a comprehensive periodontal examination.
  3. Assess a patient for the presence of etiologic factors and risk factors contributing to periodontal diseases.
  4. Diagnose periodontal diseases.
  5. Develop an individual, comprehensive, sequenced treatment plan for patients with up to localized moderate chronic periodontitis using diagnostic and prognostic information which also incorporates patient's goals values and concerns.
  6. Treat and or manage patients with gingival diseases and up to localized moderate chronic periodontitis, including patient education, management of interrelated systemic health, and effective subgingival scaling and root planing.
  7. Evaluate the outcomes of periodontal therapies provided to their patients either within their office or services provided by a periodontist to whom the patient may have been referred for treatment.
  8. Provide and assess success of periodontal maintenance for patients with up to localized moderate chronic periodontitis.
  9. Demonstrate knowledge of therapeutic and referral options for treatment of patients with moderate to severe chronic periodontitis.
  10. Manage care of patients who are candidates for referral (those with moderate to severe chronic periodontitis aggressive forms of periodontitis, mucogingival conditions, periodontal disease associated with systemic disease or periodontitis that is refractory to treatment) by effective communication and coordination of therapy with a periodontist when appropriate.

 

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