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Requirements for specialty recognition stay the same

San Francisco—The ADA will take more time to work toward consensus on the requirements for specialty recognition to avoid disenfranchising public health dentists who could have been affected by the changes.

That was the directive from the 2012 House of Delegates, which referred Resolution 17 back to the Council on Dental Education and Licensure for further study.

The decision came as a relief to the American Association of Public Health Dentistry. Changing the requirements would have meant that only specialists in public health dentistry would be able to vote or hold office in AAPHD, the sponsoring organization of public health dentistry. All specialty organizations except the AAPHD require officers and voting members to be specialists in the specialty sponsored by the organization. Over the years, AAPHD has had a handful of nondentist members serve in leadership positions. Currently, however, specialists in public health dentistry comprise only 41 percent of the membership of AAPHD, according to data provided to CDEL in 2011.


Dr. Hayes
"This is an opportunity for us as public health dentists to work with our colleagues in the profession to help them understand why our membership structure is different than other specialties," said Dr. Catherine Hayes, AAPHD president-elect. "Our hope is that by increasing dialogue and sharing information, we'll come to a resolution that will be amenable to all."

In May 2012, CDEL passed a resolution stating that voting or holding office in a sponsoring organization of an ADA-recognized dental specialty should be limited to specialists in that discipline. The move was intended to clarify ambiguities that the council identified in the Requirements for Recognition of Dental Specialties and National Certifying Boards for Dental Specialists, said CDEL Chair Ronald Venezie.

"In 2011, as part of CDEL's periodic review of dental specialties, we learned that there were two sponsoring organizations of recognized specialties that permitted nonspecialists and even nondentists to vote and hold office," said Dr. Venezie. "The requirements were vague on this issue, so we looked for a way to clarify the language."

Since that time, one of the sponsoring organizations—the American Academy of Oral and Maxillofacial Radiology—has revised its bylaws to allow only specialists in oral and maxillofacial radiology to vote or hold office in AAOMR.

The council focused on requirement 1(a), which currently states that specialties should be represented by a sponsoring organization whose membership is reflective of the special area of dental practice. In Res. 17, the council proposed to change that to "membership is reflective of that proposed or recognized dental specialty in which the privileges to vote and hold office are reserved for dentists who have either completed a CODA-accredited residency program in that proposed or recognized specialty or a formal advanced education program" and called for all specialties to come in line with the new requirements by 2015.

During the House of Delegates meeting in October 2012, a number of dentists appeared before the Reference Committee on Dental Education, Science and Related Matters to voice their opinions on Res. 17. The reference committee concluded there would be unintended consequences if the requirements were amended as proposed. In the end, the reference committee recommended that CDEL; the Council on Access, Prevention and Interprofessional Relations; the Board of Trustees; and AAPHD further explore options to define the term "reflective" and arrive at a procedure to bring the sponsoring organization of public health dentistry into alignment with other dental specialty organizations. The House then referred Res. 17 back to CDEL.

Dr. Hayes, who testified before the reference committee, explained that public health dentistry is different from clinical specialties.

"In public health dentistry, we learn to apply all that we learned in dental school to a community setting. We evaluate communities; not just patients. There is a broader scope of practice. In doing that, we bring in other people—economists, sociologists and physicians among them.

"The majority of our dentist members of AAPHD are not board-certified public health dentists," she continued. "Someone who practices in a federally qualified health center or the U.S. Public Health Service may not have pursued training to be board certified so they don't have specialty training. The way the resolution was written, only those who completed specialty training could vote or hold office, and that would disenfranchise many of our members."

"The House directed us to take another look at the requirements, incorporate issues raised in reference committee testimony and come back to the 2013 House with a consensus recommendation that brings public health dentistry back in line with other specialties without excluding dentists with appropriate education and/or experience," said Dr. Venezie. "It's a reasonable directive and we will work to achieve that."