50 Years of Excellence in Education
Evolving Academics Continues Preparing Outstanding Dentists
By Tracy Hobson Lehmann
The supply kit Warren Branch, D.D.S. Class of 1981, received when he walked into the School of Dentistry at UT Health San Antonio as a first-year student in August 1977 contained everything he would need for his next four years, including a full set of dental tools and a sharpening stone for hand instruments.
He started his freshman year in his own private cubicle that contained a television connected to a dial-up system to allow him access to not only lecture reviews but also information on many other health care issues. No other dental school in the country offered this teaching luxury to entering students, Dr. Branch said. This first-class treatment continued into his junior and senior clinical years when he and his fellow classmates were taught hands-on dentistry in their own enclosed operatories furnished completely with high-end equipment.
But then, when the School of Dentistry was less than a decade old, it was at the forefront of dental education just as it is today.
Leaders in education
“We had former military men who taught the very best in the fundamentals of dentistry and the most advanced technology in the country,” says Dr. Branch, who has practiced general dentistry in San Antonio since graduating in 1981.
One of the military members recruited for the school’s faculty was Glenn R. Walters, D.D.S. As a captain in the U.S. Air Force, he practiced dentistry at Ramstein Air Base in Germany during the Vietnam War before coming to San Antonio to become the founding chair of the Department of Endodontics. He retired as an associate professor in May 2020, having taught every one of the dental school’s graduates in its first 49 years.
“We all had the attitude that we wanted the students to be trained well, and we did it,” says Dr. Walters. The attitude of excellence never changed, but the years saw seismic shifts in the dental school’s curriculum and teaching practices as it kept pace with the rapid evolution of patient care, technology and education.
“In those early years, our instruments were different, our materials were different, and the evaluation we would give to a tooth that needed to be treated was different. But through the years, we kept moving along to be able to provide the right training to our students,” Dr. Walters says.
Birgit Junfin Glass, D.D.S. Class of 1975, M.S., had a front-row seat for witnessing the evolution in students, faculty and academics.
Dr. Glass, who retired in 2017 as associate dean for academic affairs and a professor, enjoyed a 42-year career as a faculty member and administrator at the School of Dentistry. She was a first-year student in 1971, a class of 16 that is distinct for including the school’s first two female students.
Her cohort navigated a curriculum radically different from today’s.
Then, first- and second-year students got cursory introductions to dental topics such as periodontics and diagnosis while they were immersed in basic science classes that are now integrated into dental courses.
“When you first came into dental school, you took about 20 courses your first year. Dental school is hard, and here you were trying to navigate through a whole new environment coming from college, and you have classes like biochemistry, histology, and gross anatomy. You’re learning a whole new vocabulary, memorizing tiny muscles in the body, and dissecting a human cadaver,” Dr. Glass says. “The courses that we think are so important to dentistry got relegated to the background.”
Start with the teeth
Conversely, today’s students delve into dentistry right away, thanks to a revamped curriculum implemented in 2017. The new course structure was developed through a four-year evaluation begun in 2013 with an eye toward preparing students for the new Integrated National Board Dental Examination that replaces the two-part National Board Dental Examination this year.
“We knew what was coming, so we felt it was important to make that change,” says Adriana Segura, D.D.S., M.S., associate dean for academic, faculty and student affairs and acting chair of comprehensive dentistry.
The 50-plus science classes now are spread across three integrated content areas that are given equal weight. The areas of study include health and human disease, patient care, and restorative dentistry.
Students learn biochemistry, anatomy and other sciences as they relate to oral health. “It’s all relevant to the context of what you’re studying rather than being all these separate things you’re learning,” says Dr. Glass, who led the team that mapped out the new curriculum.
Additionally, lab classes introduce first-year students to practical skills. The students not only learn to use electronic patient records and interact with patients to gather medical histories, they also work on manikins to develop hand skills critical to dentistry.
“In dentistry, you’re working within a millimeter to keep from hitting a nerve, so it’s important to develop those hand skills,” says Dr. Segura. Introducing those skills earlier and giving students more practice time allows students to be more successful and ultimately provide better patient care, she adds.
The curriculum that focuses first on the mouth and then the rest of the body is unique in dental training, notes Dr. Glass.
“It was more convenient to start with the body because dental schools were tied to medical schools,” she says. “But my philosophy was that dental students come to dental schools because they like dentistry. You need to get really good at the mouth and then move out to the body.”
Technology and treatment
More gradually, the dental school curriculum shifted to reflect changes in oral health care.
“The pace of information and the development of technology are critical,” says Archie Jones, D.D.S., M.B.A., who retired in August 2020 as a professor and director of the predoctoral division of the Department of Periodontics. “The things we do now with computers and CAD and diagnostic 3-D imaging I never would have dreamed would be part of dentistry.”
Those advances, though, mean more things for students to learn. “Our curriculum has been dynamic through the years. We’ve been good at changing to address the problem of condensing more information into less time,” says Dr. Jones, who joined the faculty in 1979. “At the end of the first semester in dental school, our students know significantly more about dentistry than I did at the end of my first year.”
The trade-off for learning more is a beefier list of prerequisite courses for entering students. Applicants need credits in sciences such as biochemistry, microbiology and physiology as well as statistics.
“The literature has gotten so complex that students have to at least be able to assess research design and the application of statistics,” Dr. Jones says. “The dentist has to take a much broader approach to treating patients now. We have to be more aware of the effects multiple medications and multiple diagnoses can have on the oral cavity.”
Karen Troendle, D.D.S. Class of 1977, M.P.H., learned different practices when she started dental school in 1973 than what she teaches today as a professor of comprehensive dentistry.
“When we were students, we learned porcelain bonded to metal and gold crowns. We actually cast the gold crown ourselves,” says Dr. Troendle. Then, working with precious metals became a hobby for some students, who practiced jewelry making in their spare time.
“The materials we used then are obsolete today. Now we have materials that can be milled and scanned,” she says.
Dr. Troendle joined the faculty in 1977, when the dental school was ramping up staffing to accommodate incoming classes of 150 students, almost 10 times larger than the inaugural incoming class of 16 and almost five times larger than her class of 32 students.
“Dentistry is very different now than it was then. We don’t just prep and fill anymore,” she says. “Dentists have grown to be health care providers who assess each patient’s individual risk factors and provide treatment with those risk factors in mind. Today we try to prevent or heal a lesion before we commit to cutting it.”
Dr. Troendle also notes the expansion of material options as well as ever-changing technological advancements.
“There’s a ton of things for students to know when they walk out of here now,” she says. “The technology is technique sensitive, and if you’re not precise with how you handle a restoration, you’re not going to be successful.”
Keeping abreast of emerging practices and technology is demanding for a faculty that also juggles clinical work. But the School of Dentistry attracts experts who bring national and international trends to incorporate into the curriculum. Faculty members also hold leadership roles in professional organizations throughout the country.
“We have a wonderful cadre of faculty. It’s a culture that you want to do the best and be the best,” Dr. Glass says.
Dr. Troendle agrees. “We have been lucky in attracting people at the top of their game. We have people who wrote the definitive textbooks in their fields as our teachers and our mentors. The ones setting the trends are the ones on campus teaching.”
Faculty members and administrators get creative in their teaching strategies to help ensure student success.
In comprehensive dentistry, for example, in order to make simulation labs more clinically relevant, Dr. Troendle helped to create “situation teeth” with simulated disease which require students to use clinical judgment when preparing a tooth for a restoration.
“At other schools, students usually cut cookie cutter preparations repeatedly,” she says. “But our students solve puzzles. We challenge them in each quadrant of both arches, and with guidance, they figure out the approach.”
The clinic structure is unique, too.
In many schools, students rotate through clinics dedicated to each discipline. “Our school was always an integrated clinic, where the student stays in one place with the patient and the faculty coming to them,” Dr. Glass says. “That clinic structure is unique in the United States.”
Student access to technology and their involvement in the community also set the school apart, Dr. Segura notes.
“We have our students in the local community and all the way to South Texas starting in their first year all the way through their fourth year,” she says. “We want them to see the needs in the communities they will serve.”
Though students may not have access to advanced equipment in their first practices, they will learn it.
“We invest in technology, and we teach the traditional way,” Dr. Segura adds. “We have digital technology for scanning for implant placement and crown fabrication in the clinic, but not everyone can afford that equipment right away.”
Much as technology has reshaped dentistry, it also has changed the face of education.
Drs. Troendle and Glass recall the planning and time they devoted to making mimeograph copies and mounting their slides for presentations. “If you dropped your slide carousel, you were out of luck,” Dr. Troendle says with a laugh.
Computerization crept onto campus beginning in the 1980s with clunky orange-screened Macintosh computers. By the mid-’90s, emails became the official means of communication on campus.
“The dental school was ahead of the rest of the campus because we had young faculty who were computer savvy,” Dr. Glass recalls. “In 2000, we started the first curriculum requiring students to have laptops, and we provided electronic resources. It was a huge change.”
Fast-forward to 2020, and faculty adapted rapidly for remote learning during the COVID-19 pandemic.
“The general trend in education is adapting to the needs of the current generation of students and how they want material presented,” Dr. Jones says. “They don’t want to listen to lectures, and they depend less on textbooks and more on created materials.”
When the School of Dentistry celebrates its next milestone, changes to technology and curriculum will most likely make academics look very different from today. But, as always, one of the country’s best dental programs will have adapted to be able to graduate compassionate, exceptionally trained dentists.