Commentary
A Major Change has Occurred with Regard to New Dental Specialties
Ronald S. Brown*
Department of Comprehensive Dentistry, Howard University College of Dentistry, USA
*Corresponding author: Ronald S. Brown, Department of Comprehensive Dentistry, Howard University College of Dentistry, Washington, DC, NHLBI/NIH, Hematology Branch, Bethesda
Published: 08 Dec, 2016
Cite this article as: Brown RS. A Major Change has
Occurred with Regard to New Dental
Specialties. Clin Surg. 2016; 1: 1240.
Commentary
Few of us presently are alive today to remember when medicine had only four recognized
specialties. In 1933, the AMA still controlled the process of specialty recognition, and at that time
only ophthalmology, otolaryngology, obstetrics-gynecology, and dermatology (and syphilogy)
were recognized as medical specialties. The American Board of Medical Specialties (ABMS) was
formed which resulted in the recognition of a great deal many more recognized medical specialties.
Furthermore, other medical specialty recognition boards were later created such as the American
Osteopathic Association Bureau of Osteopathic Specialists, and the American Board of Physicians’
Specialties [1].
The American Dental Association (ADA) solely controlled dental specialty recognition until
recently when the American Board of Dental Specialties (ABDS) was formed in 2015 [2,3]. In 1947,
there were only five recognized dental specialties - Oral Surgery, Orthodontics, Prosthetic Dentistry,
Periodontics, and Oral Pathology. Pedodontics, and Public Health Dentistry were added by 1950.
Endodontics was recognized in 1963, and Oral & Maxillofacial Radiology was recognized in 1999.
Much like how the AMA controlled medical specialty recognition previous to 1933, the ADA has
severely limited the ability of emerging specialties to become recognized. Such is accomplished by
allowing the governing legislature of the ADA to have an up or down vote regarding allowing dental
specialty recognition. Such a procedure allows existing specialties to lobby to prevent new and
possibly competing specialties from becoming recognized. Therefore, there is an inherent conflict of
interest which reflects economic interests above those of patient care [2].
Specialty recognition is important with regard to providing information to the public, generalists,
and existing specialists. It is particularly important with regard to providing inter-professional
communication. Many physicians, physician’s assistants, nurse practitioners, physical therapists,
and other health care providers are relatively ignorant of specialties outside of their immediate
frames of reference. For instance, it often takes multiple referrals before patients get to clinicians in
my particular dental specialty - oral medicine. Patient with conditions such as oral lichen planus,
recurrent aphthous ulcers, oral herpetic lesions, and atypical odontalgia, often have difficulty in
having their conditions correctly diagnosed and treated [4]. The lack of knowledge of other dentists,
physicians, and other health care providers prevents many patients from receiving the best care as
soon as possible.
In 2015, the ABDS were formed by four emerging dental specialties, the American Board of Oral
Medicine, the American Board of Oral facial Pain, the American Dental Board of Anesthesia, and
the American Board of Implant Dentistry. The ABDS recently received a successful court decision
against the Texas State Board of Dental Examiners. (This case is presently under appeal.) The United
States 5th Circuit Judge (the honorable Sam Sparks) decided in a summary judgment that the Texas
Administrative Code was an unconstitutional restriction upon the plaintiff’s First Amendment
right to free commercial speech. Similar court cases also prevailed in Florida and California [5,6].
Therefore, dentists (in Texas) within dental specialties recognized by the ABDS are allowed to
advertise that they are indeed, dental specialists. The ABDS is essentially a credentialing agency and
demands that dental specialties demonstrate appropriate standards and credibility and demonstrate
psychometric evaluation before acknowledging diplomat status with said dental specialty. The ADA
and the AMA are trade organizations, and not credentialing agencies. It is hoped for that the ABDS
will take over from the ADA with respect to emerging dental specialties, just as the ABMS took over
from the AMA eighty some years ago.
This sea-change in dental specialty recognition is expected to advance dental patient care. The
result should enhance physicians’ and patients’ knowledge of newly recognized dental specialties and
improve communication between dentists, patients and physicians.
References
- Brown RS, Mashni M. Emerging dental specialties and ethics. J Amer Coll Dent. 2015; 82: 31-38.
- American Academy of Implant Dentistry et al. vs Glenn Parker, Executive Director, Texas State Board of Dental Examiners, et al. Texas Society of Oral and Maxillofacial Surgeons. 2016.
- Another body to validate dental specialties: The American Board of Dental Specialties. J Craniomand Sleep Prac. 2014; 32: 172-173.
- Miller CS, Epstein JB, Hall EH, Sirois D. Changing oral care needs in the United States: The continuing need for oral medicien. Oral Surg Oral Med Oral Pathol Oral Radiol. 2001; 91:34-44.
- Ducoin FJ v Viamonte Ros AM, Second Judicial Circuit, Florida, #2003 CA 696. 2009.
- Potts ML v Stiger B, United States Distric Court, California, #Civ. S-03- 348. 2010.