ADA.org: Future of Dentistry Full Report

FUTURE OFDENTISTRY

United States and Puerto Rico, because there is an
accreditation agreement between the two accredit-
ing agencies.

CREDENTIALS FROM NON-ACCREDITED SCHOOLS

The Commission on Dental Accreditation (CDA) is
the recognized agency for accrediting educational pro-
grams in dentistry. The goal of accreditation is to
assure students, licensing boards, and the public that a
graduate of an accredited educational program is pre-
pared to practice competently. The accreditation
process evaluates the educational programs and the
physical facilities, not the clinical skills of the graduat-
ing students. The CDA considers all dental schools
outside the United States to be non-accredited except
Canada by reciprocal agreement; therefore, graduates
of these schools must meet individual state require-
ments before they can be licensed.
Most states will not license a graduate of a non-
accredited school unless that individual attends an
accredited school for a specified period of time and is
either granted a degree or certified as equivalently edu-
cated by the accredited institution. Only California,
Hawaii, and Ohio license a graduate of a non-accred-
ited dental school without these requirements.

POSTGRADUATE TRAINING

As an alternative to the clinical performance
examination, some United States licensing jurisdic-
tions are considering granting licenses to dentists who
have completed an additional year of training in an
accredited postgraduate dental education program.
No such programs have been implemented to date.

COMPUTER-BASED EXAMINATIONS

Computer-based clinical simulation examinations
may soon provide an additional tool for measuring
the diagnostic, treatment planning, and treatment
application skills of new graduates and established
practitioners.

INITIAL AND CONTINUING COMPETENCY

Initial Competency

In the early 1990s the American Association of
Dental Examiners established criteria that licensing
agencies across the country could use as a guide to

create more valid and reliable examinations of gradu-

ating dentists. These criteria addressed all aspects of

the written and clinical examination, including quali-

fications of examiners, the format and content of the

test, grading guidelines, test security, and the appeals

process. Nevertheless, varied results continue. This

may reflect the new graduates' lack of clinical experi-

ence and underscore the fact that dentistry is an art,

which requires practiced skill, as well as a science.

As the scientific and technical aspects of educa-

tion have expanded, some dental schools have

added to their didactic curriculum, often having to

reduce the clinical experiences for the students to do

so. As a result, some graduates may have developed

technical competence but have not received enough

experience with patients to develop in-depth clinical

competence. This can lead to poor test results on

the initial competency exam.

A 1995 Institute of Medicine study (Field, 1995) rec-

ommended that reform in the accreditation process

should focus on educational outcomes and on stan-

dards and methods that will identify and improve those

schools that are not educating their students effectively.

Continuing Competency

The Dentist's Pledge affirms a commitment to an

ongoing pursuit of knowledge and skills:

I shall accept the responsibility that as a

professional, my competence rests on con-

tinuing the attainment of knowledge and

skill in the arts and sciences of dentistry.

The ADA's Principles of Ethics and Code of Profes-

sional Conduct, 2A, requires this commitment stating:

The privilege of dentists to be accorded pro-

fessional status rests primarily in the

knowledge, skills, and experience with

which they serve their patients and society.

All dentists, therefore, have the obligation

of keeping their knowledge and skill current.

At its 1999 House of Delegates meeting, the ADA

defined continuing competency as the continuance

of the appropriate knowledge and skills by the den-

tist in order to maintain and improve the oral health

care of his or her patients in accordance with the

ethical principles of dentistry.

Forty-seven states have mandatory continuing

Licensure and Regulation of Dental Professionals