March 2013 Volume XLVIX Number 2
Per our annual tradition, this column updates you on the AAPD’s participation in the previous fall’s ADA annual session. Your AAPD officers bring the voice of pediatric dentistry to the table for various policies being considered by the ADA House of Delegates that might impact children’s oral health care. Our Executive Committee also has many productive discussions with other dental and corporate partners during the ADA annual session. The AAPD hosts a reception for our members serving as delegates in the ADA House, plus a reception for AAPD volunteer leaders and representatives from other partner organizations. To economize on travel and our volunteers’ schedules, the boards of trustees of both the AAPD and the Foundation (Healthy Smiles, Health Children) met during the ADA meeting.
Each year the AAPD reviews all proposed ADA House resolutions and develops position statements on selected items, for presentation by our leadership at the ADA reference committee hearings. I want to again thank all 37 of the AAPD members who served as delegates in 2012, who are listed at the end of this column.
DENTAL BENEFITS
In Resolution 103H1, the AAPD was able to insert the phrase "dental home" into the ADA’s updated document on principles for developing children’s oral health programs:
Resolved, that the following Principles for Developing Children’s Oral Health Programs be adopted as the Association’s framework for guiding policy development at the federal, state and local level for improving children’s oral health . . .
6. Parents and caregivers should establish a dental home with a dentist by the child’s first birthday
to determine appropriate preventive and restorative treatment . . .
The AAPD supported Resolution 36H, which added the phrase "treatment planning" to the definition of primary dental care:
Primary Dental Care. The dental care provided by a licensed dentist to patients beginning no later than age one and throughout their lifetime. Primary dental care is directed to evaluation, diagnosis, patient education, prevention, treatment planning and treatment of oral disease and injury, the maintenance of oral health, and the coordination of referral to specialists for care when indicated. Primary dental care includes services provided by allied personnel under the dentist’s supervision.
DENTAL EDUCATION
The AAPD supported Resolution 16 to approve the request of the American Society of Dentist Anesthesiologists for recognition of dental anesthesiology as a dental specialty. This was recommended by the ADA’s Council on Dental Education and Licensure (CDEL) after their extensive review and determination that the application met all criteria for specialty recognition. The AAPD drew attention to the following excerpt from CDEL’s background statement to the resolution:
"Pediatric dental specialists are the most dependent on the services of dentist anesthesiologists. The availability of dentist anesthesiologists has increased greatly in the last 15 years. At the same time, operating room charges have increased. Because of these changes, it is likely that the percentage of pediatric dentists utilizing the services of a dentist anesthesiologist will increase in the private dental office setting."
However, Resolution 16 failed in the House.
Resolution 185H provides the following:
"Resolved, that the Council on Dental Education and Licensure review the process and criteria for approving interest areas in general dentistry and recognizing dental specialties and report to the 2013
House of Delegates with appropriate recommendations on how to improve the process and evaluation criteria, and be it further
Resolved, the ADA will not take any application for recognition of a specialty in dentistry until CDEL has completed a review of the requirements for specialty recognition and reported such recommendations to the House of Delegates for adoption."
The AAPD also supported Resolution 17, an amendment to the requirements for recognition of dental specialties and national certifying boards for dental specialists. This proposal would require that the sponsoring organization of a specialty have membership that reflects the specialty, and in which the privilege to vote and hold office in the organization are reserved for dentists who are specialists in that area. This resolution was referred to appropriate ADA agency(ies) for further study and report to the 2013 House of Delegates. This resolution would not affect the AAPD, as only specialist members (pediatric dentists) can vote and hold office in the AAPD. However, in at least one other specialty association – public health dentistry – this is not currently the case.
ADA GOVERNANCE
The AAPD, along with the other dental specialty associations as part of the Dental Specialties Group, introduced Resolution 166 to study dental specialty recognition in the ADA House:
"Dental Specialties Group Resolution 166— Dental Specialty Representation in the House of Delegates
Resolved, that the ADA study representation in the ADA House of Delegates for the parent organizations of the ADA recognized dental specialties, and be it further
Resolved, that the specialty organizations be invited to nominate up to three representatives, at their expense, who are ADA members to assist the ADA in such a study, and be it further
Resolved, that the study address the following:
a. Whether each recognized dental specialty organization should have designated representation in the ADA House of Delegates.
b. Whether the number of dental specialty organization delegates should be determined based on a percentage of the total number of specialists members in the ADA.
and be it further
Resolved, that a report on the study be presented to the 2013 House of Delegates.
The AAPD’s statement to the Reference Committee was as follows:
"The American Academy of Pediatric Dentistry strongly supports this resolution for the reasons provided in the background statement to the resolution. The purpose here is not to promote geographic representation, but to inject expertise from dental specialty organizations into deliberations of the House of Delegates. ADA supports knowledge-based decisionmaking, which this proposal will promote.
The ADA board suggests that this resolution might increase the size of the House, but overall size does not appear to be a concern in their Report 3 on Governance where on p. 7000 the ADA board notes that "cost reduction is not the primary purpose of the [governance] study." In response to Westman Suggestion #11 with three options to reduce the size of the House of Delegates, the ADA Board prepared Resolution 100 while concluding that reducing the size of the House "will have no substantive financial impact." The ADA board under Resolution 100 proposes to retain House size at the current level, with a soft target of 475 delegates. Therefore, a modest addition of dental specialty representation, to improve overall expertise in the House, would seem to far outweigh any purported concern, or lack of concern, over House size by the ADA Board.
It is recognized that many dental specialists have and will continue to serve ably in the ADA House via the District representation process. This will and should continue. However, it is important for the ADA House to have the official perspective and pertinent expertise of representatives designated by the dental specialty organizations.
Finally, we would remind the Reference Committee that the proposed resolution is only to study the issue and report back to the 2013 House. With hundreds of pages this year looking at governance, it is really too complicated or controversial to simply study this one issue?"
Resolution 166 was not adopted by the House.
Many resolutions dealt with recommendations from a massive consultant’s report on ADA governance authorized by the 2011 House. Frankly, little of substance was changed. Resolutions 90H and 91H urged all constituencies to implement term limits for ADA delegates and alternates. Various resolutions to reduce the size of the ADA House were rejected.
A full text of 2012 resolutions is available on ADA’s website at: https://www.ada.org/members/sections/about/2012_Report_of_Unofficial_Actions_of_the_House_of_Delegates.pdf.
(you will need your ADA member log-in information to access the chart of 2011 resolutions)
AAPD MEMBERS WHO SERVED IN THE 2012 ADA HOUSE OF DELEGATES
2ND DISTRICT (N.Y.)
Delegate
Margaret Madonian (Liverpool, N.Y.)
Alternate Delegate
Lauro F. Medrano-Saldana (Brooklyn, N.Y.)
4TH DISTRICT (AIR FORCE, ARMy, DEL., D.C., MD., NAvy, N.J., PHS, P.R., vETERANS AFFAIRS, vIRGIN ISLANDS)
Delegates
Sidney A. Whitman (life member) (Hamilton Square, N.J.) Elaine C. Wagner (U.S. NavyPortsmouth, Va.)
6TH DISTRICT (KY., MO., TENN., W. VA.)
Delegates
K. Jean Beauchamp (Clarksville, Tenn.) Beverly A. Largent (Paducah, Ky.)
7TH DISTRICT (IND., OHIO)
Delegate
Paul S. Casamassimo (Columbus, Ohio)
Alternate Delegates
Henry W. Fields, Jr. (Columbus, Ohio) Terry G. Schechner (Valparaiso, Ind.)
8TH DISTRICT (ILL.)
Delegate
Susan Bordenave-Bishop (affiliate member) (Peoria, Ill.)
9TH DISTRICT (MICH., WISC.)
Delegate
Martin J. Makowski (Clinton Township, Mich.)
Alternate Delegates Allison L. Dowd (Fitchburg, Wisc.) Lisandra Soto (Portage, Mich.)
10TH DISTRICT (IOWA, MINN., NEB., N.D., S.D.)
Delegates
David Davidson (affiliate member) (Urbandale, Iowa) Eric D. Hodges (Omaha, Neb.)
Valerie B. Peckosh (Dubuque, Iowa)
Alternate Delegate
David C. Johnsen (life member) (Iowa City, Iowa)
11TH DISTRICT (ALASkA, IDAHO, MONT., ORE., WASH.)
Delegate
Linda Edgar (affiliate member) (Federal Way, Wash.)
Alternate Delegate
Jane Gillette (affiliate member) (Bozeman, Mont.)
12TH DISTRICT (ARk., kAN., LA., OkLA.)
Alternate Delegate
Timothy R. Fagan (Enid, Okla.)
13TH DISTRICT (CALIF.)
Delegates
LaJuan Hall (Brentwood, Calif.)
Lindsey A. Robinson (Grass Valley, Calif.) Andrew P. Soderstrom (Modesto, Calif.)
Sharine V. Thenard (Alameda and Pleasanton, Calif.)
Alternate Delegates
Samuel B. Burg (Santa Maria, Calif.) Dennis Paul Nutter (Fairfield, Calif.) Joseph P Sciarra (Woodland Hills, Calif.)
14TH DISTRICT (ARIz., COLO., HAWAII, NEv., N.M., UTAH., WyO.)
Delegates
Karen D. Foster (Aurora, Colo.) Jade A Miller (Reno, Nev.) Gilbert A. Trujillo (Reno, Nev.)
Alternate Delegate
Kirk J. Robertson (Flagstaff, Ariz.)
15TH DISTRICT (TEXAS)
Delegate
Philip H. Hunke (McAllen, Texas)
Alternate Delegate
Rita M. Cammarata (Houston, Texas)
16TH DISTRICT (N.C., S.C., vA.)
Delegate
Roger E. Wood (Midlothian, Va.)
Alternate Delegates
Scott W. Cashion (Greensboro, N.C.)
Paul T. Olenyn (affiliate member) (Burke, Va.) Ronald D. Venezie (Apex, N.C.)
1 Note that resolutions with "H" after the number mean they were adopted by the ADA House of Delegates.