FST BLOG

The Dental Curriculum: Between Regulator, State and Supervisors and the case for digital dentistry

• 26 June 2026
• Education
• Dr John Tredinnick-Rowe

In this blog, I want to explore the issues that implementation science faces when research policy, regulation, and new ideas overlap. I am building off a soon-to-be-released paper, “Student and Staff Experiences of Digital Dentistry (DD) in a Southwest Primary Care Dental School”, which will be published in the BDJ Open. However, there remains space for debate about the tension created by the introduction of new elements into clinical curricula. What can be done to balance the requirements for changes with the need to produce safe clinical practitioners?

Due to the pressure of modern clinical practice, most curricula are already saturated. Dentistry is no different. The introduction of new topics and skills functions like an oversubscribed nightclub – one in, one out. Space is at a high premium.  Whilst simultaneously recognising the need for training to be modern and progressive, it is hard to introduce new topics or methods to meet new needs.

What do we do when a demand is identified in a new area and introduced into the education of dentists to future-proof the profession? This question, also salient to medicine and other healthcare professionals, concerns the emergence of digital technologies. Largely owing to the Blairite inevitability of change, the digital shift will happen; it is just a matter of how quickly. Yet regulators, individuals, organisations, and professions still need to square this with patients' needs, safe practice, and the student experience. 

I want to surface some of the issues this creates, as we attempt to implement the inevitable into a (sensibly) risk-averse and potentially litigious environment. We want progress and innovation, but safely and at a manageable pace.  In this space, universities, policymakers, and government bodies must break bread to build a more functional workforce and better care for dental patients.

Standardisation, Variability and Equity

Digital equipment in dentistry and other clinical settings has inherent equity issues due to the human-mediated requirements for its use. DD implementation is hard to standardise and has potential equity issues due to (1) difficulties training all supervisors to the same level in all equipment/software and (2) system heterogeneity. For example, many dental schools operate on a Dental hospital model, where the hospital functions as an entity with its own clinicians, consultants, and departments. In this case, the layers will have systems and processes (such as IT) that must be aligned to synchronise technology and ensure it works. Organisational integration is as much of an issue as the quality and cost of the technology itself. This can also include funding models and GDPR regulation, the Data Protection Act, which function as dento-legal stumbling blocks for some.

Beyond this structural issue, it is common for supervisors who deliver digital curriculum content not to be trained to the same level. Even a small dental school can have 100s of clinical supervisors, who, like the students, have packed schedules. Making the harmonising of medical devices and software approaches delivered by the supervisors heterogeneous.  Some would argue that this variability is a higher resolution, real-world representation of what students will encounter after graduation. If true, this puts the fidelity of the teaching (to reflect the real world) at odds with its own equity, i.e., that each student receives the same experience and level of tuition.

Some of the variance can simply be a function of restrictions on teaching space, technical faults, and access to equipment. As with the fidelity vs student experience dichotomy, there is a need to debate how variability in student experience can be traded off against consistency in learning. What do we want more? Students to have the same experience, or students to have training that more closely mirrors the real-world of post-graduation clinical practice? Fidelity and equity bump heads in this arena, with both having importance from a regulatory viewpoint.

Governance

One of the key findings from the introduction of digital health in education was that institutions implementing DD should not underestimate how long governance processes take to be resolved. Outside of GDPR and the Data Protection Act, there is a maze of other organisations that clinical schools interact with.  With structures of dental schools varying from NHS facilities to community care organisations to lab services, the legal agreements for data management, processing, and storage can take several years to finalise.

Between fairness, safety and innovation

Introducing changes to clinical curricula in the UK is caught between Scylla and Charybdis. Digital dentistry is no different in its struggle to balance patient safety with the risks of innovation. What this ultimately results in is a piecemeal change to education practice, and often much smaller experimentation that is never fully implemented at scale. While there are many organisations involved in the ongoing debate. It's not clear whether any individual regulator or body involved has final authority over what to remove from the curriculum and what to replace it with. Because of this regulatory impasse, implementation of things like digital dentistry tends to involve experimentation at the margins of curricula, and small-scale introduction (in terms of time, not necessarily cost) with more limited effects. One of the conclusions of this work is that scalable implementation requires regulatory transparency and a clear line of sight, but these often do not formally exist to drive change.

 

 

 

 

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