Predoctoral orthodontic education in the United States: Challenges and opportunities for generation Z learners

This perspective paper addresses the current landscape of predoctoral orthodontic education in the United States. A history of American Dental Education Association (ADEA) senior dental student exit surveys consistently reveals that graduates lack confidence in space management and malocclusion. The authors, with over 50 years of combined experience in dental education, present variations in predoctoral orthodontics programs, common challenges, and underscore the need for aligning curricula with the distinct characteristics of the current Gen Z student cohort. Variations include instructional clock hours, timing and sequence, and instructor qualification. An examination of the topics covered in predoctoral orthodontics demonstrates stability from the 1993 ADEA guidelines to a 2021 consensus panel's recommendations. Specific examples stemming from the direct experiences of the authors demonstrate the variety of approaches used in predoctoral orthodontic education. Challenges in predoctoral education stem from not distinguishing curricular goals from Advanced Education in Orthodontics, or clearly defining parameters for competence. Training dental students to treat malocclusion is not practical or possible within the present dental curriculum. The authors stress the importance of shifting educational goals towards competency training in recognizing, diagnosing, and managing malocclusion, to increase relevance to general dental clinical practice. The paper highlights innovative teaching strategies to engage students in competency-based learning: Problem Based Learning, Gamification, Case-based learning, Cold calling, Test enhanced Learning, Spiral Curriculum. The paper also presents educational technological applications used in traditional classrooms or remote environments for teaching and assessment, well suited for Gen Z's preference for technologically driven interactive learning methods. Despite its challenges, predoctoral orthodontics education in the United States is filled with opportunities for growth, which will only lead to elevating the standard of dental care for all patients.