This 2009 study of dental school curricula follows a similar one conducted in 2002-03. Through a web-based survey, the authors gathered information from dental schools about 1) past trends in curricular change over seven years; 2) current changes under way in dental school curricula; 3) significant challenges to curricular innovation; and 4) projected future trends in curricular change and innovation. Fifty-five schools (fifty U.S. and five Canadian) responded to the survey for a response rate of 86 percent. In addition to background information, the survey requested information in four broad areas: curriculum format, curriculum assessment, curriculum innovation, and resources needed for curriculum enhancement. Forty-nine percent of the respondents defined their curriculum format as primarily organized by disciplines. Half of the respondents reported the use of problem-based and case-reinforced learning for a section or specific component of some courses. In a significant change from the 2002-03 study, a high proportion (91 percent) of the responding schools require community-based patient care by all students, with just over half requiring five or more weeks of such experience. Competency-based education to prepare an entry-level general dentist seems well established as the norm in responding dental schools. Forty-three percent or less of the responding schools indicated that their students participate with other health professions education programs for various portions of their educational experience. Since the 2002-03 survey, dental schools have been active in conducting comprehensive curriculum reviews; 65 percent indicated that their most recent comprehensive curriculum review is currently under way or was conducted within the past two years. Respondents indicated that the primary reasons for the configuration of the current curriculum were "perceived success" (it works), "compatibility with faculty preferences," "faculty comfort," and "capacity/feasibility." Key catalysts for curricular change were "findings of a curriculum review we conducted ourselves," students' feedback about curriculum, and administration and faculty dissatisfaction. There was an increase in the percentage of schools with interdisciplinary courses, especially in the basic sciences since 2002-03, but no change in the use of problem-based and case-reinforced learning in dental curricula. Respondents reported that priorities for future curriculum modification included creating interdisciplinary curricula that are organized around themes, blending the basic and clinical sciences, provision of some elements of core curricula in an online format, developing new techniques for assessing competency, and increasing collaborations with other health professions schools. Respondents identified training for new faculty members in teaching skills, curriculum design, and assessment methods as the most critical need to support future innovation.