Dental school is a very arduous experience; and solely finishing school doesn’t actually get us what we want – not by itself anyway. To become a dentist in most states throughout the US, there are several requirements, which include, but are not necessarily limited to:

• A degree from an ADA CODA-accredited dental school,
• Passing the National Board Dental Examinations I and II,
• Passing one of the Regional Board Examinations

Though regional board exams are a point of controversy among many in the United States right now, they are still a part of our current situation…. So we have to be able to conquer them! This becomes a daunting process when you are looking to spend upwards of $3,500 and the first things you hear about boards may be tidbits like…. “I still have nightmares about those 2 days,”  “I’ve never felt so much stress in my life,” “It was hell.”

So what was my first step? I assisted candidates taking both of the regional board examinations offered at our school, WREB and CRDTS, to help me decide which one to take.  I can’t emphasize enough how great of a learning experience this was! Not only did I get to see and experience how nerve-wracking boards is, I got to watch a plethora of students make it through the process unscathed!

What did I gain from assisting? I learned that getting good patients is vitally important (including making sure the nearby teeth are also in good shape).  I also learned how important it is to trust your instincts and skills! Another important piece of advice is to practice using all materials and instruments you intend to use on the day of - don’t try anything new you’ve never done before.  Additionally, I learned that you should always do a final inspection of your preparation with the super-sharp explorer that is sent up with the patient, because that’s what your graders will be using.  Finally, I learned how important it is to know the in’s and out’s of the specific test you are taking --- read and learn the instruction manual ahead of time!

Most importantly, I decided on which exam I will be taking.  This is a different decision-making process for everyone because it depends on multiple factors such as where you intend to live and what your specific strengths/weaknesses are.  So to all those 4^th years who passed boards in the last few months – CONGRATS! To all my fellow 3^rd years who will be taking boards less than a year from now – GOOD LUCK! To all of the 2^nd and 1^st years who still have some time – make sure to assist various boards exams, get some cash along the way, and see which exam suits you more.

When you hear the word "law" what first comes to mind?  A statue of justice blind and holding scales?  That time you went to court to serve on a jury? Marathoning Law and Order SVU with your favorite crime busting cop team?  Have you ever thought about how law might affect dentistry?  On November 5th Colorado ASDA learned just how the law and dentistry intersect and what we need to be aware of as dentists and dental students moving forward.

Troy Rackman Esq. (that means he's a lawyer for all you lay-people) visited Colorado ASDA to give a presentation about Dental law and new bills and laws recently passed on the state and local levels that impact dentists.

Troy first discussed how dental laws are monitored and instituted.  Having political representation is one of the most important things dentists can do to have the right laws retained and implemented.  The department of regulatory agencies, DORA, is responsible for licensing and regulating dentists as well as monitoring them to insure the safety and fair treatment of all patients.  You can visit the Colorado state dental board page here, and to see a list of all state dental boards click here.

The first thing to recognize is where dentistry and the law actually intersect.  Unfortunately the first topic that comes to mind is dentists being sued for malpractice.  While this is a very visible way in which dental practice meets with law, it is not the only way.  Law is not there to punish and restrict dentists.  Law is also involved in dentistry to protect patients, standardize care, and provide a means to enact change in the dental laws.

In terms of malpractice and fearing the law many dental students were given hope and a positive outlook.  Dentists are unique in their profession in that only dentists can be dentists.  Meaning, according to the law, no person can simply decide they want to be a dentist and compete.  An accountant or carpenter cannot open shop claiming to fix teeth without first going through dental school and a rigorous dental licensing procedure.  See Colorado ASDA's (and ASDA editor in chief) Christian Piers' article on dental licensure for more information.

Dental students also don't have to be as concerned about being sued and found guilty of malpractice as they may be. The facts are that dentists win 9 out of 10 malpractice suits brought against them.  Not only that but individual dentists are better protected than corporations.  It is very unlikely that a jury of our peers will convict an individual dentist who did his best and tried to follow the rules.  What is more likely is that a dental corporation would be found guilty or be penalized. Juries typically do not view corporations fondly in any situation and dentistry is no different.  Similar to how many people like their congressman but hate Congress, most people like or at least respect their individual dentist, the person, but hate the corporation.

The law is also in place to help the dentists that make up the profession make modifications and changes to their profession that benefit both the patient and the professional. Recently in Colorado, a Sunset review of the dental Board was passed to allow certain modifications to the current dental practice.  The Bill addressed topics from expanded duty assistants to anesthesia and continuing education.  Because the CDA was legislatively involved and proactive with the legal system Colorado dentists were able to effectually and efficiently alter the laws surrounding their practice to better the profession.  These changes provide better care for patients, better education for providers, and protection/ security for the profession moving forward.

It was evident through the discussion of dentistry and the law that being represented politically is a very important, yet sometimes overlooked in dentistry.  Malpractice is urgent but representation and legal knowledge is paramount to the success of dentistry.  Dentists are well represented both nationally and locally and ADPAC plays a major role in that.  Troy made it clear that having a political action committee to represent the dentist is vital.  The actions of ADPAC have protected dentists and will continue to moving forward because dentists are represented.  There have been many cases where legislative action was moving in a negative direction for dentists and political action was taken in time to prevent damage to the practice of dentistry.

The Sunset review of the Dental Board provides a tangible real world example where the legal system and dentistry collide.  Check out the Sunset review in more detail here. Because dentists are educated and invested in their profession, they are involved legislatively to protect dentistry for the future moving forward.  Having a "run in with the law" does not have to be a bad thing, in fact it can mean the difference between an informed provider and an oblivious "driller and filler".  Staying up-to-date on current political events and legislative reform is vital for the modern dentist.  Know how the law and the legislative process are impacting you and your future. Involve yourself with ADPAC, align yourself with your local dental association, and stay informed for the sake of the dental profession.

~Chris Klekamp, Class of 2016, Colorado ASDA Legislative Liaison

 

If you want to practice dentistry, you need to have a license. And if you want to have a license, you should read this post.

You need to complete three requirements (educational, written, and clinical) to get a dental license. You can fulfill the educational component by graduating from a dental school accredited by CODA (the Commission on Dental Accreditation), and complete the written requirement by passing NBDE Parts I and II as administered by JCNDE (the Joint Commission on National Dental Examinations). The clinical component is where things get tricky.

There are five regional testing agencies that administer these clinical exams:

Council of Interstate Testing Agencies (CITA)

Central Regional Dental Testing Services (CRDTS)

North East Regional Board of Dental Examiners (NERB)

Southern Regional Testing Agency (SRTA)

Western Regional Examining Board (WREB)

Each of these agencies gives a separate, subtly different examination, and those exams are all accepted by different sets of states. In other words, no one exam is accepted by all 50 states. So you need to figure out where you want to practice. Once you’ve done that (no big deal), go to the ADA list of state dental boards and click on the relevant state dental board’s website. There you can figure out which clinical licensure exams are accepted by your dream state.

But is this the way it has to be?   ASDA doesn’t think so. The association’s formal position on licensure is outlined in ASDA’s L1 policy, which you can read at http://asdanet.org/licensure/.   (If you’d prefer a more audiovisual experience, check out this video of Colleen Greene, 2012-13 national ASDA president.)

Here’s the big highlight: ASDA doesn’t support the use of live patients in clinical licensure exams.   Instead, the second half of its L1 policy presents these alternatives:

• “Initial licensure without an independent clinical licensing examination. Graduates of a U.S. CODA-accredited dental school should be eligible for initial licensure without taking any additional clinical examination.
• A portfolio-type clinical examination based on cases compiled during the final year of dental school. Such an examination should require a standardized catalog of required clinical procedures and the portfolio should be evaluated by an examiner independent of the dental school. (Currently under development in California.)
• A non-traditional patient based clinical licensure examination. Although ASDA does not support the use of live patients in traditional clinical licensing examinations, the association recognizes the potential for creation of an ethical, patient-based examination.
• An Objective Structured Clinical Examination designed to evaluate a candidate’s diagnostic and treatment planning skills. (Currently accepted in Minnesota.)
• Completion of a one-year postgraduate residency program. Completion of a U.S. CODA-accredited postgraduate program that has a minimum duration of one year should be sufficient to substitute for the clinical licensure examination requirement in any jurisdiction.” (Currently mandated in New York; accepted in Washington, Minnesota, California and Connecticut.)

This desire for alternatives springs from concerns about the ethics and accuracy of the current exams. To outline those facts, ASDA is drafting a licensure “white paper,” which is a document intended to help readers understand an issue, solve a problem, or make a decision. It’s also working to eliminate live-patient licensure examinations at the state level through work with state dental associations, state dental boards, state legislators, and national dental organizations.

The American Dental Education Association (ADEA) has also formed a task force to report back to its 2015 House of Delegates with recommendations about how to help dental schools transition from patient-based clinical examinations to an Objective Structured Clinical Examination (OSCE). We’re excited to hear those recommendations in March 2015.

In the meantime, the licensure reform process is moving forward, and the state-by-state requirements for licensure continue to evolve-- so make sure to check back with your state dental board's website as your exam date approaches!  Does all that make sense?  Don't worry if it doesn't!  It’s easy to get lost in the forest of jargon and acronyms surrounding licensure, so make sure to post your questions in the comments section below!

~Christian Piers, Class of 2016, Colorado ASDA President