ALL LICENSURE PATHWAYS NOW ACCEPTED IN COLORADO FOLLOWING A STATE DENTAL BOARD POLICY AMENDMENT

DENVER, Colorado—The Colorado Dental Board voted to amend their licensure policy to accept all existing licensure pathways including all regional clinical examinations, PGY-1, hybrid-portfolio, and the OSCE.

ASDA has been working for some time now to make changes to the current licensure model that includes the use of live-patient exams. Little by little, steps have been taken in Colorado to ensure that this change would happen.

In 2013, DORA released a document as part of the Sunset Review stating that one of their top 3 “Key Recommendations” was to revise the clinical examination requirements for the state in order to allow acceptance of alternative licensure pathways including those that do not require a live patient.

In 2014, the state adopted new wording to the Dental Practice Act adding letter C to statute 12-35-119 (1) saying that the state will accept “other methodology, as determined by the board, designed to test the applicant’s clinical skills and knowledge, which may include residency and portfolio models” in lieu of a traditional live-patient clinical exam.

And lastly, just this year, the Colorado Dental Board amended their 1.A Clinical Examination policy to officially accept all existing licensure pathways in the US including all regional clinical examinations (ADEX administered by CITA and CDCA, CRDTS, SRTA, and WREB), the completion of a PGY-1 program or hybrid-portfolio model from the state or jurisdiction where licensure was originally obtained, and the Canadian OSCE for initial licensure, making Colorado the first state to make this change.

Here is what we know:

• You can take any regional clinical examination to apply for initial licensure in Colorado
• You can take the Canadian OSCE to apply for initial licensure in Colorado
• If you went to school in California and were licensed via the hybrid-portfolio model, you can now apply for licensure in Colorado
• If you went to school and were licensed in a state that accepts PGY-1 (a one-year residency), you can now apply for licensure in Colorado

Although some details are not known at this time, this is a huge step forward for licensure reform in the United States.

Stay tuned for updates and more information as we receive it. Get all the news first right here with Colorado ASDA on your number one advocacy blog—the Colorado Quickset.

This blog post is adapted from a letter originally published via email on March 2, 2016. This post is reprinted with permission from the American Student Dental Association. For more dental student news and updates, visit ASDAnet.org.

ASDA has had a remarkable past year as an association, and personally this year has been one of the wildest, most fulfilling experiences I could have imagined.  From the 2015 election in Boston to National Dental Student Lobby Day in Washington DC to National Leadership Conference in Chicago to our House of Delegates in Dallas, this year has been a whirlwind of challenge and excitement.  Because it's difficult to get an accurate sense of what it's like to serve on ASDA's Executive Committee, I’d like to share some insights about our work over these past 12 months.

Wellness Initiative

As I was reading over farewell speeches given by ASDA presidents over the past ten years, I came across the one delivered by Jiwon Lee, and I was reminded again what an intelligent, insightful, talented leader she was. Jiwon was ASDA's immediate past president when we lost her to suicide just a couple months after she gave that speech to open ASDA's 44th Annual Session.

That loss is still difficult for those of us who knew and worked with Jiwon, but one of ASDA's most important accomplishments this year - the one that makes me most proud to be a part of this association - has been the continued rollout of the Wellness Initiative that we launched in response to her passing.

That initiative has expanded from a mental and emotional focus to include ASDA's five dimensions of overall wellness. Each of those dimensions — emotional, physical, intellectual, occupational, and environmental — has a separate section on our website with a variety of ASDA and external resources that are updated throughout the year. This is in addition to:

• Monthly wellness challenges like "going dark for 24 hours"
• The testimonials you heard at NLC about addiction and overcoming obstacles in dental school
• The upcoming wellness webinars that will kick off this month
• And the fact that the AADEJ selected the Wellness Issue of Mouth for the Larry Meskin Award for Excellence in Dental Student publications — and furthermore, that content from that issue will be re-published this month in the Journal of the California Dental Association.

Because of course, this is about much more than fun runs and catchy hashtags. This is about the fact that dental school can be a dark time. And many of us haven't experienced that — we made it through undergrad as the helpers, not the helped. But we need to destigmatize the idea of being helped. If you log onto our website, you can click on your school and learn how to connect with the wellness resources offered by your university. Yes, dental school is hard on your mind, hard on your body, and hard on your spirit — and you're not the only dental student who feels like that. ASDA's Wellness Initiative is here because we want to be able to show you where to turn.

Student Debt

Another major development that's going to affect dental students this year is the work of the ADA's Student Debt Work Group. According to ADEA, the average dental student debt for 2015 graduates is $255,567. ASDA participated in that work group, which was chaired by ADA Trustee and former ASDA Board Liaison, Dr. Jeffrey Cole. The group secured a deal with Darien Rowayton Bank (DRB) that will allow dental students to refinance their loans at much lower rates upon graduation.

Licensure Reform

I told all of you last year that licensure reform would be my top priority. Many now agree that our licensure system is broken, but there is still little consensus about which path to take in fixing it.  There are many organizations advocating for different pathways to licensure reform, but there's only one American Student Dental Association.

This past July, the Board of Trustees revisited the idea of our ideal licensure examination and passed an interim L-1 policy that has allowed the Executive Committee to be extremely nimble and clear in advocating for reform. And not just reform -- but the right reform.  I was honored and proud when the House of Delegates approved that policy at Annual Session last week.

If you haven't had a chance to review the policy, do so now. This policy is empowering us — and things are changing. Because of the way candidacy for licensure is determined, reform can't be accomplished by any kind of sweeping federal legislation. Licensure is a state's rights issue, so change on the licensure front has to happen on a state-by-state basis. You can imagine that running 50 separate reform efforts is a daunting task, and it is. But change is happening, however incrementally.

ASDA's power is in its voice, because we are the future of the profession. I'm looking forward to hearing that voice in the coming days.

Final Thoughts

I really credit the Board of Trustees for the decisions they've made to steer ASDA in the right direction. Our Board members are dental students with exams, practicals, and competencies like the rest of us, but they've turned themselves into experts on the issues that affect dental students in order to make decisions for the best interest of everyone. Thanks to all of them, including our inexhaustible Colorado ASDA president and District 9 Trustee, Kyle Larsen. And I especially want to thank my fellow Executive Committee members — Adrien Lewis, Niveditha Rajagopalan and Nancy Honeycutt — for their humor, talent, stamina and intelligence.

One of the greatest challenges about ASDA's leadership structure is that we serve one-year terms, which means our leaders turn over almost completely every year. But this is also one of ASDA's greatest strengths. It gives every set of ASDA leaders exactly one year to aggressively throw themselves into the fight for ASDA's initiatives, and then turn that work over to a new group of fresh, creative minds.

I think this is so incredible because it gives our association the ability to reevaluate ASDA's direction through new eyes every single year. It's such a gift to know that Adrien, Niv, and I will pass our work on to a new Executive Committee that can analyze and critique what we've done, and potentially take this association in a direction the three of us could never have imagined. It's not with a heavy heart that I'm ending this term - it's with a happy one. I can't wait to serve in a supporting role for the next leaders of this association.

I feel so humbled to have had the chance to serve you as president this year.  I see bright, exciting futures ahead for all of our members, and I feel fortunate to have been a part of an association that's making our collective future brighter by the day.

Thank you,

Christian Piers, Colorado ‘16

ASDA Immediate Past President

I-de-al (adj):  satisfying one's conception of what is perfect; most suitable.

Ideal is a word we think we understand. A word we often use to describe our goals and ambitions. A word we hope people use to describe us. Colorado ASDA recently won the Gold Crown Award for Ideal ASDA at the 2016 Annual Session in Dallas, Texas.  This means that our chapter, among the 65 ASDA chapters nationwide, exemplifies what is considered a perfect ASDA chapter.

Ideal ASDA means our chapter successfully completed items in multiple categories such as membership, communication, activities, pre-dental involvement, and advocacy. On a chapter level, membership, communication, and activities are the direct benefits a student has by being involved at the local level. This includes the how-to guides, TAD talks, lunch and learns, as well as leadership opportunities. Remember back to 2013 and imagine what ASDA looked like then: basically free pizza only 3 times a semester or so. A huge improvement in our chapter involved delegating fundraising, which resulted in students being served gourmet meals several times a week, and learning about our sponsors simply for being an ASDA member.

To the shock and dismay of the admissions committee, students do not seek out community outreach activities once accepted into dental school, yet many still want to be involved. Our ASDA chapter organizes community outreach opportunities for those individuals, and provides a variety of ways for students to give back to our community. These frequent events are some of the best opportunities for members to get involved in our chapter without committing to a leadership position.

Not only does our chapter provide for the students of our own dental school, but Colorado ASDA is a huge resource for pre-dental students in the state. One of the main goals of our chapter is to increase pre-dental involvement, and we have a committee designed to facilitate this. In the past year, our chapter has helped create pre-dental clubs at our local universities, as well as involving pre-dental students in dental school such as a leadership workshops.

Perhaps the most beautiful part of being Ideal ASDA, is that we give a home to everyone who wants to participate, whether it’s just attending lunch and learns or  obtaining a leadership position. ASDA is unique in that it is the only organization at our school that all students are members of. If it weren’t for the efforts of our leadership and the participation of our membership, our chapter could never have achieved the prestigious Ideal ASDA award. Thank you to all of our members for making this the best chapter ever!

If you want to become more involved in our chapter, please contact any Colorado ASDA Executive member.

Like many other dental students, I’m from a state that doesn’t have its own dental school. Unfortunately, this leads to a very high lack of access to care for the residents of my home state, New Mexico. When speaking to several members of the NMDA about issues that are impacting our state, the words “mid level care providers” and “dental therapists” inevitably pop up. My basic assumption of these words (which are one in the same) at the time was “a non-dentist” that can perform “dentist” duties. Those are scary words to hear as a dental student, investing hundreds of thousands of dollars and four years of my life, only to have the same job done by somebody who has only received a bachelor’s degree. I decided to dive a little further into the subject about the pros, cons, regulations, and education requirements surrounding the dental therapist…so here we go!

The Basics….  

• Dental therapists operate under a dentist’s license in an office or satellite clinics. Their basic duties vary depending on each state’s rules.
  • Scope of practice includes fillings, seating crowns, performing extractions, adjusting dentures, diagnosing radiographs, making treatment plans
• Dental therapists are currently practicing in Minnesota, Maine, and Alaska. There are different names for the profession popping up in legislature all over the country (including Colorado)
• Two types:
  • Dental therapist-
    • Requires a bachelors’ degree in Dental Therapy with several licensure and competency exams in order to practice. May perform some services under “indirect supervision,” which means a dentist must be on-site to authorizes procedures, or under “general supervision,” which means the dentist is off-site and must still authorize procedures.
  • Advanced dental therapist-
    • Dental therapy degree along with a masters’ degree in Advanced Dental Therapy which requires 2,000 hours of clinical practice and a certification exam. They may do all that a dental therapist can do, and also perform oral evaluations, treatment plans, and non-surgical extractions of teeth.
    • Practices under the supervision of a dentist, but all procedures can be completed under “general supervision.”

The Case FOR Dental Therapists…

• Contrary to what many believe, there isn’t a lack of dentists in certain “at need” states, rather a lack of distribution. This can be alleviated by dental therapists working at satellite clinics in rural areas addressing basic needs of the community without patients being forced to travel to far-away dental offices.
• They only perform routine care, so it opens up the dentist’s schedule to perform more complex care like endodontics, prosthodontics, and implantology, while still addressing basic needs of the office’s patient pool. This is viewed as a way to expand a dentist’s practice and maximize profit.

The Case AGAINST Dental Therapists…  

• It is a common opinion within the dental community that if Medicaid and insurance reimbursements didn’t drive practitioners to lose money on certain procedures, many more would practice in areas where fee-for-service dentistry isn’t the norm. Many dentists believe that more changes to Medicaid and insurance reimbursements need to be made in order to drive practitioners to “low income” areas.
• States should address access to care issues by reimbursing dentists who work in rural areas. Dental therapists have the ability to work on simple cases, but comprehensive care is the only way to effectively provide dentistry that is at the standard of care.
• The ADA believes that the “one-size-fits-all” model provided by dental therapists is not the best way to reach populations that live in rural communities.
• Dentists do not want their profession’s quality to be in jeopardy with the addition of therapists who are less educated in dentistry.

In the end, it is up to YOU as a dental professional to decide what is best for you, and most importantly, the patients in your home state. Being involved in your local ASDA and ADA chapter will make a difference whether dental therapists become a reality where you live.

Getting concrete information on world affairs can often feel like trying to build a restoration out of Jello. It seems no matter where you look, news is inherently biased and trying to push one political agenda or another. Factual reporting seems to have evaporated like acrylic monomer beneath the sun. So it is with some trepidation that I set out to write about the Syrian refugee crisis. In case you’ve been living under a rock for the better part of the decade, there has been a fair amount of strife in Syria. And that, ladies and gentlemen, is how you write an understatement. There are at least three factions—and really more like five or six—vying for control of a country 25% smaller than Colorado. Imagine, if you will, living in a place where instead of hearing honking horns, gunfire is more the norm. A place where you must live in constant fear of bombings—both from the sky and from the ground. A place where, at any given moment, your life could end. Try to imagine what you would do in such a place.

I recently met a patient in screening. He told me his teeth hurt, which is not uncommon in that clinic. We chatted for a while about how the school works and what he could expect from his time with us. I did notice he wasn’t opening his mouth much to talk. While playing the waiting-for-faculty game, we made small talk. Food came up, and I mentioned I like middle-eastern cuisine. He told me he was from Syria, and he suggested I try the restaurant at which he works. I thought nothing of it.

Then I looked in his mouth.

His teeth—all 28 of them—were ground down to below the CEJ. His mouth looked like someone had taken a handpiece and leveled every tooth to an almost-perfect flat plane. I had to resist the urge to gasp. I asked him about his habits, trying to determine an etiology of what I was seeing. It was a short conversation.

His answer was that he ground his teeth during times of stress. Over the past couple of years, twenty-nine of his extended family members had been killed in and around Syria. Twenty. Nine. They had been killed in the civil war. They had been murdered by ISIS. They had perished trying to flee across the Mediterranean. The how doesn’t really matter.

Imagine your extended family. If I think, I can come up with about fifty names of family members with whom I have a connection. Now imagine that over half of them are dead. It’s a sobering thought.

I set out to write this article without taking a side on the refugee crisis. But every time I hear about the thousands of people fleeing Syria, my mind involuntarily returns to this patient. Never have I met someone who so starkly illustrated just how good our lives are in this country.

In the wake of the attacks in Paris, this issue has risen to the very forefront of mainstream media. Like so many issues, it has become politicized, where every person has to pick a side—red or blue. There are those who fear ISIS will sneak into our country under the guise of refugees. And there are those who feel compelled to open our borders and welcome the refugees.

I completely understand both sides of the argument. Am I afraid of ISIS entering our country? Of course I am. It’s a very real fear, the kind of fear that can turn your stomach to ice. But you all know the line: “All we have to fear is fear itself.” That fear shouldn’t make us lose our decency as human beings. If we let fear divide us, ISIS has already won.

To say it is a complicated problem would be to call the sun warm. But I always go back to this patient. How can I, in good conscience, sit in the relative safety of my home, and at the same time deny this man a chance to reunite with the remaining members of his family? No matter how many arguments I read, I can’t bring myself to do it. I don’t know the right answer. As H.L. Menkin once said, “For every complex problem, there is an answer that is clear, simple, and wrong.”

What I do know is that, this week especially, I’m thankful for the country in which I live. I’m thankful for the men and women who fight to defend the freedoms I often take for granted. And I’m thankful that—in the not-too-distant future—my chosen profession will allow me to help patients like this, taking away some part of their pain, however small a part it may be.

I would welcome conversation and debate, as long as it is kept civil. At the end of the day, we’re all on the same team.

 

I still remember sitting in the back of the room, not sure what to think: it was hard to not be depressed after seeing how far ahead in ASDA spirit several other chapters were compared to us.  Rather than wallowing in sadness or shrugging it off, my rebellious spirit almost immediately stepped in.  My attitude immediately changed from one of vexation to one of determination: "Challenge accepted,” I said to myself. Equipped with a notebook full of ideas and inspiration from amazing people, I left NLC 2013 ready to get to work.

Fast forward two years, and with 20 more chapter members than were with me the first time, my feelings were very different.  I felt confident and ready to show Colorado ASDA off to the world! Sitting at the front of the room as the District 9 Trustee, I looked back at my clan of chapter members and felt so accomplished— not just because of how well our chapter had done since my first NLC, but because we were about to have yet another amazing conference!

My third NLC was much different from my first, and being on the other side of things gave me a very different perspective. My first year, I attended breakout sessions, introduced myself to those who inspired me and talked to national leaders about what it is like to be involved at that level. This year, I led two breakout sessions, tried to inspire as many people as I could, and encouraged everybody I saw to apply for a national ASDA position. All three years have been great experiences, but in completely different ways.

If I learned anything from attending NLC three years in a row, it is that you only get out of it what you put in—which is why NLC gets better each year. The benefits of networking become more and more valuable because my connections with other students have become more and more personal. The speakers become so much more motivating because I am looking for a different level of inspiration. The meetings become increasingly energizing because I am exceedingly excited to attend. Of course, this shouldn’t be surprising because that, in essence, is what ASDA is—everything you need! You take away whatever you put in and you put in whatever it is that you need. Opportunities are everywhere and it is up to us to take advantage of them. NLC is the perfect place to do that!

Looking back at this year’s ASDA National Leadership Conference, I noticed something that stood out like my first wax up on #8: First year dental students were the obvious minority at NLC. Initially, I thought that was to be expected since academic excellence is of the upmost importance at this stage in dental school. I believe the rigorous pre-dental journey has shaped the majority of us to feel uncomfortable receiving a grade lower than an A, and at the worst, a B. For this reason, the value of a leadership conference the weekend before a few tests is superseded by the fear and anxiety crafted well before dental school. There is an obvious financial barrier to a conference such as NLC and that will not be ignored here. For those who did not consider finances to be a barrier this year, my goal is to push you a little closer to attending next year. I like to do a cost-benefit analysis on many decisions in my life because it helps to paint situations a little more clearly:

THE COSTS:  Registration and airfare (hotel and food included in registration), and a weekend of study for tests the next week (potentially a letter grade lower on an exam).

THE BENEFITS: Eating lunch with the president of the ADA, gathering a pocket full of business cards from national speakers and leaders in the dental profession, building a network of future leaders around the country (adding as many people on Facebook as you possibly can), building relationships with vendors, and having a great time with peers who enjoy and realize the value of self improvement in their careers.

Now, the cost-benefit ratio seems great, and is probably pretty fair.  However, one could justify it still not being worth the price and sacrifice in grades the next week. But, if I told you that in 10 years you could successfully run a dental team thanks to Dr. Warnken, out-market your competition thanks to Dr. Salierno, and start a scratch practice while working for a DSO thanks to Dr. Meru, would you consider attending a conference that gave you those tools?. In today’s instant-gratification world, it’s hard to look too far ahead, but with crystal clear vision and future planning, you can see that the benefits more than outweigh the costs of this weekend in Chicago.

I challenge my classmates and every dental student in the country to assess their goals and perform a proper cost-benefit analysis. I challenge you to think about the number of patients in your life that are going to ask you about your grades. I challenge you to think about the number of word-of-mouth referrals you will get as a result of tactful communication and comprehensive patient care. These are trainable and learnable skills that NLC offers and they are yours for the taking.

As a first year student who attended NLC, I feel it is my responsibility to encourage other first year students not to wait. Don’t miss out on a relationship that could change the path of your life. Don’t miss the gems that will mold your leadership not only for the profession but for every interaction you make with another person. Mistakes will cost you more each year you wait, but being proactive and yearning for knowledge will significantly lessen the risks we face as dental professionals.

As a student of the Dental Medicine program of Colorado, I was lucky to have been chosen to attend the National ASDA Leadership Conference in Chicago. I had never even heard of ASDA before entering dental school, and was honestly apprehensive of the passion and excitement many showed for this organization. As an undergraduate, I was apart of the Biology and Chemistry club, but they were never the most exciting parts of my undergraduate career. I was really mostly excited to see Chicago, which was about to change.

Before attending, I had written a paper on the word “leadership” and what it meant to me; this put me in the running to be fully funded to Chicago NLC. I was then informed that my essay was chosen, and I was lucky enough to be fully funded. I was so ecstatic, but had no idea what to expect. With my anatomy exams the following week, I was worried that attending NLC would take away invaluable study time.

Nevertheless, I attended NLC and can truly say I regret nothing. I arrived at the gorgeous Hilton Chicago and I was in awe. I attended the sessions and it was so exciting to see so many dental students from so many places in one room. These people were like me, and all were hungry for knowledge of the career they are pursuing.

Sessions I attended included mostly post-grad options and ways to be smart financially while owning a business. While I still have a while until I have to worry about these things, it’s never too early to start having a plan. As a first year dental student, I think a lot of us lose sight of the reason why we’re here; many of our beginning classes have nothing to do with dentistry. It’s so easy to get bogged down in the day-to-day tests and studying that sometimes it becomes the question “why am I doing this”, rather than “I’m so excited I made the right career decision”.

NLC brought back the motivation I came into this semester with, fresh out of being accepted into dental school. I’ve heard many times that these conferences “aren’t for first years,” when ASDA NLC has so much for first year students. The great thing about this conference is that students of ALL CLASSES can take home information on study strategies, residencies, practices, budgeting, and so much more!

As if all of this information wasn’t good enough, I was able to attend  so many events to interact with other dental students from in and out of our district. Hearing that another student 2,000 miles away was going through the same worries and fears as me was comforting. I was also able to bond with my own classmates, reassuring each other that our missed study weekend was worth it.

Chicago NLC was one of the most fun, informational, and motivational trip I have ever attended.  I would recommend ANY dental student that has a desire to be successful to attend next year. I may have missed a weekend of studying (which ended up not mattering because I did great on my exams), but I gained a an endless amount of knowledge about dentistry and becoming a business owner.

Thank you ASDA!