ADA.org: Future of Dentistry Full Report

FUTURE OFDENTISTRY

Public policy as it is expressed in legislation and
regulation may have significant impact on the den-
tal profession in the coming decade. In 1983 the
ADA House of Delegates adopted five recommen-
dations from the Future of Dentistry report and one
resolution from the House of Delegates as part of a
strategic plan to be developed for the ADA. It was
considered imperative that the profession's ability to
influence public policy be strengthened. Since then,
the demand for regulation has increased.
Public attitudes and opinions, shaped by the pro-
liferation of ideas and assumptions, both correct
and incorrect, must not be allowed to lead to leg-
islative initiatives or regulations without scientific
validation. All affected parties must work together
to ensure that valid science is the basis for necessary
and appropriate regulation. It appears very likely
that one of the greatest issues of today––access to
care––may be addressed tomorrow with regulation
and legislation at state and federal levels.
All licensing jurisdictions should develop consensus
regarding standards for the validity and reliability of all
phases of licensure examinations, both written and clin-
ical, and for licensure without examinations (credential-
ing). States should also assure that all regulation is based
on valid scientific evaluation and solutions. More den-
tal professionals should serve as advocates and resources
for developing regulatory policy development.
It is very important that the dental profession con-
tinue to maintain the competency of dentists and
allied dental personnel through innovative
approaches to education, strengthened standards
for continuing education credits, and outcome
assessments for relicensure and recertification.

SCOPE OF PRACTICE

In the interest of increasing access to dental care,
independent practice by dental hygienists and dental
laboratory technicians does not best serve the public;
however, allied personnel may be trained to perform
more technical procedures of dentistry with the dentist
being responsible for diagnosis, treatment planning,
implementation, assessment, and supervision.
Increased recruitment efforts will be necessary to
assure sufficient numbers of dental hygienists, den-
tal assistants, and dental laboratory technicians.

State licensing boards should develop a uniform

scope of practice for allied personnel that is mutual-

ly recognized among states. This will allow in-

creased interstate mobility.

To increase access to preventive dental care for chil-

dren of low socioeconomic status, medicine and den-

tistry should partner in certain aspects of patient care.

The aging population is creating a demand for more

services that need the laboratory technician's expertise

in the fabrication of fixed and removable prostheses to

replace the teeth and related dental structures. The

expansion of the predoctoral curriculum has limited

the dental schools ability to teach their students the

laboratory skills that were traditionally taught in the

past. Dentistry must proactively promote dental labo-

ratory technology as an attractive career choice, as

well as increasing the availability of education for den-

tal laboratory technicians.

LICENSING

The dental profession should be cautious about

the creation of multiple types of licenses to practice

dentistry (limited scope specialty licenses) because

regulations and overlap of scope may render it diffi-

cult to establish clearly separate responsibilities. All

licensing jurisdictions should meet basic psychome-

tric standards for validity and reliability of all phas-

es for licensure examinations, both written and clin-

ical. Accreditation of the evaluation process for

licensure examinations should be investigated. If

and when the accreditation process includes out-

come assessments of the clinical skills of dental

school graduates, a diploma from an accredited den-

tal school could eliminate an entry-level exam.

The dental profession should consider whether the

Commission on Dental Accreditation should be in-

volved in accrediting non-U.S. dental schools to ensure

similar standards and outcome of graduating dentists.

Licensure without examinations (credentialing)

should be encouraged as long as it includes a mean-

ingful evaluation of the applicant's competence to

practice dentistry and includes a thorough investiga-

tion of the applicant's personal history.

Alternatives to live-patient examinations should

continue to be investigated. However, any alterna-

tive must prove to be equal to live-patient examina-

Licensure and Regulation of Dental Professionals

III. PATHWAYS AND STRATEGIES FOR LICENSURE AND REGULATION

OF DENTAL PROFESSIONALS IN THE FUTURE