Singapore dentists debate new competency pathway

Dental Tribune International

Wed. 9. September 2026

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SINGAPORE: A new competency certification for third molar surgery has divided opinion among dental practitioners in Singapore and prompted debate over the balance between formal safeguards and opportunities for dentists to develop advanced surgical skills. Announced by the Singapore Dental Council (SDC) in July, the certificate of competency for third molar surgery is the first in the phased implementation of competency-based accreditation pathways for higher-risk dental procedures.

Although the certificate of competency is not mandatory, the council has encouraged practitioners who perform third molar extraction to undertake training beyond their undergraduate education and to work only within the limits of their competence. Dentists who complete an SDC-approved course may apply for an initial three-year accreditation. The programme must be completed within six months and requires at least 8 hours of theoretical instruction, observation of at least one third molar surgery and a minimum of five supervised clinical cases assessed as satisfactory. To obtain lifelong accreditation after the initial period, practitioners must submit evidence of having performed at least 30 third molar surgeries during those three years.

The framework also defines which mandibular third molar cases are suitable for the training. Impactions considered more difficult—including some involving deeper impaction or proximity to the mandibular canal—fall outside the scope of the course and are recommended for management by oral and maxillofacial surgeons.

The Singapore Dental Association supports the aim of improving patient safety, but has questioned whether the framework gives general dentists sufficient scope to advance after mastering the cases covered by the certificate of competency. In a letter published in August, Singapore Dental Association President Dr Eugene Tang wrote that excluding more complex cases from the framework “creates a potential ceiling” because general dentists who attain the certificate of competency have “no defined pathway within the framework to progress, through further training, mentorship and supervised experience, to cases of greater complexity”.

Dr Tang called for greater dialogue with dental professionals and cautioned against placing excessive emphasis on procedural volume when assessing ongoing competence. He emphasised: “Clinical experience matters, but professional development should also consider appropriate case selection, clinical judgement, outcomes and continuing education.”

In response, the SDC said that the 30-case threshold represents only one element of assessment and that accreditation also takes into account the quality and range of clinical experience, appropriate supervision, professional judgement and adherence to professional standards. The council said that feedback from dentists and professional bodies would inform future refinement of the system.

Reporting by the local English-language daily the Straits Times showed that views remain mixed. Some experienced general dentists have questioned how the framework will recognise prior expertise, whereas some dental practice leaders have welcomed a common training benchmark that could increase dentists’ confidence in treating appropriate cases and reduce avoidable specialist referrals. The Ministry of Health has said that the framework will be reviewed periodically.