Evidence Based Practice in Dentistry

Before 1979, there were only 5 undergraduate dental schools in Iran with a total admission of 200 students per year, and only 2,000 dentists and about 50 specialists practicing in the country. Currently, there are 18 dental schools with a total admission of 750 undergraduate students, 5 postgraduate programs in 10 disciplines with a total of 100 students, more than 11,000 dentists (1 dentist per 5,500 population) and nearly 1,000 specialists in the country. Two new schools have recently begun offering specialty training courses in 2 disciplines. The length of the dentistry curriculum is 6 years. Students take general and basic science courses during the first 2 years, then continue on the predental and dental courses for the remaining 4 years. The curriculum has been revised over the past 20 years to establish intership and specialty programs and introduce courses reflecting current trends in the dental profession. Dental services in Iran are provided by both public and private sectors. Oral health care was integrated into the Public Health Care network by 1997, and 4 levels of a Dental Health Care Delivery System were established. The first level is concerned with primary prevention at ‘health houses’, where auxiliary health workers called ‘behvarzes’ provide periodic examinations, referrals, and oral health education. At the next level, oral hygienists and dentists in ‘health centers’ perform basic oral health care services such as fillings, scaling, and extraction. At the third level, dentists manage and treat oral diseases in ‘urban health centers’, while the last level is for advanced treatment by specialists in university health centers in the cities. Copyright © 2003 S. Karger AG, Basel Profile of the Country The Islamic Republic of Iran, with an area of over 1,648,000 km2, is a vast region in southwest Asia and ranks 16th in the world in surface area. The country is divided into 28 provinces, 285 districts and over 66,000 villages. Based on the latest census, the population of Iran is estimated to be 60,550,000 with a density of 36.44/km2. The percentage of the total population residing in cities is 61.3%, while 38.44% live in rural areas. The annual growth rate in 2000 was 1.47%, with about 46% of the population under 14 years of age, 51.38% under 20, and 4.32% aged 65 years and older. Thus the population of Iran is regarded as one of the youngest in the world (table 1) [1, 2]. National Education System Article 30 of the Constitution of the Islamic Republic of Iran states, ‘The government is duty-bound to prepare free education facilities for all people upon graduation D ow nl oa de d by : 54 .7 0. 40 .1 1 10 /1 4/ 20 17 7 :5 7: 22 A M Dental Education in Iran Med Princ Pract 2003;12(suppl 1):56–60 57 from high school. Higher education should be available to all aspirants as the self-sufficiency of the country prescribes’ [2]. The educational system of Iran consists of 1 year of preschool (5 years old), 5 years of primary school (6–11 years old), 3 years of guidance school (12–14 years old), 3 years of high school (15–17 years old), and 1 year of preuniversity programs (18 years old). To enter dental school, a student must have a secondary education diploma or a preuniversity certificate for higher education as well as a passing grade on the National University Entrance Examination. Of the nearly 500,000 preuniversity students in the experimental sciences who apply for higher education in medical universities each year, only about 700 enter dental schools [1, 2]. Another route to dental schools is available to oral hygienists who are selected from the local communities and trained for 3 years in special dental schools, during which they learn skills such as simple fillings, scaling and extraction. After 6 years of service in local rural communities and after passing the entrance examination at the end of their service, they may continue their education to obtain the degree of Doctor of Dental Surgery [1]. Profile of Dental Schools As shown in table 2, before 1979 only 5 dental schools in 4 cities (2 in Tehran, and the other 3 in Shiraz, Isfahan and Mashad) offered undergraduate dental education to a total of 200 students each year, and only 2 schools offered postgraduate training in 5 disciplines. Currently there are 18 dental schools in Iran, with an annual total admission of 750 undergraduate and 100 postgraduate students. Four of the undergraduate schools offer training programs for dental assistants, with an annual total admission of 100 students, while 3 schools have training programs for dental technicians with the same number of admissions. In 1975, there were only 250 academic staff members working in 5 dental schools. By 1990, there were 400, and currently there are around 800 academic staff members working in different departments in all the schools (table 3). Approximately 700 new dentists graduate each year [3]. In addition to undergraduate programs, the 5 older dental schools, known as ‘mother schools’, now offer postgraduate programs in 10 disciplines. Recently, 2 new dental schools have also started postgraduate programs in 2 disciplines. Following the increase in the number of schools and academic staff, the annual number of postTable 1. Country profile of the Islamic Republic of Iran Official name The Islamic Republic of Iran Official language Persian (Farsi), Turkish, other Land area, km2 1,648,000 Number of provinces 28 Number of districts 285 Number of villages over 66,000 Population 60,550,000 Density of population 36.44/km2 Annual population growth rate, % 1.47 Population under 20 years, % 51.38 Population 65 years and over, % 4.32 Population/physician 2,821 Population/dentist 5,500 Population residing in cities, % 61 Population residing in rural areas, % 39 Table 2. Profile of Iranian dental schools