This year marks the 150th anniversary of the Licence in Dental Surgery (LDS), the first dental qualification issued in the UK. It marked a great leap forward in the professionalism of dentistry. The museum has been working with Tariq Qureshi, a third year Bachelor of Dental Surgery (BDS) student at King’s College, London, to compare student life in 1860 and 2010.

Students’ backgrounds
In the early 19th century many people practised ‘dentistry’ as a sideline to their main occupation; blacksmiths, barbers and wigmakers all extracted teeth. A very small number had diplomas in medicine but many people were introduced to dentistry through training in family businesses or through apprenticeships.
Modern students can enter dentistry in a variety of ways. Tariq chose to go into dentistry after completing his first degree in Biomedical Science. He spent two years looking into the various options open to him for further qualifications. Dentistry was the best option for me because I really enjoy the practical aspect of it; the fact that every patient is different and has the potential to be a challenge. The camaraderie between the dentist and the dental team is always present and of great importance. Dentistry has a good balance between work and family life and I like the idea of being responsible for my own business and the possibility of flexible working hours. Last but definitely not least is the privilege of having a positive impact on another person's life.

Dental schools and universities
The Royal College of Surgeons of England established the LDS in 1860 but they did not provide any training. The need for training institutions led to the founding of dental schools and their associated hospitals. In 1859 both the London School of Dental Surgery and the Metropolitan School of Dental Science were founded in anticipation of the new LDS exam. The dental hospitals, such as the Dental Hospital of London (which later became the Royal Dental Hospital) and the National Dental Hospital, provided free treatment by students to patients unable to pay. There was a great demand for this service. The hospital was open for outpatients six days a week and 35 operations a day were carried out in 1862.  Over time universities began to incorporate dental schools. The first BDS was awarded by Birmingham University in 1906. The universities were still associated with dental hospitals and many, including Guy’s and St Thomas’s, continue to offer free treatment to patients treated by dental students.

Curriculum
The original LDS course was two years long compared with five for a modern BDS course. In order to enrol on the course LDS students had to be at least 21 years old and have four years experience of dentistry, which could include the required three years training in dental mechanics. The curriculum covered surgical, dental and medical subjects such as anatomy, physiology, surgery, medicine, chemistry and metallurgy. Students had to undertake two years of clinical work in a variety of departments in the dental hospital. The LDS curriculum changed considerably over the years. By 1899 students were required to take a preliminary exam in chemistry and dental histology had been added to the curriculum. In the 1926 curriculum dental bacteriology was also included and there was a greater emphasis on the practical aspects of the course. Comparative anatomy was taught until the 1980s but is no longer on the curriculum.

The BDS course has a much stronger emphasis on clinical work. Students, like Tariq, meet patients from their first year where they spend time shadowing dental practitioners. In the second year students carry out periodontological and restorative work and this continues throughout the rest of the course, with the treatments becoming more complex and oral surgery and prosthetics being introduced. Students have to fill quotas set by the General Dental Council for different treatments. They move to different hospitals to treat patients from various demographic areas and spend time in a dental clinic. BDS students gain theoretical knowledge through lectures and individual study. Topics cover dental and biomedical sciences, patient management and clinical protocols, human disease, prosthetics, oral surgery, periodontology, implant dentistry and oral disease.

Examination
The 1877 regulations for the LDS issued by the Royal College of Surgeons require candidates to undertake an exam which was partly written and partly oral. The written section covered Anatomy, Physiology and Surgery while the oral exam used preparations, casts and drawings to examine the candidate’s knowledge. In 1877 Sir John Tomes called for improvements to be made to the exam by the introduction of a practical element.
For the modern dental student assessment is continuous throughout the course. Students take a written exam at the end of each year but clinical and modular assessments occur throughout the year. The examinations are still a combination of written theoretical exams, practical clinical tests and oral presentations.

Student life
The Royal Dental Hospital had a popular Students’ Society run by the students themselves. Members presented papers at the society meetings, where invited guests and other students could comment on the findings. The transactions of the meetings were shared with other student societies in England and America. The society had its own library and museum as well as active hockey, tennis, football and cricket clubs. It organised regular trips and dinners. 
Kings College has a thriving DenSoc society for dental students. Speakers from commercial companies attend meetings to introduce new products and developments and the society has an active social calendar. 

LDS today
In this anniversary year an updated version of the LDS is being reintroduced by the Royal College of Surgeons of England after last being awarded by them in 2003. The new LDS is aimed at students who have already completed a UK dental undergraduate course or similar and have at least 1600 hours clinical experience. The LDS will be of degree standard and will be recognised by the GDC for full registration in the UK Dentists’ Register.

In association with King's College, London.