The European Federation of Conservative Dentistry (EFCD) is a learned federation of national conservative, restorative and operative dentistry societies whose stated purpose is to provide global leadership in the promotion of oral and dental health, preventing and managing dental caries, tooth wear and trauma, aiming to reduce the impact of such common debilitating dental diseases / conditions on individuals, with a consequential improvement of the oral and general systemic health of individuals and populations.

The EFCD’s constitution was created on 20 December 2001 in Basel, Switzerland by national societies of conservative, restorative and operative dentistry (Belgian, British, Dutch, French, German, Irish, Italian, Portuguese, Spanish, Swedish and Swiss). The EFCD aims to be one of the leading authorities in conservative / restorative / operative dentistry worldwide and a leading authority in dentistry in Europe and beyond. This global reach will be garnered a result of exemplary co-operation between independent national societies and other stakeholders, together with a deep conviction amongst its member societies that the federation will continue to fulfil its leading role in the field of restorative dentistry.

The decision of the EFCD council to review, update and disseminate its strategic plan has been an opportunity to set up and re-establish priorities, to focus resources and energies, to enable the establishment of common goals for the benefit of all stakeholders, to establish agreement around the planned outcomes and also to allow adjustments in the direction of the EFCD in response to continually changing global economic environments and challenges.

The EFCD Council is charged with the challenges of looking at the “big picture” with an eye on the future, has delivered with clarity, a document that indicates a willingness to provide leadership in this field, guidance for colleagues and support to patients.

Mission EFCD:

The primary aim of the European Federation of Conservative Dentistry, here after referred to as the “EFCD”, shall be to contribute to the promotion and delivery of better oral and dental health in the public interest by encouraging excellence in procurement and dissemination of knowledge, clinical practice, teaching and research, pertinent to all aspects of Conservative / Restorative / Operative Dentistry. (Constitution article 2)

1. Introduction

1.1 What is Conservative / Restorative / Operative Dentistry?

Conservative, Restorative & Operative Dentistry are collectively the scientific and clinical study / practice of the dental hard tissues. Their scope is substantial given its broad biological base, including those disciplines related to oral biofilms, namely microbiology, immunology, histopathology, pharmacology and molecular biology. As a consequence of research and development, the scope of study has extended to include restorations placed to reconstruct teeth, the management of tooth wear and dental trauma, as well as the awareness of the associations and interactions between dental caries, pulp biology, oral mucosa and dental biomaterials.

The European Federation of Conservative Dentistry (EFCD) is a Federation of national societies whose purpose is to reduce the impact of oral and dental diseases and conditions on individuals and upon society, with the aim of improving oral and general health and wellbeing in the primary care setting. Whilst the EFCD has industry partners who support the much-needed educational outreach activities and public awareness campaigns of the Federation, the EFCD is independent and does not endorse any company, company policy or product. Independence and objectivity are the core tenets of the EFCD.

1.2 Background and History of the European Federation of Conservative Dentistry

As conservative oral healthcare is the basis and core business of primary care dentists, dental hygienists and dental therapists, it is important that conservative oral healthcare is supported and promoted by a scientific society analogous to Endodontics (ESE), Prosthetic Dentistry (EPA) and Periodontology (EFP). The scientific research in Cariology is covered by ORCA, but this is solely an academic society of researchers. Therefore, in 2001 the EFCD was founded on basis of the individual societies of conservative/restorative/preventive dentistry being its members, akin to the other societies aforementioned. The first conference of EFCD (Conseuro) took place in Munich in 2003. Conseuro is a biannual conference organized in one European country by EFCD and the local member organisation / society. Other activities of EFCD in the past included guideline development and position papers, some of them in collaboration with ORCA. The Covid-19 pandemic resulted in years that conferences were not possible to organize and now in 2024 EFCD aims to extend and develop new activities.

1.3 Purpose of the EFCD

The prime purpose of the EFCD is to provide pan-European, and as appropriate, global leadership, in the promotion of Conservative / Restorative / Operative Dentistry. This is specifically linked to the prevention and management of dental caries, tooth wear and trauma, and in turn, oral and general health and wellbeing by means of education, research and evidence-based advances in clinical preventive and operative practice. The intended outcome is to enhance public awareness and generate a positive influence on national and international health policy.

The groups that the EFCD represents / works with in promoting oral & dental health include:

  • General dental practitioners
  • Oral healthcare professionals and other members of the oral healthcare team
  • Patients and other members of the public
  • Funders of oral healthcare services, together with all those with interests in the business of dentistry
  • Societies, associations, other federations, colleges and all other relevant healthcare bodies and organisations at national, European and international levels
  • Providers and funders of dental education and students at all levels
  • Charities and other agencies which may fund relevant aspects of research
  • Governments, policy makers and champions of the art and science of oral health
  • Industry, in particular, dental industry partnerships
  • Publishers and all those involved in the dental and related press / media.

Since its founding, the EFCD has evolved into a European umbrella organisation of Operative and restorative dentistry and cariology with Conseuro meetings becoming highly regarded, cutting-edge events for the sharing, discussion and debate of contemporary knowledge and understanding in Cariology, operative and restorative dentistry and as a showcase for state of the art, techniques, instrumentation, devices and biomaterials. Other activities of the EFCD include consensus meetings in collaboration with ORCA and the production of international clinical guidelines for diagnosis, prevention and treatment of dental caries. A dental curriculum for conservative oral healthcare has been published to support dental schools deliver their educational programmes.

1.4 Background to the present Strategic Plan

The disciplines of Conservative / Restorative / Operative Dentistry and the environment in which they are applied clinically in primary care, is rapidly changing. In Europe, dental associations that represent highly specialized clinical practitioners such as ESE or EFP have a strong foundation, as they provide an identity through which the associations and their members can promote their specialities.

In contrast, EFCD represents general primary care dentists with a broader therapeutic spectrum, which constitute the majority of dentists across Europe (and globally). However, due to the lack of discipline-specific specialisation, it is harder to appeal to practitioners and their teams. It was therefore considered timely for the EFCD to reassess and review its goals.

Clinical Oral Investigations (CLOI – Springer) is the professional journal in which peer-reviewed science generated from EFCD workshops and the wider Conservative Dentistry scholarly community is published. The Council and EFCD staff work closely with the CLOI editor helping him/her to deliver and maintain the quality of the journal.

A further key focus of the New Strategic Plan in line with global trends, is sustainability which will be integral across all aspects of the EFCD strategy and management decisions. The wellbeing of our members must also be on the agenda and importantly, recognition of success with new awards being created. The EFCD acknowledges the importance of embracing diversity, equity and inclusion for all and a such will reflect this in its strategic plan.

1.5 Challenges

The EFCD aims to expand its activities over future years, specifically in communications, heightening public and political awareness and in the dissemination of oral health messages to patients and the public. There is a need for engagement with patients and the public as well as oral healthcare professionals, in this regard. The need for professional support to sustain and further develop this expansion is identified by the senior council officers. This challenge creates a tension between realising the goals of the EFCD and affordability, which needs to be carefully managed. Each project identified in the New Strategic Plan will become the responsibility of the Executive Council, with a budget agreed with the EFCD Treasurer. Each committee will identify the actions necessary to deliver it delegated strategic objectives and will map these against timelines to help monitor and track progress. The website, which historically served us excellently, needs to be redesigned to accommodate the New Strategic Plan, refreshing and rebuilding as required to accommodate our vision for the next tranche of activities. With advances in technology, the revised website should enhance communication both internally for EFCD’s management information systems, and externally with stakeholders and a world profile. It will also facilitate greater integration with the national societies and improved digital communications in line with the sustainability policy.

2. Environmental Context

The EFCD is a leading learned society in the field of Conservative / Restorative / Operative Dentistry in primary care. The EFCD, with its wide-ranging activities and reputation for excellence, is highly regarded among sister organisations, including the American Academy of Operative Dentistry (AOD) and the Asian-Oceanian Federation of Conservative Dentistry (AOFCD).

Many factors influence the activities and direction of travel of the EFCD. These include, in no particular order:

  • Political, social and economic changes in Europe which affect the professional environment
  • Strategic changes, funding arrangements and advances in healthcare across EFCD Europe and beyond
  • The impact of change in population demographics, notably the increase in the proportion of older adults, most of whom are retaining more teeth for longer and those vulnerable groups living in socio-economic deprivation, where a greater proportion of disease is prevalent, but often these groups have the least access to primary care
  • Recognition of the importance of oral health to general health and wellbeing – the importance of prevention-based, risk/susceptibility/needs-related care
  • Changes in patient behaviours and consumer group attitudes to oral and dental health, and the influences of these changes on general health and wellbeing
  • Increasing interests in dental attractiveness and oro-facial soft tissue aesthetics
  • The impact of the increasing use and expectations of implant dentistry and prosthodontics – “smile make-overs”
  • The ever-increasing rate of advances in dental and related technologies, and associated knowledge and understanding which create opportunities for new treatment modalities
  • Increasing expectations in relation to evidence (value)-based care
  • EFCD partnerships with other societies enabling benchmark definitions and guidelines to be established, including environmental sustainability
  • Advances in dental education and the impact of the implementation of the Bologna process
  • Increasing competition for research funding, research priority setting and the increasing need for open access dissemination of research findings
  • Growth in awareness of the importance of inter-professional working in future healthcare provision – the development of the roles of the oral healthcare team
  • Shifts in approaches and attitudes to professionalism and ethics in dentistry
  • Engagement of young practitioners in professional bodies and associations, in particular, young practitioners who show interest in becoming the next generation of leaders of organisations such as the EFCD
  • The impact of the world-wide web / digital social media as a source of information / misinformation on matters pertaining to the practice and further development of Conservative / Restorative / Operative dentistry
  • The international heterogeneity of the recognition and regulation of Conservative / Restorative / Operative dentistry in primary care, despite widespread support for greater harmonisation.
3. Vision & Strategic Objectives

3.1 Vision and definition

Conservative / Restorative / Operative dentistry encompasses the art, science and practice of attaining and maintaining healthy dental hard tissues, replacing lost tooth substance by implantation of natural and/or synthetic devices and reconstructing lost supporting structures by regeneration or repair with the goal to maintain the health, function and aesthetics to improve oral and general health and wellbeing.

3.2 Strategic Domains

Improved Health & Wellbeing: Improve and promote oral and dental health globally as part of general health and wellbeing, ensuring socio-economic inclusion, by working in partnership with patients, public, governments, professional bodies, industry, consumer groups, media and other organisations.

Education & training: Maintain, refine, harmonise and further develop the highest standards of education and training in the art, science and clinical practice of Conservative / Restorative / Operative Dentistry to increase knowledge/awareness on the importance of dental diseases and their consequences for other oral and allied healthcare professionals.

Policy and Influence: In collaboration with national member organisations and through strong leadership, influence policy at national and international levels, including the recognition of oral & dental diseases as a public health problem as well as source and consequence of social inequality / inequity.

Science and Research: Promote research and knowledge procurement in all aspects of Conservative / Restorative / Operative dentistry, with global dissemination and application of research findings to enhance patient and public awareness and promote the practice of evidence-based and person-focused care and, in turn, clinical outcomes.

4. Strategic Actions

The following actions are considered necessary to realise the strategic objectives of the Federation. These strategic objectives are inclusive of development and maintenance of effective communication channels across all aspects of EFCD’s activities, both internally and externally. A sustainable approach will be taken whenever possible with regards to all strategic objectives.

Once these actions are approved, an implementation plan will be developed. This plan will assign individuals, groups or national associations the responsibility for completion of the actions and set out desired timeframes.

Strategic Domain 1: Improved Health and Wellbeing

1.1 Promote the maintenance of oral & dental health across all ages to increase tooth retention and improve general health and wellbeing by increasing the awareness of the impact of dental diseases upon oral health, tooth loss, nutrition, self-confidence/esteem, general health and quality of life.

1.2 Monitor the changes in the global burden of dental caries and its socio-economic impact in an increasingly ageing population, with multi-morbidity. Develop and foster the implementation of effective prevention plans with the objective to reduce the burden of dental diseases in Europe, especially on those vulnerable groups often with highest treatment need.

1.3 Develop and widely disseminate evidence-based clinical guidelines aimed at identifying and preventing dental diseases, and re-establishing and maintaining periodontal and dental health.

1.4 Develop and disseminate evidence-based clinical guidelines aimed at restoring masticatory function by implantation of natural and/or synthetic devices and to reconstruct lost supporting structures with the goal of re-establishing the health, function and aesthetics to improve oral and general health and wellbeing.

Strategic Domain 2: Education and training

2.1 Update periodically, EFCD primary dental degree competencies and curriculum guidelines (with ADEE collaboration), with the aim of enhancing the harmonisation of learning, teaching and clinical instruction outcomes in Conservative / Restorative / Operative dentistry amongst new dental graduates across EFCD member countries.

2.2 Support the development of graduate training programmes in Conservative / Restorative / Operative dentistry across EFCD member countries

2.3 Promote EFCD accreditation of postgraduate programmes in order to establish a common standard across EFCD member countries (mentor system) and become an international standard.

2.4 Develop and disseminate educational materials, such as a clinical journal, webinars, podcasts, materials developed in association with EFCD projects, aimed at four distinct targets: universities (at graduate and postgraduate levels), general dental practitioners (GDPs), dental hygiene and dental therapy schools; allied healthcare professionals (including medical doctors and pharmacists amongst others).

2.5 organize in-person conferences (Conseuro) and online activities in order to inform primary care practitioners and their teams on the latest developments in operative/restorative/preventive dentistry research and clinical practice.

2.6 Promote and enhance the role of the individual member, creating a path that can certify, in harmony with corporate members, advanced clinical skills and scientific knowledge in the field of operative, restorative, conservative dentistry. This could be achieved with national organisations, e.g. the College of General Dentistry in the UK.

Strategic Domain 3: Policy & Influence

3.1 Develop a network of professional alliances with international healthcare organisations (e.g. WHO / FDI / CED / European Platform for Better Oral Health) and international associations with the goal of oral and dental health being recognised as an integral component of general health and wellbeing.

3.2 Continue to lobby public health organisations (e.g. WHO / EU) and policy-makers to embrace dental caries and toothwear as a significant public health issue.

3.3 Encourage and support national societies to continue, and wherever possible expand dialogue with their national authorities to ensure that national issues are taken into account in EFCD policy-making.

3.4 In collaboration with the EFCD Member Societies, increase awareness of the competent authorities and the public about the high prevalence and socio-economic consequences of oral and dental diseases in the general population.

3.5 Furthermore, increase the awareness of the public and competent authorities on the effectiveness of preventive and therapeutic strategies to improve oral and dental health, function and aesthetics.

3.6 Increase the collaboration with medical learned bodies and associations to raise awareness on the evidence of the association of dental diseases (esp. dental caries) with an increasing number of non-communicable diseases, their impact on quality of life and the benefit of co-management.

3.7 Strengthen the EFCD brand in order to improve dissemination to the professionals, the national competent authorities and the public.

3.10 Foster the development of the EU patient and public associations interested in oral health to establish a relationship with these key stakeholders.

Strategic Domain 4: Science and Research

4.1.Promote knowledge development and the evidence base in Conservative / Restorative / Operative Dentistry through EFCD expert workshops.

4.2 Promote oral and dental research excellence amongst health professionals and scientists by encouraging research funding.

4.3 Promote oral and dental research excellence amongst health professionals and scientists by encouraging applications to current and new awards.

4.4 Publication of the workshop systematic reviews and consensus reports in Clinical Oral Investigations (Springer)

4.5 Disseminate new relevant research findings globally in all EFCD communication formats and EFCD activities.

4.6 Develop an EFCD e-learning platform.

5. Implications

The ethos and philosophy of the EFCD, being a Federation run by professionals continues to create logistical challenges as exemplified below:

– Continue to engage and drive to action a ‘voluntary’ scientific community, often very busy with their practices, day to day professional/academic engagements;

– Greater involvement of the EFCD Member Societies and make them feel part of this community;

– Finding enthusiastic young leaders of the future that will assure the continuity of the Federation and offer them challenging new projects;

– Diversification of EFCD activities, allowing a more stable financial future;

– Maintain a high-quality scientific journal, workshops and scientific congresses;

– Being able to deliver partner projects in parallel with each other and meeting timelines and expectation.

– Continue to professionalise our administration according to affordability to help deliver our business continuously rather than in peaks and troughs and to improve internal communication.

This 2024 Strategic Document sets out a realistic plan for the next 15 years and it is hoped that it will help the EFCD to realise its stated goals.

6. Implementation Planning & Monitoring

This Strategic Plan will only be successful if the different EFCD Committees turn this strategy and plan into specific, measurable, achievable, realistic and timed (SMART) actions. The implementation planning process requires, therefore, to identify clearly the “who, where, when and how” for each Strategic Objective that is set in the present document.

In this sense, the four focus areas outlined in the present document will require a specific implementation plan to be undertaken during the next 5 years.

Each focus area should have an ‘owner’ that may or may not be the chair of the relevant Committee. The role of this leader will be to evaluate the strategy set for his/her focus area, review it, obtain advice from the specialists in a specific area, highlight any element of the area that might be especially challenging and recognize any part that might be unrealistic or excessive in cost either with respect to time or money. A team will be establish to create feasible actions and name a responsible officer for each action.

The focus area implementation plan should list the actions, the names of the people responsible for implementing each action and set an achievable and coherent timeline for each action planned.

The challenge should be to engage motivated professionals in each section of the Strategic Document and ensure that they report to their leader’s the progress made in their different duties and actions. The role of the different proposed EFCD Committee Chairs, whether or not they are leaders of an area, will be crucial in order to establish regular progress reports to the Executive Council.