FUTURE OFDENTISTRY
dental schools encourage their clinical faculty mem-
bers to practice privately a prescribed number of
hours each week. The presence or lack of such
opportunities can tip the balance in favor of or
against a person's accepting a faculty position. As
the dental faculty market becomes tighter, this fac-
tor is becoming more important.
Certain states grant a "teaching license" to for-
eign-trained dentists, which enables the person to
practice under certain prescribed conditions, usual-
ly the direct treatment of patients for the purposes
of teaching and research. In some instances the den-
tist cannot charge directly for services rendered.
This type of license does not allow the foreign-
trained dentists to supplement their incomes.
Licensing of foreign-trained dentists raises certain
concerns within the dental community, as expressed
in the 1995 Institute of Medicine study (Field,
1995), Dental Education at the Crossroads: "The
committee recognizes that foreign dental graduates
who do become licensed in the United States may
provide needed services, and it opposes discrimina-
tion on the basis of nationality. Nonetheless, the
committee is troubled by shortcomings in the
processes of assessing student performance and
graduate competency, and it is concerned that these
shortcomings may be even more serious for foreign
dental graduates who enter with advanced standing.
The committee urges dental educators, accrediting
organizations, and related groups to assess current
policies for the admission, education, graduation,
and licensure of graduates of foreign dental schools
and to eliminate admissions policies or other prac-
tices that may exploit these students or threaten the
quality of patient care." This recommendation has
yet to be implemented.
A special case regarding licensure of foreign-
trained dentists recently has surfaced in the State of
California and may provide insight for other states,
as well as for the globalization of dental education.
In 1998, a new law changed the manner in which
foreign-trained dentists must qualify for admission
to the California dental licensure examination.
Prior to 1998, a foreign-trained dentist could apply
to take the California restorative technique exami-
nation (a prerequisite for admission to this exami-
nation was passing National Boards Part I & II). If
successful, the foreign-trained dentist was eligible to
apply for the clinical examination. The new law
eliminates the restorative technique examination
effective 2003. After 2003, the only foreign-trained
dentists eligible for California clinical licensure exam-
ination will be graduates of non-U.S. dental schools
approved by the California Dental Board. A hearing
was held in November 2000 for comments on the
proposed regulations. The regulations must be
approved by the Office of Administrative Law and if
approved, are subsequently enforceable after 30 days.
The decision is expected to be made by August 31,
2001 (Georgetta Coleman, Executive Officer, Dental
Board of California, Personal Communications,
November 16, 2000 and July 11, 2001).International Need for Well-Trained FacultyThe demand for well-trained faculty members in
non-U.S. dental schools is equal to, if not greater
than, in the United States. Many non-U.S. schools
look to the United States as the preferred location
for their dental faculty to receive training. Although
there has been a gradual increase in the numbers of
non-U.S. citizens who receive graduate education in
the United States, many applicants are turned down
because a method does not exist to evaluate dental
schools in most countries.GLOBALIZATION OF DENTAL AND
CRANIOFACIAL RESEARCHSolutions to many global oral health issues will
rely increasingly on scientific and technological
knowledge developed through research. Oppor-
tunities to expand knowledge depend in large meas-
ure on the availability of appropriately qualified sci-
entific talent to address needed research questions
and the availability of research cases. Both condi-
tions lend themselves to more international involve-
ment. The United States oral science workforce is
among the best in the world, but has shortfalls in a
number of critical areas, particularly in clinical
research capacity (National Research Council, 1994
and 2000). The United States population experi-
ences some oral diseases and conditions that are
severe but are not prevalent and, therefore, provide
only a limited research base. For example, head and
neck cancers, and cleft lip and cleft palate exist in
this country, but there are higher incidences in
Southeast Asia and in Brazil. Rare infectious dis-
eases, such as noma, have been observed in the
United States and in Western Europe, but are more
prevalent in Africa. Even questions about the opti-
mal level of fluoride for humans can no longer beGlobal Oral Health