The American Association of Orthodontists goes to bat for our members in countless ways. Just this past year, we have been the voice for orthodontic issues in the United States, Canada and Puerto Rico. As part of the AAO’s strategic plan, we aim to mobilize AAO members to actively engage in AAO’s advocacy efforts, which we believe best protect patient health and safety.
As just one part of these efforts, the AAO supports laws that require those practicing and/or advertising as “specialists” to have successfully completed a post-doctoral program, consisting of at least two full-time years and which is accredited by an accreditation agency that is recognized by the U.S. Department of Education. At this time, that agency is the Commission on Dental Accreditation (CODA).
The AAO’s efforts in regard to specialty advertising in particular have taken a wide-ranging approach, as we strive to protect the health and safety of orthodontic patients, both current and prospective. We are pleased to share several important updates on ongoing advocacy work being completed by AAO staff, and in certain instances volunteer members, in regards to specialty advertising.
By simply being a member of the AAO, you play a part in presenting a unified voice that advocates for the health and safety of orthodontic patients and supports the orthodontic field.
The West Virginia legislature recently passed Senate Bill 400, which allows the West Virginia Dental Board to create dental specialty licenses and limit who may advertise as a dental specialist in West Virginia. Previously, the Board’s only rule regarding dental specialties was limited to allowing dentists to “[u]se the words specialist, specializing in, limited to the specialty of, or practice limited to if the dentist has a current license to practice his or her specialty issued by the board entitling him or her to engage in a specialty practice.”
The new statute provides further clarification and rules to limit which specialties are recognized. The statute reads, “(b) a dentist may not represent himself or herself to the public as a specialist, nor practice as a specialist, unless the individual: (1) has successfully completed a board-recognized dental specialty/advanced education program accredited by the Commission on Dental Accreditation; (2) Holds a general dental license in this state; and (3) Has completed any additional requirement set forth in state law or rules and has been issued a dental specialty license by the board.” The new statute further includes each specialty that the Board recognizes – including orthodontics.
AAO member, Dr. Dan Joseph, spearheaded the effort and worked with the AAO’s Vice President of Advocacy and General Counsel, Sean Murphy, to draft comments for legislators to consider. The bill ultimately passed and was signed by the Governor on March 22, 2019.
The AAO has successfully opposed a South Carolina measure that would have substantially expanded who could advertise as a dental “specialist” in the state.
In January 2019, the South Carolina legislature introduced HB 3160 to amend which dental specialties would be recognized for a specialty license. Under the existing version of the current South Carolina statute, a special license is required for the practice of a specialty area of dentistry, and no dentist shall announce or hold himself out to the public as being a specialist without first obtaining a special license from the Board.
The amendment language would have allowed dentists that practice specialties not recognized by the ADA’s Commission on Dental Accreditation (CODA) to be recognized as specialists and able to receive specialty licenses from the state, including those dental specialties recognized only by the American Board of Dental Specialties (ABDS) (i.e. implantologists).
The AAO voiced its opposition about dentists with less education and training being able to advertise in the same manner or with similar words used to describe those who have graduated from CODA accredited programs, as the AAO believes it is not in the best interest of patients’ health and safety.
Through the Component Legal Support Fund, the AAO worked with a local lobbyist to inform members of the South Carolina House Committee of the implications the proposed language would have. Thanks to the AAO’s efforts, the bill did not pass through the House Committee and did not even come close to becoming law during the 2019 legislative session.
The AAO’s efforts in Oregon involving specialty advertising have also reached a successful conclusion. In March of 2019, an Oregon State Senator introduced SB 835, a bill to amend statutory language in the Dental Practice Act relating to dental specialties. The bill provided that a dentist licensed by the Oregon Board of Dentistry may advertise that the dentist practices in one or more specialty areas of dentistry if the dentist:
- Has completed a post-doctoral residence program accredited by the Commission on Dental Accreditation, or its successor organization, and approved by the board by rule;
- Is a specialist as defined by the National Commission on Recognition of Dental Specialties and Certifying Boards, or its successor organization, and adopted by board rule; or
- Has completed an advanced dental education program recognized by the United States Department of Education and approved by the board by rule.
While the bill was in the Senate, the AAO, the Oregon State Society of Orthodontists (OSSO), and several Oregon members submitted official comments to support the bill. The bill passed in the Senate almost unanimously. While in the House, the bill faced some opposition and even legal threats, and amendment language was proposed to include programs accredited by the American Board of Dental Specialties (ABDS).
The AAO’s State Affairs Specialist, Gianna Hartwig, attended the final public hearing in May 2019 and explained to the rules committee that the AAO supports the bill’s original language, as the AAO believes that it best protects patients from dental providers with less education and training from being able to advertise on the same level or in the same manner as those dentists who have graduated from multi-year, CODA accredited programs that are recognized by the U.S. Department of Education.
The bill, with the language supported by the AAO, ultimately passed in the House and was signed by the Governor on June 13, 2019. This concludes the AAO’s specialty advertising efforts in Oregon, which also included amending regulations in 2018 that list specific specialties recognized by the Board (including orthodontics), rather than deferring to the ADA’s list of specialties.
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The AAO Component Legal Support Fund, established by a vote of the 2015 House of Delegates, provides grants to component organizations to assist with state legal and legislative issues that impact the orthodontic field. To date, the CLSF has assisted dozens of components (including Canadian components) with their issues.
Individuals and patients who come across dental issues can contact their state or territory/provincial dental boards or authorities, state Attorney General’s consumer protection office or provincial consumer affairs office, regulatory agencies like the Food and Drug Administration (“FDA”), and their elected officials (e.g. Governor, state representative, etc.) about such issues.
The AAO’s advocacy activities regarding direct-to-consumer orthodontics can be found at – https://www1.aaoinfo.org/legal-advocacy/dtc-advocacy-page/.