May 2020 Volume LV Number 3

 
 
 
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CEO's Message

March 2020 Volume LV Number 2

Pediatric Dentistry at the 2019 ADA Annual Session
 
During the American Dental Association (ADA) 2019 Annual Session in San Francisco, Calif. this past Sep- tember, the AAPD hosted a reception for members serving as delegates or alternates in the ADA House of Delegates (HOD), pediatric dentistry speakers, representatives from other dental partner organizations, and corporate sponsors. The AAPD Executive Committee met with the Dental Specialties Group (which consists of the ten ADA-recognized dental specialties), as well as officers and executive staff of the Academy of General Dentistry and the American Association of Oral and Maxillofacial Surgery.
 
As is done every year, we reviewed resolutions of interest to pediatric dentistry being considered by the ADA House of Delegates.
 
Resolution 77
 
DENTAL SPECIALTIES REPRESENTATION IN HOUSE OF DELEGATES – SUBMITTED BY DR. JAMES D. NICKMAN, 10TH DISTRICT DELEGATE AND PAST AAPD PRESIDENT
 
This resolution was drafted and fully supported by the AAPD as well as all other dental specialties currently recognized by the National Com- mission on Recognition of  Dental Specialties and Certifying Boards (that number is now 10 with the recent addition of dental anesthesia). This resolution would have provided official representation in the ADA HOD for each specialty, having one delegate and one alternate apiece for each of  the 10. The AAPD also prepared the following Talking Points in support of the resolution:
 
What exactly is the proposal?
That each of the 10 dental specialties currently recognized by the in- dependent National Commission on Recognition of Dental Special- ties and Certifying Boards as represented by their recognized national dental specialty organizations have one Delegate and one Alternate Delegate in the ADA House of Delegates. This would mean a to- tal of  10 additional Delegates and 10 additional Alternates. The 10 dental specialties referenced above are: American Academy of  Pediatric Dentistry, American Academy of  Periodontology, American Academy of  Oral and Maxillofacial Pathology, American Academy of  Oral and Maxillofacial Radiology, American Association of Endodontists, American Association of Orthodontists, American Association of  Oral and Maxillofacial Surgeons, American Associa- tion of Public Health Dentistry, American College of Prosthodontists, and American Society of  Dentist Anesthesiologists.
 
The current structure of  the American Dental Association House of Delegates represents the 53 constituent societies, the five federal dental services and the American Student Dental Association. There is no official representation of the dental specialties.
 
Aren’t dental specialties currently well-represented in the ADA HOD?
There are certainly a number of dental specialists currently serving  as Delegates and Alternates, and their service and dedication to the ADA is greatly appreciated. However, it’s important to keep in mind that such individuals are selected by constituent societies and are under no obligation or directive to represent the principles or policies of the national dental specialty organizations to which they may belong. Their primary duty and loyalty is appropriately owed to their constituent societies.
 
Will there be any significant cost to the ADA?
No. Each dental specialty is committed to funding the transportation and lodging of their Delegate and Alternate.
 
Will this result in fewer Delegates for Constituent Societies?
No. The proposed 10 dental specialty delegates will be outside of the delegate allocation formula for constituent societies and have no impact on that number allocated for each district.
 
Doesn’t this run counter to efforts to reduce the size of the HOD?
The overall ideal size of the ADA HOD is a subjective decision that the ADA BOT and HOD have grappled with for several years. However, simply adding 10 delegates would have a minimal logistical and voting impact while adding considerable benefit to the ADA as discussed below.
 
What is the benefit to ADA?
Each dental specialty brings a unique set of knowledge and experi- ence. National dental specialty organizations establish principles, policies, and recommendations to support and enhance the profession of dentistry and advance the health and safety of patient population. Designated representatives of such national dental specialty organiza- tions in the American Dental Association House of Delegates shall advance the same.
 
This further strengthens the American Dental Association as the leader and advocate in oral health.
It also builds dental specialist loyalty to the ADA by having a direct role in the ADA governance structure. Dental specialists already join the ADA at a much higher rate as compared to general dentists. This resolution provides even stronger incentive and encouragement for ADA membership.
 
Finally, dentistry is far more united in its advocacy efforts as com- pared to medicine where the AMA and the various medical special- ties are often at variance. This resolution further promotes unity in the dental profession.
 
Unfortunately, the ADA Board of Trustees opposed this resolution, and it was not adopted by the HOD.

Resolution 12
 
STATEMENT ON THE USE OF SILVER DIAMINE FLUORIDE
SUBMITTED BY COUNCIL ON DENTAL PRACTICE
12. Resolved, that the ADA policy, Statement on the Use of Silver Diamine Fluoride, be adopted:
Statement on the Use of Silver Diamine Fluoride
 
38% Silver Diamine Fluoride (SDF) is a topical antimicrobial and remineralizing agent which was cleared by the FDA as a Class II medical device to treat tooth sensitivity. In certain limited circum- stances, SDF can be used as a non-restorative treatment to arrest cavitated carious lesions on primary and permanent teeth. SDF treat- ment for carious lesions requires appropriate diagnosis and monitor- ing by a dentist.
  1. When using SDF for caries management, the following protocols should be followed:
  2. A diagnosis of  caries and comprehensive treatment plan, de- veloped by a dentist, are necessary for each patient prior to the application of  SDF.
  3. Patients or their lawful guardians who opt for this treatment modality should be informed of  all available treatment options, possible side effects, and the need for follow-up monitoring when giving informed consent.
 
The application of SDF may be delegated to qualified al- lied dental personnel with the appropriate training under the
indirect or Public Health supervision of a dentist, in accord with state law and in conjunction with the above protocols, keeping  in mind that caries removal may be indicated for effective use of SDF.
 
The AAPD supported this resolution. However, it was referred to the "Appropriate Agency for Further Study and Report to the 2020 House of Delegates."
 
Resolution 48
 
RECISSION OF THE POLICY, STATE REGULATION OF ADVERTISING – SUBMITTED BY COUNCIL ON GOVERNMENT AFFAIRS
Resolution 48 would rescind the ADA’s policy entitled State Regula- tion of Advertising (Trans.1984:549), based on the argument that it prescribes an action already addressed, rather than stating a position. The current policy states:
 
"Resolved, that constituent dental societies be urged to consider state legislation, consistent with the recognized rights of commercial speech, that will authorize the appropriate agencies of state govern- ment to regulate dentist advertising in the public interest to ensure the dissemination of complete and accurate information through appropriate means of communications including time, manner and place."
 
The AAPD supported referral back for further modification, noting that even though the statement is outdated, it is still important for the ADA to have a policy statement supporting the authority of state dental boards to regulate and sanction false and misleading advertising and set parameters for specialty advertising. Resolution 48 was subsequently withdrawn.
 
Resolution 70
 
USE OF THE TERM "SPECIALTY" – SUBMITTED BY COUN- CIL ON ETHICS, BYLAWS AND JUDICIAL AFFAIRS
70. Resolved, that the ADA policy entitled "Use of the Term ‘Spe- cialty’" (Trans.1957:360) be amended as follows (additions under-  scored, deletions stricken through):
 
Resolved, that the use of the term "specialty" be reserved for those by  any groups which that does not represent a dental specialties specialty formally recognized by the American Dental Association National   Commission on Recognition of  Dental Specialties and Certifying   Boards and/or groups accepted as specialties in the jurisdictions in which they practice be disapproved.
 
The AAPD recommended that this resolution should be strengthened by inserting the word "national" before "use" and deleting everything after "Certifying Boards." This would make it clear that the ADA believes the National Commission is the "gold standard" for specialty recognition, without intruding upon decisions that are made by state dental boards.
 
Unfortunately the HOD in resolution 70RC rescinded the entire policy. However, the ADA believes that existing language in Section 5.H. of the ADA Principles of Ethics and Code of Professional Conduct means that the parameters of proper and ethical announcement of specialty practice continue unchanged.
 
Resolution 78
 
RESPONSE TO RESOLUTION 55H-2018: ESTABLISHING A CULTURE OF SAFETY IN DENTISTRY – SUBMITTED BY COUNCIL ON ADVOCACY FOR ACCESS AND PREVENTION
78. Resolved, that the appropriate ADA agency Council on Ad- vocacy for Access and Prevention be tasked with implementing, in a measured and methodical manner, a three year framework for action that will begin to:
 
  • Develop a curriculum on patient safety and encourage its adoption into training;
  • Disseminate information on patient and dental team safety through a variety of in- person, print, web and social media communication vehicles on a regular basis;
  • Recognize patient safety considerations in practice guidelines and in standards;
  • Work collaboratively to develop community-based initiatives for error reporting and analysis; and
  • Collaborate with other dental and healthcare professional as- sociations and disciplines in a national summit on dentistry’s role in patient safety.
 
and be it further,
 
Resolved, that the Council on Advocacy for Access and Prevention be urged to use its existing workgroup.
and be it further,
 
Resolved, that an annual report be submitted to the ADA House of Delegates detailing progress in nurturing this culture of safety in order to raise awareness, while alleviating fear and anxiety associated with making the dental environment safe for patients, providers and the dental team.
 
This was approved with minor revisions as indicated above. The AAPD supported this resolution as it is consistent with AAPD’s efforts in this area.
 
AAPD Member Speakers
 
The following AAPD members made CE presentations during the ADA Annual Session:
  • Dr. Catherine M. Flaitz presented on A Mixed Bag of  Oral Lesions in Tots and Teens, Mouthful of  Lesions in Peewees: Maximizing Infant Oral Health, and Pediatric Oral Diseases: The Times They Are A-changin.
  • Dr. Martha Ann Keels co-presented on Managing and Presenting Dental Erosion in Children and Adults.
  • Dr. Jeannette K. MacLean co-presented as part of  An Interac- tive Session with Our SDF and GIC Expert Panel.
  • Dr. Greg Psaltis presented on Stainless Steel Crowns are a Snap and Behavior Management of Children, Parents and Self, I Was on the Internet Last Night, and Think and Work Like a Pediatric Dentist.
  • Dr. Francisco Ramos-Gomez co-presented on Hot Topic Session: Latest Clinical Approaches on Pediatrics – Age One Visit and presented on Help! I Have a One-Year-Old in My Chair.
  • Dr. David L. Rothman presented on Ouch! That Hurts: Dental Emergencies in Children, 4 ‘Ps’ of  Pediatric Dentistry, The Caries-Free Child: Understanding and Sharing the Science, and Medical and Sedation Emergencies in Children.
  • Dr. Rebecca L. Slayton presented on Use of Nonrestorative Treatments for Caries Management.
  • Dr. Jane A. Soxman presented on Clinical Techniques in Pediatric Dentistry and Diagnosis and Treatment of  Oral Trauma (including a Continue the Conversation campfire session).
  • Dr. Sidney A. Whitman co-presented on Being a Medicaid Provider in the Era of Accountability.

AAPD Member Delegates and Alternates
 
We thank those AAPD members who served in the 2019 ADA House of Delegates:
 
1ST DISTRICT (CONN., MAINE, MASS., N.H., R.I., VT.)
Delegate
Jonathan D. Shenkin (Augusta, Maine)
Alternate
John Kiang (Providence, R.I.)
 
2ND DISTRICT (N.Y.)
Delegates
Loren C. Baim (affiliate member) (Glen Falls, N.Y.)
Jay Skolnick (Webster, N.Y.)
Alternates
Lois A. Jackson (New York, N.Y.)
Margaret Madonian (Liverpool, N.Y.)
Ioanna G. Mentzelopoulou (New York, N.Y.)
Sydney Shapiro (predoctoral student member) (Pleasantville, N.Y.)
 
4TH  DISTRICT (AIR FORCE, ARMY, DEL., D.C., MD., NAVY, N.J., PHS, P.R., VETERANS AFFAIRS, VIRGIN ISLANDS)
Alternate
Rachel A. Maher (Wilmington, Del.)
 
5TH  DISTRICT (ALA., GA., MISS.)
Delegate
James I. Lopez (Columbus, Ga.)
Alternates
Robert David Bradberry (Marietta, Ga.)
Lauren B. Moore (Mobile, Ala.) 
Ryan M. Vaughn (Gainesville, Ga.) 
Erik H. Wells (Watkinsville, Ga.)
 
6TH DISTRICT (KY., MO., TENN., W. VA.)
Alternate
K. Jean Beauchamp (Clarksville, Tenn.)
 
8TH  DISTRICT (ILL.)
Delegate
Susan Bordenave-Bishop (affiliate member) (Peoria, Ill.)
Alternate
Sharon J. Perlman (affiliate member) (Chicago, Ill.)
 
9TH DISTRICT (MICH., WISC.)
Alternate
Martin J. Makowski (Clinton Township, Mich.)
 
10TH DISTRICT (IOWA, MINN., NEB., N.D., S.D.)
Delegates
Valerie B. Peckosh (Dubuque, Iowa) 
James D. Nickman (North Oaks, Minn.) 
Aruna S. Rao (Minneapolis, Minn.)
Alternate
David C. Johnsen (Iowa City, Iowa)
 
11TH DISTRICT (ALASKA, IDAHO, MONT., ORE., WASH.)
Delegates
Austin Baruffi (affiliate member) (Tukwila, Wash.) 
Christopher Delecki (affiliate member) (Kirkland, Wash.) 
Bernard J. Larson (Mount Vernon, Wash.)
Hai T. Pham (Hillsboro, Ore.)
 
12TH  DISTRICT (ARK., KAN., LA., OKLA.)
Alternates
Timothy R. Fagan (Enid, Okla.)
John T. Fales, Jr. (Olathe, Kansas)
 
13TH  DISTRICT (CALIF.)
Delegates
John L. Blake (affiliate member) (Long Beach, Calif.) 
Lindsey A. Robinson (Grass Valley, Calif.)   
Andrew P. Soderstrom (Modesto, Calif.)
Sharine Thenard (Alameda, Calif.)
Alternates
Paul Ayson (affiliate member) (Visalia, Calif.)
 
14TH DISTRICT (ARIZ., COLO., HAWAII, NEV., N.M., UTAH., WYO.)
Delegates
Jeffrey A. Kahl (Colorado Springs, Colo.)
Stephanie H. Kaufmann (affiliate member) (Woodland Park, Colo.)
Kirk J. Robertson (Flagstaff, Ariz.)
Alternates
Karen D. Foster (Greenwood Village, Colo.) 
Darren D. Chamberlain (Springville, Utah) 
Christopher C. Lee (Honolulu, Hawaii)
 
15TH  DISTRICT (TEXAS)
Delegates
Paul A. Kennedy, III (Corpus Christi, Texas)
Charles W. Miller (Arlington, Texas)
Rita M. Cammarata (Houston, Texas)
 
16TH DISTRICT (N.C., S.C., VA.)
Delegate
Scott W. Cashion (Greensboro, N.C.)
 
17TH  DISTRICT (FLA.)
Delegates
Natalie Carr-Bustillo (Riverview, Fla.)
Stephen D. Cochran (Jacksonville, Fla.)
Alternates
Casey Lynn (Valrico, Fla.)
Suzanne Thiems-Heflin (Gainesville, Fla.)