Dear Virginia Board of Dentistry,

I am strongly opposed to this amendment. As a dentist, I have always understood and appreciated the role of the American Dental Association in taking charge of accreditation of dental schools to ensure a standard of education throughout the country. In so doing the ADA sought to protect the public by ensuring a continually high standard of newly graduating dentists across the US over many decades. In fact on the website of the Commission of Dental Accreditation, an ADA commission, is the statement, “Accreditation is the ultimate source of consumer protection…” Included in this accreditation oversight has been the 9 ADA recognized specialties all of which require 2-4 years of post dental school education. As a dental specialist in periodontics, I did 2 years of additional training after dental school with extensive didactic education and daily hands-on treatment of multiple patient cases under direct supervision of periodontists and under review by faculty and resident peers continually in those 2 years. I am not aware of a more complete education that would give the same experience and surgical mastery.

The ADA now appears to be shifting toward a newly formed  ADA National Commission on Recognition of Dental Specialties and Certifying Boards independent of the ADA on which are 9 general dentists and 9 specialists from the 9 ADA recognized specialties. Cases won by the ABDS (American Board of Dental Specialities) in Florida (2009) and in California (2010) allowed advertising by groups other than the ADA recognized specialties by citing restraint of trade and classifying the ADA as a trade organization. Has there has ever been a restraint of trade since all dentists are licensed to perform all dental procedures? In Texas (2015) the ABDS stated that there was a required credentialing process to achieve their board certification and the Texas court granted the ability of these groups to advertise as specialists under the First Amendment (freedom of speech). Dr. Richardson's comment in support of the dissenting opinion of Judge James Graves of the 5th Circuit Court of Appeals is correct. Judge Graves asserted that “Misleading Speech” is not covered under the right of the First Amendment. Those dentists who do not have an equivalent educational foundation as the 9 ADA recognized specialties but call themselves specialists are misleading the public regarding their education and clinical experience. The public will never know and the Virginia Board of Dentistry will have failed to protect the public.

My hope is that the National Commission on Recognition of Dental Specialities and Certifying Boards will consider the depth and weight of education and hands-on experience that is done by the ADA recognized specialty candidate and done by the ABDS candidate. The US courts do not seem to be evaluating that distinction. And that distinction is what is so critical to the care and safety of the public. I support the current regulations specifying that a dentist may claim that his practice is limited to a specialty but that he must note that he is providing this care as a general dentist.I would oppose any amendment change until we have heard from this joint commission.

Thank you for the opportunity to respond.

Claire C. Kaugars, D.D.S.

Diplomate, American Board of Periodontology

Drs. Kaugars and Miller, PC