Dentistry then, now, and tomorrow

Imagine that you are in dental school 70 years ago.

It’s 1947, and life was so different back then. Gas was 15 cents a gallon and the average home cost sixty-six hundred dollars. Jackie Robinson joined the Brooklyn Dodgers. And an unidentified flying object crashed near Roswell, New Mexico.

The world was still rebuilding from a devastating World War and trying to settle into a new normal.

Dentistry was returning to normal, too.

The War hit the profession pretty hard. More men serving at the Front meant that more dental professionals were needed to care for them. Every effort was made to enlist more dentists, and the dental education system joined the effort to train more dentists, by compressing the time to complete the curriculum from four years to three.

The need was great. Almost one-fourth of the men who joined the Army had, or needed, dentures. Oral health was awful, and we can suspect that the dental health of the older, non-military population was even worse.

After the war ended, the biggest issue for the ADA was a social one: How can we improve dental health for the nation as a whole?

There were two main sides to the debate.

On one side was a push to make universal dental care a reality, possibly rolling it into the new Social Security program.

On the other side of the argument—and this was dentistry’s position—was a push for a more thoughtful approach. The belief was that in order to make a dent in the dental health crisis, we needed to address the causes underlying the problem. We needed to first invest in research, then in preventive education.

To fund dental health care, without first addressing the causes of the disease, was a Band-Aid solution.

Our colleagues 70 years ago won the debate, and the country invested in education and research. That was a big risk and it was unpopular, but in hindsight, this clearly was the right path.

The very next year, in 1948, President Truman signed the National Dental Research Act, establishing what is now the NIDCR. Not long after that, in 1950, the results from the first fluoridation trial in Grand Rapids, Michigan demonstrated that water fluoridation was an effective way to reduce caries.

Dental health started improving across the nation.

The dental profession, led by the ADA, took a position that over time proved wise.

As this House of Delegates plans for our future and turns its attention toward the business at hand, let’s look to the past as a guide: That we not put Band-Aids on problems, but address root causes. That we act on plans that promise long-term viability. We want future generations to look back and see that we took a wise position and a long view.

Fast forward to today.

I’d like to touch on what we accomplished this year to become a more nimble Association that’s responsive to member needs, and those things that position us to continue to be America’s leading advocate for oral health.

For example, the Council on Scientific Affairs revitalized the trusted ADA Seal of Acceptance program and established the new category of enamel erosion.

We also continued to work more closely with the dental industry, with repeat partnerships like Oral Heath Month with Colgate. And we are also working together with major medical centers like the University of Texas MD Anderson Cancer Center to prevent oral and oropharyngeal cancer.

We strengthened our relationships with tribal nations, opening up new pathways for working together. Many of those pathways involve the Community Dental Health Coordinator program which continues to grow, with more than 115 graduates now working in 25 states, and another 130 students in training. CDHC training is available in all 50 states through one national program, with another 14 programs offering the curriculum locally.

We worked on a number of fronts to ease burdens and make life easier for our member dentists.

In March, for example, we made significant progress toward our longstanding goal to overturn the McCarran-Ferguson Act. The House of Representatives voted to overturn the Act, and we are waiting for the Senate and President to act.

We also continue to double-down on enhancing our technology portfolio. This week we launched the ADA credentialing service, powered by CAQH ProView, to save dentists time on credentialing paperwork from multiple dental plans. It’s a one-and-done solution that reduces administrative burdens on their offices.

Earlier this year we launched a new Find-a-Dentist, the new search tool that patients can use to find our members, and we started advertising it in July.

Since then, consumers have completed more than 238,000 searches, and conducted more than 348,000 views of profiles of our members.

These results have far surpassed our expectations.

Our investment in this marketing campaign demonstrates to our members that the ADA is responsive to their needs.

It means that patients turn to the ADA—and not some other organization—to find their dentist. That builds trust with the public.

It means that patients are being introduced to our consumer health resources, which they can access from the site.

It means that when future ADA members go to Google and search for dental topics, they are seeing the ADA’s name at the top of those search results. It shows that we’re a major player in the market.

The House set the right tone last year by implementing this innovative program to help members succeed, and it’s great that so many consumers are now looking to us to help them find an ADA dentist. We need to continue to invest in programs like this one that promise long-term payoffs.

Another long-term effort that we moved forward this year is licensure. 

We’re forging ahead to make licensure portability and the elimination of patient based exams a reality, consistent with the House’s longstanding policies on these matters.

You know the portability stats: Today, the majority of students at over half of the country’s dental schools don’t practice in the same state where they’re educated.

We’ve been working on these extremely complex issues for years. We’ve made some progress.

For example, several states that just a few years ago only accepted one licensure exam, now accept all exams. We’re also pleased that the OSCE is gaining acceptance in several states.

The pace of progress is slow, and we’re not backing down.

This year, based on the recommendation of the Joint ADA-ADEA-ASDA Licensure Task Force, the Board approved the development of a Dental Licensure OSCE. We are taking a leadership role in moving this issue forward.

We’re also taking a leadership role in revising a specialty recognition process that was in bad need of revision.

As you well know, ADA’s current specialty recognition process is perceived to be biased and subject to conflict of interest issues. It is also out of the norm when compared to other health professions.

There have been legal challenges to specialty advertising in California, Florida, Ohio, Indiana, and Texas.

It’s time to make a change before outside forces do it for us.

That’s what we’re doing here.

This year the Task Force on Specialty and Specialty Certifying Board Recognition evaluated the process and criteria by which specialties and specialty certifying boards are recognized, and it put forth a proposal which this House will consider. It proposes transferring the specialty recognition function to a new, independent Commission while keeping the criteria for specialty recognition under the purview of the Council on Dental Education and Licensure and the House of Delegates.

The goal is to mitigate the risk of a challenge to the process, and I believe that the Taskforce’s proposal is the best way forward.

Finally, let’s talk about the budget.

And I want to ask you the same questions I asked you last year.

How many of you have spent 50 hours studying the budget?

How many of you spent 25 hours?

How many districts rely on 1 or 2 members to tell them what’s in the budget?

These are things we need to think about. We need to let the people who are best informed, and who have worked on this, and who have the most knowledge, do this work.

This is about being responsive to member needs, and about being positioned to rapidly respond to changes in our market—two things that are absolute requirements if our Association is going to continue to prosper.

Three out of four associations like ours place authority to approve the Budget with the Board, and they do it because it’s a process that works. The ADA needs to adopt a process in which the House maintains its responsibility for setting dues and the policy direction of the Association, but in which the approval of the Budget to enact the House’s policies and programs rests with the Board.

My friends, from the budget process, to specialty recognition, licensure and Find-a-Dentist, we’ve made incredible progress. And now we have to make decisions. We can continue to put Band-Aids on problems.

We can maintain the status quo.

We can wait for government to mandate change or for market forces to make us irrelevant.

But we don’t have to do that.

We have a proud history. Our colleagues who came before us, who 70 years ago made unpopular and difficult decisions, took the long view. Let’s move forward with their courage.

And let’s act so that in another 70 years, when an entirely new generation of dentists looks back on what did here, they are as proud of their history as we are.

It’s been an honor to serve as President of this Association, and today—because of all that we’ve accomplished together—I’m proud as ever to be an ADA member.