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Multi-Institutional Assessment of Dental Students' Knowledge in Oral Soft Tissue Pathological Entities
Nicole McKee1, Paul Edwards2, Gerardo Maupomé1
1Department of Periodontology, Indiana University School of Dentistry, Indianapolis, Indiana, USA.
Journal of Dental Education
|February 21, 2026
Summary
Dental students excel at recognizing common oral lesions but struggle with nuanced cases, showing variability in diagnosis and management across institutions. This highlights a need for improved, case-based dental education strategies.
Area of Science:
- Oral pathology recognition and management
- Dental education assessment
- Multi-institutional comparative analysis
Background:
- Prior studies on dental students' diagnostic ability were single-institution.
- A multi-institutional comparison is needed to assess variability in recognition and management of oral soft tissue pathological entities.
- Understanding educational implications of diagnostic variability is crucial.
Purpose of the Study:
- To conduct a descriptive, multi-institutional comparison of dental students' accuracy in recognizing and managing oral soft tissue pathological entities.
- To identify variability in recognition and decision-making across four US dental schools.
- To explore potential educational implications of observed variability.
Main Methods:
- An anonymous online survey with 20 image-based multiple-choice questions was administered to 160 dental students.
- Questions included images, patient demographics, and case details, with reference diagnoses provided for management questions.
- Statistical analyses included descriptive statistics, t-tests, logistic regression, chi-square tests, and multi-rater kappa statistics.
Main Results:
- Students showed high recognition for common conditions (e.g., candida, tobacco keratosis) but lower accuracy for subtle lesions (e.g., erosive lichen planus, idiopathic leukoplakia).
- Management accuracy generally lagged behind recognition accuracy.
- Significant inter-school differences in both recognition and management were observed, with low kappa values indicating wide variability.
Conclusions:
- Dental students possess strong theoretical knowledge of common oral pathologies but exhibit variability in identifying and managing less common or nuanced conditions.
- The study's findings, evaluating recognition rather than clinical competence, underscore the need for competency-aligned, case-based teaching approaches.
- Strengthening diagnostic reasoning and management decision-making in dental education is essential.
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