Dental Quality Improvement

Dental education is central to dental practice, both for undergraduates and for practising dental professionals. Quality improvement (QI) methods apply just as well to dental teaching as they do to routine dental care. A recent paper from Dundee offers a useful example: it describes QI applied to teaching early career dentists how to repair a furcal perforation using hydraulic calcium silicate-based cement.

Their project illustrates several core QI approaches:

Understanding the needs of the customer. In preparation for the endodontic study day, the organisers surveyed early career stage dentists and asked what they wanted to learn. In all QI work, it is best to ask the people who know the problem best — in this case, the dentists themselves — to identify problems and priorities. The decision to focus on furcal perforations came directly from the participant survey results.

Error Prevention and Response. Approaches to safety used to focus on remonstrating with staff who made mistakes and telling them to be more careful. Error prevention takes a different approach: reduce the likelihood of an error as far as possible, make errors easier to identify, and act quickly to prevent them affecting outcomes. In this case, the focus on furcal perforation repair acknowledges that perforations can and do happen, and that being able to respond to them is an important clinical skill. Learning is more important than blame.

Using PDSA cycles. Plan Do Study Act (PDSA) cycles are a core quality improvement tool. They involve trying out an intervention designed to solve or improve a problem, measuring its impact, and making further changes if required. In this example, participants asked for greater availability of microscopes and supervision, as well as a longer session. The organisers made alterations and ran the course again, with larger numbers and good results.

Scaling up interventions. This is also an example of scaling up: testing an intervention with a small number of participants, making changes after feedback and observation, and then extending it further. The first cycle involved 9 participants; the second, after the PDSA cycle modifications, involved 25.

This article is a useful example of an educational PDSA cycle in action. It is worth reading for anyone interested in applying QI methods to dental education, particularly where clinical teaching needs to respond to learners’ priorities and feedback.

References

Mai F., Parkinson E., Mumford F. and Shehabi Z. (2026) Interactive workshops on improving dental students’ understanding of environmentally sustainable dentistry: a quality improvement project. BDJ Open, 12(1), pp. 38. https://www.nature.com/articles/s41405-026-00427-y