The dental student as technician: an 18-year follow-up of preclinical laboratory programs

In 1977, a survey of American and Canadian dental schools was conducted by Weintraub to determine the delegation of laboratory procedures in preclinical and clinical complete and removable partial denture programs. This was performed in light of challenges raised to the value of requiring dental students, rather than laboratory technicians, to perform the various laboratory procedures involved in the fabrication of complete and removable partial dentures. Since 1977, the rate of edentulism has declined in the United States, and fewer edentulous patients have sought regular dental care. In addition, approximately 20% fewer curriculum hours have been spent in dental schools in removable prosthodontic instruction; a declining number of graduating dental students have felt comfortable with their level of knowledge of removable prosthodontics, especially complete dentures, and have performed fewer removable prosthodontic procedures in practice because of a perceived lack of treatment cost-effectiveness. The present study, an 18-year follow-up to the 1977 survey, was designed to determine if such trends toward a deemphasis on removable prosthodontic treatment have affected the mechanisms of instruction in and the extent to which dental schools instruct students about removable prosthodontics laboratory procedures. The 1995 survey was mailed to 53 American dental schools. Forty-six schools returned the completed survey, for a response rate of 87%. Results showed that the proportion of schools with removable prosthodontic preclinical programs, especially those in removable partial dentures, increased, as did the relative amount of material presented to students in these programs. This was accomplished primarily through the enhancement of laboratory technician support, both in-house and commercial, of student preclinical removable prosthodontic laboratory procedures. The conflict between these outcomes and the call by the dental community, as well as that of the 1995 Institute of Medicine Study, for a reduced emphasis on teaching students about the technical details involved in removable prosthesis fabrication is recognized and explored.