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Specialty Recognition

Update on Specialty Recognition

Specialty recognition is a critical issue not only for prosthodontics but all of the recognized specialties – and our patients.

This series of articles was developed to describe how the ACP has been involved in representing your interests as prosthodontists. Please share them with your colleagues!

Recent changes in specialty recognition
Susan E. Brackett, DDS, MS, FACP

From 1947–1963, the American Dental Association (ADA) recognized eight dental specialties. Since then, only one additional specialty, Oral & Maxillofacial Radiology, has been approved. Four other clinical entities have made multiple attempts to achieve specialty recognition (Implantology, Dental Anesthesia, Orofacial Pain, and Oral Medicine) but did not succeed.

In the 1980s, the courts began to recognize the right of professionals to advertise, and the landscape for the ADA-recognized dental specialties began to change dramatically. Cases in Florida (2009) and California (2010) allowed advertising as a specialist by groups other than the nine ADA-recognized specialties, citing restraint of trade and classifying the ADA as a “trade organization”. Several of these groups banded together and formed a certifying board, the American Board of Dental Specialties (ABDS).

In 2015, a lawsuit was filed in Texas challenging the designation of “specialist”. This case questioned the state’s deferral to the ADA for “specialty recognition.” Since the ABDS claims that these “specialists” are required to complete a credentialing process, the Texas court decided that, under the First Amendment, these groups are entitled to call themselves specialists. In the current litigious climate, the judiciary is extremely cautious when handing down a ruling that could be perceived as interfering with laws governing restraint of trade or free speech. The Texas Board of Dental Examiners filed an appeal with the Fifth District Federal Court of Appeals, but the ruling was affirmed in 2017.

In response to these developments, two task forces were formed: an ADA-supported Task Force and a Task Force on Specialty Recognition sponsored by the Dental Specialty Group. Both task forces included representatives from the ACP.

What emerged was a recommendation for a new commission devoted to specialty recognition and the formation of certifying boards. This commission would be independent of the ADA. This is intended to protect the specialty recognition process from any real or perceived influence by the ADA.
A draft of bylaws for this new commission was circulated to the Dental Specialty Groups, of which the ACP is an active participant, and representatives from the specialties and their corresponding specialty boards were invited to attend a summit meeting. After reviewing the comments, a final draft was developed and referred to the ADA Board of Trustees.

In August 2017, the ADA Board of Trustees voted to recommend approval of modification of its bylaws to change the process by which new dental specialties and certifying boards are recognized. This recommendation became Resolution 30. The ACP testified in support of Resolution 30 and recommended that it go forward to the House of Delegates. On Oct. 23, 2017, the House of Delegates met, discussed, and voted on Resolution 30. The resolution was approved, and the National Commission on Specialty Recognition and Certifying Boards will move forward. The ADA House of Delegates is no longer the final determinant of specialty recognition. Removing the HOD’s role in identifying a “specialty” is critical in blocking the onslaught of court cases against the different states that defer to the “ADA-recognized” specialties.

There is still much work to do and many details to implement before the new commission becomes fully operational. But this is a major step forward.

At every stage of the process, the American College of Prosthodontists has been active to ensure that your interests are represented as specialists.

Key Points

Moving forward, specialty recognition will be handled by a new commission that is independent from the ADA.
Prosthodontics has full representation on the National Commission on Recognition of Dental Specialties and Certifying Boards. Any prospective specialties will be held to fair, unbiased, and rigorous requirements.
The change in terminology by CODA has no effect on your status as a specialist. CODA has no role in specialty recognition.
As a member of the American College of Prosthodontists, you belong to the organization that represents the specialty of prosthodontics and ensures national recognition of the specialty.
Your membership proves that you are a specialist. It is a symbol of your dedication to patient care.
Your membership makes it possible for the ACP to represent the specialty with a unified voice.