Letters (October 01, 2003)

Re: Editorial, ‘What’s In a Name?’ March 2003

Dr. Goodlin suggests that the public’s best interests are served in recognizing the accreditation in AACD as a specialty degree in “cosmetic dentistry”.

The assumption is that cosmetic dentistry exists in a vacuum, that it is a discipline unto itself and that it should be recognized as such. Yet in spite of our best efforts to restore a smile according to various esthetic parameters, the chances of those restorations surviving long term will often depend on how we manage forces on those restorations.

Nonetheless, Dr. Goodlin states, “These dentists have demonstrated the ability to provide excellent quality cosmetic procedures for their patients, with the knowledge, skills, and expertise to provide the public with a highly specialized service and with greater expertise than the average dentist who has not spent the time in this or similar programs”. It is in this last sentence that we should all share concerns over “similar programs”. Exactly how much extra training goes into accreditation for the AACD? According to their guidelines:

1. One must pass a written and oral exam.

2. Three 2-3 hour workshops (total of 6-9 hours of CE).

3. Review of five clinical cases.

4. Annual meetings and memberships.

Furthermore who will review these cases and exams? How does this training compare to the training in traditional specialties such as Periodontics, Endodontics, Orthodontics or Oral surgery? How does accreditation in the AACD compare with other programs promoting excellence in dentistry? Let us consider three such programs; the Pankey Institute, the Seattle Institute and the Misch Institute.

The Pankey institute offers six continuums plus an esthetic continuum a removable prosthodontics continuum, a program for the lab technician and more. The program is structured for general dentist and for specialists with over 500 hours of continuing education to complete the entire program.

The Seattle Institute offers 5 seminar type format programs (total of 100 hours of CE) and three hands-on workshops (total of 60 hours of CE).

The Misch offers a surgical implant program (15 days in the USA and 9 days in Canada) and a six day program in implant prosthodontics (total of 150-200 hours of CE) plus advanced courses to enhance the training. At best the Misch offers no more than a fellowship in the ICOL.

What if participants (graduates) of these programs or these institutes themselves decided to arrange for accreditation in some academy for the purposes of recognizing their training as a “specialty” in those fields? We could have numerous “specialties” all spawned out of continuing education all with the promise to better serve the public.

The onus is on the universities to develop programs in these subspecialties such as implant dentistry and cosmetic dentistry to ensure universality of training. Until then dialogue with patients and not misleading advertising is the best way to inform our patients. Recognition is great. Display all CE certificates proudly on your wall, explain them to your patients and make a commitment to ongoing CE, but expecting the public to understand or accept accreditations, as a specialty is dangerous.

Dr. D. Belcastro