Early clinical exposure in undergraduate dental education: a systematic review of effectiveness, experiences, and outcomes

PURPOSE: The objective of this systematic review was to synthesize evidence on the early clinical exposure (ECE) and its effectiveness, student experiences, and outcomes in undergraduate dental education. METHODS: In August 2025, the systematic search was carried out in PubMed, Scopus, and Web of Science. The quantitative, qualitative, and/or mixed-methods peer-reviewed studies evaluating ECE to undergraduate dental students were included. Summary synthesis of included studies was carried out. The risk of bias and quality assessment was assessed with Cochrane Risk of Bias 2, ROBINS-I tool, Joanna Briggs Institute, and Critical Appraisal Skills programme. RESULTS: Nine studies (2007- August 2025) from a range of countries were included. ECE interventions were chairside demonstration, peer-assisted shadowing, simulation, clinical/community placements, and hybrid models. There is evidence of effectiveness of ECE in knowledge, psychomotor skills, and affective domains. In addition, student experiences were reported as positive and significant increases in satisfaction, confidence, motivation, clinical reasoning and other learning gains such as professional identity, empathy, and communication. Six out of nine included studies were non-randomized studies. All the non-randomized studies were reported methodological biases, including small single-center samples, self-report measures, short follow-up periods, and rated as some concern and high risk of bias. CONCLUSIONS: ECE in undergraduate dental education promising contribution to the cognitive, psychomotor, and affective domains and reduces transition stress to clinical training. However, presence of methodological bias in included studies undermines the evidence. Future studies with robust objective performance measures, multicentre designs, and longitudinal follow-up should be carried out to better establish the educational and clinical impact of ECE in dental education.