Table of Contents
Applying to US Dental Schools: Points to Note
The Structure of a Doctor of Dentistry Programme
Admission to Dental Schools for the Dentistry Degree
Obtaining a License to Practise Dentistry
Advanced Dental Training for Foreign Dental Graduates
Additional Resources

This is an overview of the dental education system in the United States as well as information on dental licensure and completing residencies and electives in the US.

Applying to Dental School: Points to Note

Level of Dental Education
There is no undergraduate dental degree in the United States. Therefore, it is not possible to begin dental school directly after A levels or Scottish Highers as it is in the United Kingdom. You will need to attend a university for at least two years before you can be admitted to dental school, and preference is often given to applicants who have completed a bachelor's degree.

Length of Dental Education
Dental school itself takes a minimum of four academic years and leads to one of two equivalent degrees: Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DDM).

Practising Dentistry in the US
International students should note that holding a US professional dental degree does not in itself give you the right to work in the US. When applying for a visa, it is important to remember that a student needs to show intent that he/she will return to his/her home country after finishing his/her degree. Check with the appropriate professional association in your home country to see if the US degree will meet your home country's requirements to practise dentistry. Questions regarding specific education credentials, visa requirements, and examinations required for licensure should be directed to the individual US state dental boards.

Acceptance Rates at US Dental Schools
Competition for places is fierce. US dental schools have a primary obligation to train US citizens and are strict about accepting international students into the first year class. This obstacle can be overcome if the international applicant has established permanent residency status prior to making an application. If you plan to apply to a state supported school be aware that most are required to give preference to in-state residents.

Expenses
The American Dental Association estimates that the average annual cost of tuition and fees for first year dental students can range from approximately $8,000 to over $35,000. In addition, the cost of living for one academic year (nine months) ranges from $8,000-$13,000 depending on location in the US. There are large extra educational expenses during the first two years owing to the dental instruments that need to be purchased. Few scholarships are announced for international students to pursue dental education, and loans are generally not available from US lending institutions. The dental school or its parent university may offer some financial aid packages. However, individuals with permanent residency in the US may also be eligible for federal student loan programmes. It usually takes a permanent resident one year as a non-student to establish residency in a state. State residency allows students to pay in-state tuition fees at state universities, which are lower than both out-of-state and private university fees.

The Doctor of Dentistry Programme
Dental schools are located within or close to medical and hospital facilities. The traditional four-year programme of study consists of two pre-clinical years of basic sciences and two years of clinical study. The pre-clinical years focus on biomedical sciences, in particular the basic principles of oral diagnosis and treatment. Subjects covered usually include anatomy, biochemistry, embryology, histology, pharmacology and physiology. Many dental schools now provide an introduction to clinical dentistry during the pre-clinical training. The clinical years are spent treating patients that have a variety of oral diseases and disorders while working under the supervision of clinical instructors. In this way, students can develop skills in the planning and provision of dental treatment. This will usually involve rotations through the various clinics in the dental schools as well as in outside clinical settings. Other topics covered include practice management, patient management, professional ethics and the use of allied dental personnel. After four years the first professional dental degree is conferred.

Alternative Programmes
A small number of students enter dental school prior to completing their undergraduate studies. In such cases a bachelor's degree can be earned while completing the dental curriculum, but only if the college at which the individual did their undergraduate work offers such a programme and awards the degree independently from the dental schools.

Some schools provide the opportunity for selected studies to earn their dental degree together with one of the following advanced degrees:

Master of Science (MS) - This degree is usually offered in oral biology or a basic science. It requires about one additional year of study.

Masters in Public Health (MPH) - This is a programme designed for those especially interested in dental public health. It requires from one summer to one year of additional study.

Doctor of Philosophy (Ph.D.) - This degree is usually awarded for work completed in one of the basic sciences. It requires at least two additional years of study and is designed for those planning careers in academic dentistry.

Admission to Dental Schools

How to Apply
For an overview of the application procedure to US universities for postgraduate study you should read EAS Guide to Postgraduate Study in the United States.

There are two methods of applying: either directly to the school or indirectly through an application service. Applications made to the individual schools should be done well in advance; it is advisable to begin the application process about one year before you wish to start. Application forms must be secured from the dental schools themselves, and transcripts and recommendations must be sent to each school individually.

American Association of Dental Schools Application Service (AADSAS)
Applicants can obtain application materials from the American Association of Dental Schools Application Service (AADSAS). AADSAS is a centralised application processing service that sends a single application form to the dental schools specified by the student for a fee. It does not render admissions decisions, nor does it advise students. At present, 51 out of 55 dental schools participate in AADSAS. You can obtain an application by writing to AADSAS, 1625 Massachusetts Ave NW, Suite 600, Washington DC 20036 (202) 667-1887 Web site: www.aadsas.com Email: appl@aads.jhu.edu. Applications must be received by AADSAS by April 1st.

Entry requirements for dental school vary from one institution to another, so for specific requirements contact schools directly. The admissions committees of US dental schools where you apply will generally consider the following factors:

Undergraduate Coursework and Performance
The nature of the US liberal arts degree allows students to obtain a strong foundation in the natural sciences, but also take courses in the arts, social sciences and humanities. The majority of US students who intend to apply to dental schools take their Bachelor's degree in biology, chemistry or another science-related subject, although this is not mandatory. All US dental schools emphasise the importance of the liberal arts education.

Although mandatory courses at the undergraduate level vary from school to school the basic requirements for dental schools are:

Biology or Zoology, 1 year with lab
Inorganic Chemistry, 1 year with lab
Organic Chemistry, 1 year with lab
Physics, 1 year with lab
English, 1 year

A number of schools also require coursework in mathematics, behavioural science, the humanities and computers. Note that a "pre-dental" degree (one that was designed to include the coursework required and to prepare students only for entry into dental school) does not guarantee admission to dental school and may not even be treated as the best curriculum for all students, depending upon your individual interests. It is also possible to take this sequence of subjects at a US university while majoring in an unrelated subject.

In addition to successful completion of required undergraduate coursework, a strong cumulative Grade Point Average (GPA) is also necessary. The GPA for the average dental school matriculant is about 3.5 on a 4.0 scale (the approximate equivalent of a B+ or 2:1). A high GPA by itself, however, does not guarantee admittance to dental school. As has already been mentioned, admission to US dental schools is extremely competitive, so students applying with bachelors degrees lower than a 2:1 would have a very slim chance of admission.

The Dental Admission Test
Most dental schools require applicants to take the Dental Admission Test (DAT). The DAT measures 1) knowledge of natural sciences (biology and general and organic chemistry), 2) reading comprehension (natural and basic sciences), 3) quantitative reasoning, and perceptual ability. The DAT, which is offered as a computer-adaptive test, is given almost any day of the year on computer. It is administered at numerous US testing centres and can be administered outside of the US by special request which must be made three months in advance of the regular testing date. Dental admissions committees review test scores in conjunction with undergraduate academic records. The DAT should ideally be taken in the spring one year prior to applying. Applications can be ordered through the American Dental Association's website at www.ada.org.

Other Factors

• Personal statement – this is the chance for you to sell yourself and your abilities to the admissions committee as well as express your motivation for wanting to attend dental school. A good essay requires careful planning, reviewing and revision. EAS can review your essay and offer tips for improvement.

• Letters of recommendation - these can be from undergraduate advisers and faculty, from dentists, community leaders, and other individuals who have employed you or supervised your volunteer experience.

• Exposure to dentistry field and community service - - this includes extracurricular activities that reflect public or health-related services. This experience shows that you are genuinely dedicated to the field.

• Interview with an admissions officer - this interview can be used to show the personal characteristics you will bring to the profession. Interviews are held towards the end of the application process. Many dental schools invite the most promising applicants to an interview at the dental school with faculty and other members of the admissions committee. This can pose problems for students who apply from abroad.

Obtaining a License to Practice Dentistry
There is no national dental licensing authority in the US. The license to practise dentistry is granted by the individual dental licensing authorities in each of the 50 states, commonly known as the "state dental boards". As each state varies in its licensure requirements, students should contact the state board of the state in which they wish to practice (a list of state boards can be obtained from the EAS or at the following web site: www.ada.org/prac/careers/statebds.html). Licensure requirements usually include a satisfactory formal education programme in dentistry (frequently graduation from an accredited dental programme), written examinations (usually National Board Dental Examinations) and clinical examinations. For more information contact the appropriate state board or check the American Dental Association's website.

Licensure for Foreign Dental Graduates
The first step is to contact the state board for the state in which you plan to practise. According to the American Dental Association, 16 US states will consider graduates of foreign dental schools but 12 of the 16 require the foreign dental graduate to complete additional education at a US dental school. Graduates from foreign dental schools can be accepted, with advanced standing, into the second or third year at about half of the accredited dental schools in the US. Upon graduation, they may apply for licensure.

The licensure procedure for most states usually entails the following steps:

• Educational evaluations

• National Board exams

• Bench test

• Clinical skills test

For a thorough treatment of this subject please refer to the Dental Licensure information sheet produced by the American Dental Association, which is available from the ADA website.

Advanced Dental Training for Foreign Dental Graduates
The US offers opportunities for advanced dental training for individuals who already hold dental degrees. These programmes do not in themselves confer or prepare dentists for licensure. Advanced programmes can take the form of:

1) Graduate Programmes: these are usually conducted by universities and lead to a Master of Science (MS), a Master of Science of Dentistry (MSD) or PhD. These degrees usually require coursework and a thesis. Students on such programmes are usually planning careers in teaching and/or research. Applicants to these programmes usually need to meet the general requirements of the university's graduate school as well as the specific programme requirements.

2) Postgraduate programmes: these are usually conducted in hospital and lead to a certificate rather than a degree qualification. Foreign-trained dentists may find admission to these types of programmes difficult owing to state licensure requirements.

Advanced Programmes in General Dentistry
These type of programmes usually last at least a year and can be either a general practice residency or a general dentistry programme. A general practice residency is usually conducted in a hospital and involves extensive contact with hospitalised patients. A general dentistry programme is usually conducted by a dental school and involves contact with all population groups.

Advanced Programmes in Dental Specialities
There are eight dental specialities recognised by the American Dental Association: dental public health, endodontics, oral and maxillofacial pathology, oral and maxillofacial surgery, orthodontics and dentofacial orthopedics, paediatric dentistry, periodontics and prosthodontists. Becoming a specialist usually requires two to four additional years of training beyond a dental degree and practical experience in the field.

Other Advanced Programmes
Dental schools can also run advanced programmes in specific disciplines rather than recognised specialities such as anatomy, anaesthesiology, biochemistry or pharmacology.

For further information on institutions offering postgraduate training, contact The Commission on Dental Accreditation, American Dental Association, 211 East Chicago Avenue, Chicago, Il 60611, or the American Dental Association Web page at www.ada.org.

Additional Resources

Other On-Line Resources
American Dental Association 211 E. Chicago Avenue, Chicago, IL 60611. Tel: 001 312 440 2500; Fax: 001 312 440 7494;

American Association of Dental Schools, 1625 Massachusetts Avenue, NW, Washington, DC 20036-2212.

Academy of General Dentistry, 211 E. Chicago Avenue, Chicago, IL 60611. Tel: 001 312 440 4300;

The Dental Students Network, Student Doctor Network

State and Regional Dental Practise Boards

Off-Line Resources
The US Educational Advisory Service's reference library contains several directories concerning dental education in the US and catalogues for dental schools and US universities. The EAS can also proctor the Dental Admissions Test (call 020 7404 6994 for details). you are welcome to consult these materials during our opening hours.