Integrating Policy Advocacy and Systems Change Into Dental Education: A Framework for Preparing Future Oral Health Leaders

Persistent inequities in oral health reflect systemic, not solely clinical, challenges-shaped by policies, payment structures, and institutional norms that govern care delivery. Yet dental education has historically prioritized technical competence over preparing graduates to understand and influence these systems. This perspective argues that policy advocacy should be recognized as a core competency for dental professionals and embedded throughout predoctoral education. Drawing from the experience of the University of North Carolina at Chapel Hill Adams School of Dentistry (UNC ASOD), this commentary presents a replicable framework for integrating policy advocacy and systems-change training within dental curricula. The ACT model reframes dental education around three identities - Advocate, Clinician, and Thinker - ensuring advocacy is woven into foundational, clinical, and individualized learning experiences. Required courses such as Civic Engagement and Leadership in Health Care and Partnering with Community to Improve Oral Health introduce students to health policy, systems thinking, and community-based engagement through assignments like oral health policy analyses and community health needs assessments. Quantitative evaluation shows statistically significant increases in students' confidence and self-efficacy to engage in oral health policy reform (Cohen's d = 0.45-0.86, p < 0.05). Building on these foundations, the UNC Program for Oral Health Policy and UNC Oral Health Policy Scholars Initiative provide advanced pathways for experiential learning through externships, mentorship, and capstone policy projects. Together, these initiatives demonstrate that advocacy and clinical excellence are mutually reinforcing. The UNC ASOD framework offers a scalable model that other dental schools can adapt by embedding advocacy education across coursework, clinical experiences, and individualized learning. Integrating policy advocacy education within dental curricula equips graduates to not only provide high-quality clinical care but also address the social and political determinants of oral health. As health systems evolve, preparing dentists to serve as informed advocates is essential to achieving equity, access, and systemic transformation in oral health care.