Education in Periodontology: The Past, the Present, and the Future

The harmonization of dental education in Europe occurred alongside the broader process of European convergence in higher education initiated by the La Sorbonne Declaration in 1998 and the signing of the Bologna Declaration in 1999. This declaration emphasized the importance of achieving coherence within the European higher education area while maintaining diversity. It established a two-tier structure consisting of undergraduate and postgraduate cycles [1]. Additionally, it introduced a common credit system known as the European Credit Transfer and Accumulation System or ECTS. It promoted curricular development, inter-institutional collaboration, and the integration of studies, training, and research to enhance mobility and ensure comparable criteria and methodologies. With this aim, the Association for Dental Education in Europe (ADEE) and the “DentEd” thematic network secured funding from the European Commission for a third Network Project, “DentEd III” (2004–2007), to create a curricular model in dentistry that fully complies with the principles of the Bologna Declaration [2].

The first step in this challenge was to agree on a professional profile with a defined set of general and specific competencies. Despite the need for graduates equipped to undertake independent dental practice safely, the educational and training programs varied significantly, with each school and country adopting different approaches shaped by their structures, cultures, and resources. Nevertheless, there was a common aspiration to achieve the highest possible standards in educational outcomes and relevant clinical competencies, enabling graduates to move freely and practice anywhere in Europe [3]. The profile of the dentist was defined in the European Union by a directive on the recognition of professional qualifications, which stated: “All Member States must recognize the profession of dental practitioner, equipped with the skills needed for the prevention, diagnosis, and treatment of diseases related to the teeth, mouth, jaws, and associated tissues.” It was further emphasized that dental training should consist of at least five years of full-time theoretical and practical training.

Based on these legal provisions, the proposed ADEE Dental Curricular structure was organized into modules according to the ECTS and aligned with the profile, domains, and competencies approved by ADEE. This framework defines competencies as a combination of knowledge, skills, and attitudes relevant to the dental education process, with a minimum acceptable level of performance for graduating dentists, emphasizing speed and accuracy that is consistent with patient well-being rather than performance at the highest possible level. Competencies were organized into seven domains representing the broad categories of professional activity and dimensions that occur in the general practice of dentistry: (I) professionalism, (II) communication and interpersonal skills, (III) knowledge base, (IV) information handling and critical thinking, (V) clinical information gathering, (VI) diagnosis and treatment planning, and (VII) the establishment and maintenance of oral health. While domains I, II, and IV pertain to all dental disciplines and thus represent horizontal competencies, those related to domains III, V, and VI concern the content, learning outcomes, and specific competencies of the different classical dental disciplines (cariology, periodontology, orthodontics, endodontics, restorative dentistry, prosthetics, etc.) [2].

These well-established disciplines have defined the specific supporting competencies relevant to their respective fields, outlining the attitudes, skills, and learning outcomes expected of dental graduates. This framework provides a benchmark for reviewing, refining, and reshaping the undergraduate curriculum, enhancing student evaluation processes, and implementing outcome measures to assess the effectiveness of the educational process. Among these disciplines, Periodontology is one of the major oral health sciences that studies the biology of periodontal and peri-implant tissues and the diagnosis, prevention, and treatment of their associated conditions and diseases. In the last 25 years, formal education and training in Periodontology have been redefined as part of the harmonization process of higher education in Europe, defined by the Bologna Declaration and, specifically for dentistry, by the DENTED project.

This perspective article aims to examine this process by focusing on past, present, and future perspectives in Education in Periodontology.

As explained above, education in Periodontology encompasses various tiers, ranging from formal undergraduate training to become a dentist, to postgraduate education and training for achieving specialist status and including other forms of education in Periodontology. These forms allow general dentists to complement and enhance the competencies and learning outcomes acquired during their undergraduate training as part of continuing education or professional development. This is particularly relevant in dentistry, where advances in research and technology clearly surpass the framework of the undergraduate curriculum and require the development of new competencies, learning outcomes, and skills needed to stay current in modern periodontics. In fact, the European Union developed a framework for this mode of education, under the name “vocational education and training”, based on the Bruges/Copenhagen process [9, 10]. However, the very limited penetration of this initiative and the heterogeneity of regulations among the European countries [11] prevent the discussion of this mode of education within the present perspective article. Given the high prevalence of periodontal diseases, dentists with specialist-level training (if available) can care for only a very limited proportion of patients with periodontal needs. Therefore, general practitioners and dentists with a specific interest in periodontal practice are essential for managing the periodontal health of the general population.

At both undergraduate and postgraduate levels, the future of periodontal education in Europe was recently discussed during the second EFP European Consensus Workshop on Periodontal Education in 2023. One of the objectives of this workshop was to ensure the full integration of the 2018 classification for periodontal and peri-implant diseases and conditions [21] into the periodontal undergraduate curriculum, along with the S3 Clinical Practice Guidelines for the treatment of periodontitis patients and the prevention and treatment of peri-implant diseases [22-24]. It also aimed to adapt the 2009 EFP periodontal educational framework to the updated educational framework for Dental Undergraduate Education and Training adopted by ADEE in 2017 [25].

The authors declare no conflicts of interest.