Changing Course in the Middle of the Education Stream

This is part of an occasional series on course directors in the School of Dentistry.

Pinelopi Xenoudi

Pinelopi Xenoudi, DDS, MS

In dental school, periodontology isn’t usually one of the glamour subjects or specialties. Oral surgery, orthodontics and others get more shine.

But in the past few years, periodontology has enjoyed a nice bump in attention in the UCSF dental curriculum. And that seems to paying off for third-year students who are getting their first hands-on experience in the clinic.

“Periodontology has been like a stepchild in dentistry,” said Pinelopi Xenoudi, DDS, MS, associate professor in orofacial sciences. “Everyone wants to do the cool stuff, like crowns and implants.”

But ask patients who’ve needed scaling and root planing or have lost teeth because of gum disease, and they’ll vouch for the importance of dentists, especially general practitioners, who can quickly assess periodontal problems and fix them.

Xenoudi was course director of the PCC 138 course series – Management and Treatment of Periodontal Disease – from 2013 until last July. Like the periodontology predoctoral courses, she’s moved up the School of Dentistry ladder, becoming director of the Postgraduate Program in Periodontology.

Nearly three years ago, Xenoudi and other faculty were instrumental in pushing the PCC 138 series ahead two quarters in the curriculum. Students now learn the basics of clinical periodontology in the winter quarter of their second year instead of the summer quarter of their third year.

The key, she said, is that students learn earlier some important principles and evidence-based approaches that give them better mental tools for when they hit the clinic.

“Before, when we surveyed students at the end of the year, some complained that they were thrust into clinical problem-solving situations without enough knowledge or experience,” said Xenoudi. “At the same time, some clinical instructors were a bit frustrated that students sometimes were slow at getting it.”

So, in addition to moving the course up two quarters, she and other faculty altered instruction, introducing more small group lectures and seminars in which students and instructors analyze real periodontal cases, to pose such questions as “how would you treat this patient?” Course tests and finals focus on a solving a clinical case rather than asking multiple-choice questions.

“Now, you can see students translating that knowledge into the clinic,” she said. “Sometimes you can see the light bulb turn on when they’re with a patient.”

It might also be turning on more students to periodontics. In 2013, only two members of the UCSF graduating class chose postdoctoral training in periodontology. Last year, seven graduates — who may have benefited from the course change — were in the UCSF program and eyeing a specialty in periodontology.

The curriculum change for periodontology may seem like an obvious putting-the-horse-before-the-cart situation. But altering curricula in a school as renowned and prestigious at UCSF is a bold move. Like the practice of dentistry, you don’t need to fix what’s not broken. But academics here want to close any gaps in learning and make sure the School continues to turn out the most thoughtful and well-prepared practitioners.

And there may be more changes and improvements in the School’s curriculum in the future. Xenoudi is a member of a steering committee, appointed in 2015, to draft and outline principles and direction for changing the way the School teaches and runs its predoctoral clinics.

Teaching is Xenoudi’s passion. A native of Greece, she received her DDS in 2003 from the Kapodistrian University of Athens, taught at the University of Colorado School of Dental Medicine, and came to UCSF in 2013. She’s an accomplished researcher, too, studying regenerative materials and dental lasers for periodontology and implantology. But she’s “not a very good lab rat” and much prefers being in the classroom and clinic.

She spends up to 10 hours a day with lectures, clinical instruction and faculty meetings. Now, add on another two hours at night to read papers from postdoctoral students.

The hours may be long, but the reward comes when she sees “the sparkle in the eyes of students” when they figure out a complex patient case, she said. “It makes the sweat and long hours well worth it.”

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