State Board of Dentistry Report – September 10, 2021

Chairperson Dr. Lugo welcomed attendees. The minutes were approved as drafted.

Prosecutorial Report

The board waived the prosecutorial report and no details were shared. Consent agreements were approved, with some opposition. One application for initial licensure was denied for unspecified reasons.

Board Counsel Report

Board Counsel presented a summary of HB 1729 for the board’s information. HB 1729 establishes a teledentistry program, requires insurance coverage, and demands the SBOD to promulgate regulations within 24 months. Board members asked about details such as whether on-call dentists would be expected to treat teledentistry for patients that are not of record, and that ADA and specialty care organization standards are referenced. Board counsel noted that these comments can be part of the SBOD inquiry and regulations if it got to that level. There is no timeline for its passage.

Report of the Chair

Dr. Lugo asked that his comments be recorded verbatim. He noted that the state has been looking for a single standardized test for licensure and portability for state-to-state license transfer. Part of this change involved moving to simulated teeth for licensure exams rather than live patients, which was discussed before the pandemic and accelerated due to it. He noted that this would ideally be voted on at this meeting.

Committee Reports

The Scope of Practice committee met the previous day. Ms. Murray will schedule a presentation from the Academy of Laser Dentistry regarding hygienist use of lasers. Dr. Funari will research the policies of neighboring states regarding botulism injections and dermal fillers. Dr. Casey will research the delegation of digital impressions to auxiliary team members. Delegation of nitrous to auxiliary will continue to stay on the agenda while board counsel investigates the necessity for statutory change.

The committee recommended removing tooth whitening from further discussion and abandon proposed rulemaking or statements of policy. The board accepted the motion with no opposition.

Special Report

Dr. David Waldschmidt of the Joint Commission on National Dental Examiners presented a report. Dr. Waldschmidt presented findings regarding the objective structured clinical examination (OSCE). The OSCE exam measures intellectual and didactic capacity, not motor skills. The dental OSCE is completely multiple choice and covers several subject areas. Each question has several areas that can be considered correct, some differential diagnoses that allow for partial credit, and some incorrect answers that receive no credit.

Dr. Waldschmidt addressed why the dental OSCE had no measure of motor skills. Joint Commission reports noted that there is no peer reviewed scientific evidence that correlates hand skill exams to protection of the public. Statistical evidence shows that failures are randomized and are either dependent on difficult live patient experiences or related to lapses in clinical judgement, which is measured in dental OSCE.

The board discussed acceptance of mannequins for clinical examinations. At the last meeting, the board allowed mannequin exams for the Northeast Regional Board of Dental Examiners (NERB) until December 2022. A motion was made to accept mannequin examinations for the other licensing exams until December 2022. The board addressed them one by one:

The Central Regional Dental Testing Service (CRDTS): Drs. Arndt, Funari, Mountain, Unis-Sullivan, Ms. Groody, Ms. Hart-Hughes, and Ms. Sizemore voted nay. The motion failed.

Southern Regional Testing Agency: Drs. Arndt, Jaspan, Mountain, Unis-Sullivan, Ms. Groody, and Ms. Sizemore voted nay. Dr. Lugo broke the tie by voting nay.

Western Regional Examining Board: Drs. Arndt, Jaspan, Mountain, Unis-Sullivan, Ms. Groody, and Ms. Sizemore voted nay. Dr. Lugo broke the tie by voting nay.

The board tabled the vote for several license applicants who took the mannequin exam from one of the rejected testing agencies. Board counsel will reach out to each testing agency to get more details before voting on these applicants at the next meeting.