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Contemporary dental education requires a student-centred, competence-based curriculum that facilitates training for our next generation of practitioners, emphasising in particular their roles as clinician scientists, critical thinkers, oral health team leaders and lifelong learners. In this article, Peter Thomson presents a view of dental education from “Down Under” and reviews the Australian Dental Council’s 2023 approach to defining the professional competences required of newly qualified dental practitioners, reflecting on how dental curricula must continually change and adapt to deliver the precise knowledge and skills required of modern dental practitioners.

Patient and population health are influenced by a myriad of factors outside the traditional biomedical model of disease. Health partnerships, based on a collaborative approach and involving both individuals and institutions, provide an important mechanism to improve health service delivery and enhance health outcomes. In order to be successful in delivering health promotion (and therefore improve health itself), the supporting pillars of patients, populations, and relevant and effective partnerships are of fundamental importance in contemporary practice to deliver better health outcomes for our communities.

Oral squamous cell carcinoma is a lethal and deforming disease of rising global significance. While advances in diagnosis and management have improved many aspects of quality of life, approximately 50% of patients die from progressive, recurrent or metastatic disease. The authors of this paper look towards the future of cancer therapy, combining innovative and imaginative approaches, to hypothesise new, effective tumour targetting therapies that reduce deleterious side effects from contemporary invasive and ablative treatment. Ultimately, they pose the question: can we envisage a time when terminal diseases are regarded as chronic, manageable conditions?

As he approaches his 40th year of clinical practice, Peter Thomson reflects on a professional lifetime as a clinician, surgeon, teacher and researcher. His clinical expertise as an oral oncologist, and his research work in carcinogenesis and interventional management of potentially malignant disease has taken him on an international journey spanning the UK, Singapore, Hong Kong and Australia. Taking time to reflect on his career to date, he poses the fundamental question: if life truly begins at 40, what about dentistry?

Simulation is increasingly recognised as an integral component of modern healthcare education, especially for learning irreversible interventional procedures. Dentistry has utilised various types of simulation activities during preclinical education for many years. This article reviews the application of the simulation clinic in contemporary dental education at James Cook University’s dental school in Australia and offers insight into how ‘making it real’ can stimulate the successful acquisition of clinical skills.

As Peter Thomson returns to Australia to take up the position of head of dentistry at James Cook University in northern Queensland, he reflects on the unique rural and regional clinical educational base as well as the significant contributions that the College of Medicine and Dentistry is making to ensure relevance and effectiveness in the delivery of education and contemporary clinical practice in the tropics.

Oral squamous cell carcinoma (OSCC) is a lethal and deforming disease of rising global significance. Although traditionally presenting in older patients, evidence suggests that OSCC is increasingly seen in the young (≤45 years at diagnosis), who are believed to exhibit aggressive disease and poor prognosis. By reviewing a cohort of 467 consecutive OSCC patients treated over a 19-year period, this study investigates the demographic profile, clinicopathological features and clinical outcomes characteristic of young OSCC patients in Hong Kong.

Traditional Chinese medicine (TCM) is an ancient practice that dates back more than 2,000 years and has evolved into a unique system of diagnosis and disease management that, in particular, employs herbal medicines and dietary therapies but in addition utilises acupuncture, massage and qigong (meditation, breathing and movement) exercises.1,2 It is especially popular in Hong Kong and, following legislation to establish the Chinese Medicine Ordinance in 1999 and subsequent registration of TCM practitioners via the Chinese Medicine Council of Hong Kong, has seen widened patient participation.

Delivering clinical excellence is fundamental to the success of a 21st century dental school's mission and yet, our ability to define clinical excellence in practice remains surprisingly elusive. In this paper, Peter Thomson explores the complex and multi-faceted nature of clinical excellence, confirming its pivotal role throughout knowledge creation, teaching, training, lifelong education and clinical practice. Ultimately, our ability to deliver optimal patient care, manage new and emergent disease and enhance prevention and health promotion for the future require dental education and clinical service to be better aligned and more fully integrated with general healthcare provision for all.

Internationalisation may be defined as a series of processes whereby an institute strives to increase its influence and effectiveness through global networking. In higher education, this offers opportunities to enhance communication and mobilisation between educational systems. To be globally competitive, the international university of the future must embrace digital technology, online courses and ongoing lifetime learning, especially for alumni to facilitate networks of global expertise. Oral disease neither recognises nor respects international boundaries, nor therefore should dental education, research and clinical expertise which are highly valued commodities in society. For dentistry, internationalisation offers real opportunities to influence and promote the highest standards of oral health education and clinical practice throughout the world. The international university of the future must recognise the importance of setting the highest standards for oral health across the world while maintaining regional structures and priorities.

To realise the benefits of new diagnostic techniques for the prediction of oral cancer, further validation and multicentre analyses are needed to determine their clinical impact in contemporary practice.

How can underlying disease be identified in patients with apparently routine signs and symptoms?

How have revolutionary cell proliferation theories progressed over the past 30 years?

Oral potentially malignant disorders (PMDs) are clinically identifiable mucosal diseases that share an increased risk of squamous cell carcinoma (SCC) development. This article presents a rationale for defined terminology to encourage uniformity both in clinical practice and in research.

We have reported previously on the organisation of oral and maxillofacial surgery (OMFS) services in Hong Kong, and the role of the academic discipline within the Faculty of Dentistry at the University of Hong Kong. 1 This article reviews OMFS involvement in the management of dental and facial deformity, with particular reference to the treatment needs of the local population.

For many years, early diagnosis and management of OSCC have been areas of clinical practice where variability in decision-making and lack of high-quality evidence confounded treatment initiatives. Could an improved understanding of minimal interventional therapy offer an opportunity to improve clinical care?

How research can help identify those most at risk of oral carcinogenesis.

As our regular contributor takes up a new academic role at Hong Kong University, he reflects on the evolution of the specialty in the region.

A leap of faith took Peter Thomson from years of service in the NHS to an Oral Health Alliance ‘down under’. Here, he talks about oral health and the organisation of dental services in Australia, as well as the drivers of change in academic dentistry that led to the formation of the Alliance between the University and a large public healthcare provider to deliver excellence in teaching, research and clinical practice.

The concept of an oral disease process that presents as a ‘potentially malignant state’ that is neither entirely benign nor frankly malignant is a difficult concept both for clinicians and their affected patients. While it is recognised that a range of oral mucosal conditions, now collectively termed ‘potentially malignant disorders’, harbour an increased risk of squamous carcinoma, we remain frustratingly unable in contemporary clinical practice to predict individual lesion behaviour, quantify the risk of malignant transformation or objectively plan interventions.

Oral potentially malignant disorders are mucosal diseases with a significantly increased risk of squamous carcinoma development – a lethal and deforming disease with rising incidence, especially in young people. Despite the ability to recognise pre-cancer disorders in patients, clinicians remain unable to predict individual mucosal lesion behaviour or quantify the risk of malignant transformation. No clear management guidelines exist and the available scientific literature is unable to answer the fundamental question: does early diagnosis and interventional management treat pre-cancer effectively and prevent malignant transformation?