What’s in a Name?… My View

by Janice Goodman, DDS

This commentary is based on the editorial by Dr. Ron Goodlin in this issue where he suggests that we recognize the specialty of cosmetic dentistry and change the general dentistry title to family dentist. In his opinion, accreditation by the American Academy of Cosmetic Dentistry should warrant membership in this elite specialty. He states that creation of the title would protect the public from dentists who are not as well qualified. I don’t agree.

I have an urban downtown general practice and although I don’t have a sign on my door that says I do cosmetic dentistry, I don’t object to someone else having one. I do resent the thought that I would become a “Family Dentist” even though the bulk of my practice is business people and I see fewer families. In medicine, family practice is a specialty. I think the titles of family dentistry and cosmetic dentistry when used selectively (as is presently practiced), to reflect the particular nature of a practice, better serves the public and the dentists.

The American Academy of Cosmetic Dentistry has 260 Canadian members from all provinces, and accreditation in it is not recognized by the ADA or the CDA. Only 13 Canadian members have achieved accreditation and not all of them went through the process as some were grandfathered in.

At present, there are only 13 Canadian individuals in the process of getting accredited. In addition, any accredited member who misses three consecutive scientific meetings will actually loose their accreditation status. Membership has its price. Aside from the annual fee (US$330 plus US$1,395 for the annual meeting… not including expenses and lost practice time), there is a written exam (US$200), three compulsory 2-3 hour workshops (US$1,050), five clinical cases are checked (US$750), and an oral exam (US$400). All of which must be completed within a period of five years, following very precise protocols, including detailed requirements with respect to photography.

I think that there are many routes to achieve excellence in cosmetic dentistry and becoming accredited by the AACD is certainly one of them. I admire those who have attained this status. I also understand that it must be frustrating to be so focused and dedicated to one aspect of general practice without being able to market it to the public, especially in this lucrative and competitive area.

I would suggest to the reader to take Dr. Goodlin’s editorial seriously — it is interesting to note that the accredited American Academy of Cosmetic Dentistry members were actually successful in the courts in Florida and California, where they can now legally advertise that they are specialists in cosmetic dentistry.

Most specialty programs are very competitive to get into. You apply to a program and only the best candidates are admitted. You give up your private practice and devote years in universities and clinics, enduring grueling hours of call and study. You read papers, write papers, and do research. Most programs require some teaching component, which is essential to undergraduates, with the lack of dental professors these days. Specialties give up some aspect of general practice and limit themselves to their area of expertise, in that way they are not in direct competition with the general dentists. Does accreditation from the AACD really stack up to the other specialties to warrant specialty status? One day, cosmetic dentistry, just like implantology, could become a specialty, but it will take time, partly because of the lack of funding to do it right now, and partly because these fields are still young and evolving.

Cosmetic dentistry is in every aspect of general practice. Most dentists are having a lot of fun enjoying the rewards of being really good in aesthetics. You would think that the most outstanding general restorative dentists also do very aesthetic work.

As more and more dentists become educated through all the learning opportunities available, we’ve really seen the gap between the “elite’ and the “average” dentist’s quality narrow. In my opinion, this trend will continue among both laboratories and dentists, and I don’t think that it should be discouraged by only allowing accredited American Academy of Cosmetic Dentistry members to display that they practice cosmetic dentistry to the public.