What Does it Mean to Be Dean of a Dental School?

Reprinted with permission from the Western Los Angeles Dental Society, from the winter 2024 edition of WestViews Magazine.

By Teresa Yang, D.D.S. ‘83

We all know that every U.S. dental school is led by a dean, but what does its top administrator actually do? I recently sat down with Dean Krebsbach for a wide-ranging discussion touching on his career ascension, daily routine, celebrations and challenges, and the current state of dental education.

Paul Krebsbach holds many titles, among them D.D.S., Ph.D., periodontist, biomedical researcher, and diehard Green Bay Packers fan. In 2016, at the age of 56, Dr. Krebsbach added his most high-profile title to date: Dean of the UCLA School of Dentistry, the eighth individual to hold this position in the institution’s 60-year history.

How did you decide to pursue a career in academia?
About midway through college, I felt I wanted to be an artist and a scientist at the same time. Then through my externships in hospitals and other health clinics, I thought that being a dentist would be the way to go because you're always working with your hands, and it's a science-based profession. So that’s why I went to dental school, but I almost quit my first year because I thought the science was kind of weak! I was just memorizing the same textbooks like I did in college. Thankfully, I was talked out of it and pursued research in dental school and then advanced to do a Ph.D. at UConn [University of Connecticut] and a postdoctoral fellowship at the NIH [National Institutes of Health]. And now I'm really happy that someone talked me out of it because it's been a really great pleasure and honor to be able to do both.

In addition to training as a periodontist, you have a Ph.D. in Biomedical Sciences and were heavily involved in research. Can you describe your path and pivot to becoming dean?
I wouldn't call it a pivot; it's more of an evolution. I was always involved in the ongoings of the school even back when I was an assistant professor. Then there was a progression where I was promoted to associate professor, I became vice chair of my department, and that led to more administrative duties and to me applying for and being named a department chair. I was a department chair at [the University of] Michigan [School of Dentistry] for 11 years.

I was also involved in a lot of outside activities related to the profession through the International and American Associations for Dental Research. I served on the board twice, once as treasurer, and then a few years later, was elected vice president and then served as president. So, it's more about holding leadership positions and evolving in one’s career. After running the largest department at my previous institution, the opportunity to serve as dean at the UCLA School of Dentistry was a chance to continue developing those skills and applying them to a very large organization.

What is a typical day like? Or isn’t there such a thing?
Well, the only thing typical is that I go to the John Wooden Center to lift weights and work out at 5:30 every morning; that's the bedrock of my day. And it kind of clears my head as I get to work. As you might expect, the days are full of meetings and planning. I wouldn't say there's always a typical day because almost every day, there are at least two or three surprises that kind of commandeer your time and make you put your energy somewhere where you weren't anticipating it to be.

What is the most challenging part of your job?
The challenging thing – I think for me and for most schools of dentistry – is the financial management, particularly in public schools where the mission and the funding sources are somewhat different than in some private schools. For example, 30 to 40 years ago, when I went through a public dental school, the state probably covered 70 to 80% of the budget, so there was not a lot of worry about the financial aspect. We could focus on teaching and learning and research and service. Today, that number is closer to 10%, and we can’t make up that 90% gap simply by increasing tuition. So we are constantly looking for other ways to generate revenue: Through clinical care, research, philanthropy, and ancillary revenue like programs for international dentists.

What is the most enjoyable aspect of your job?
I think it’s the sense that you're making an impact on a larger organization that is rewarding. There are so many brilliant, talented individuals affiliated with the School of Dentistry, from our Ph.D. researchers to our highly motivated D.D.S. students and our excellent clinicians. I’m thankful to be surrounded by a great team including our faculty, staff, and researchers. My job is to provide the support that allows them to thrive, discover, and advance oral health.

I’ve now been here long enough to watch many of the students I got to know as D1s [first-year dental students] establish successful private practices, or continue in academia as educators themselves. That’s really rewarding as well.

Speaking about your eight-year tenure at UCLA, what do you feel is your top accomplishment to date, and what is one of your top goals?
The biggest and most rapid change that we made was to introduce and develop our Community-Based Clinical Education program. When I arrived, there was a sense that students were not getting the optimal amount of clinical training experience. I realized we had to take the school to the community and build partnerships with affiliated organizations. Now our students go on two-to-four-week rotations and see different types of practice models so that they can make fully informed decisions when they graduate. These real-world experiences are not meant to mirror what happens at Westwood; they’re meant to augment it. You show them options of working in an FQHC [Federally Qualified Health Center] or a private practice or a DSO [dental support organization], and students can see how they function and determine which is a good choice for them.

For the future, I know this won't happen while I'm still dean, but if I don't start paving the path it will be too late: We have to think about significant and major renovations to the clinical and preclinical teaching spaces in our school.

How is dental education changing?
The use of digital technology and artificial intelligence is already having a huge impact on how we teach and practice dentistry and will even more in the future. It's being explored in diagnostics, and right now, probably most robustly in imaging and oral radiology. AI might also augment how pathologists read slides, leveraging a robust database of past cases. Our students will also need to learn the operational applications of AI in the clinic, like scheduling patients, AI chat boxes on websites, and the like.

Have dental students changed since you were a junior faculty member? How?
Every generation grows up in a different environment and with different circumstances in the world. There are well-studied generational trends and that's no different in dentistry than it is in any other part of the workforce or life. I think for today's students, their ability to experience the world is so different than it was, you know, 40 years ago when we had one TV station and a newspaper; now they’re bombarded with information in small chunks all day long. When so much is coming at you, you feel pressure to be a voice as well, so students today have a lot on their plate. But then the positive side is they are so connected to the world, and they are doing amazing things with that knowledge. We have UCLA students who are entrepreneurs and have started businesses already, or published musicians, while others are very in tune with public service.

If a young dentist or dental faculty member approached you and said, “I would like to be a dental school dean one day,” what advice would you give that person?
Well, I think it circles back to my earlier answer about career evolution; if you're thinking about being a dean when you're 25 years old, you probably won't become one. You really have to go through all the paces: You have to be a scholar, you have to develop leadership skills, you need to have a range of experiences, and that takes a lot of time.

And there are some soft skills that are not related to your profession, like how you treat people or how you ask questions. There’s no naturally occurring gene to be a dean.