Minnesota Board of Dentistry The Wonderful World of Dentistry: License to Drill Marshall Shragg, MPH March 4 th, 2011

Minnesota Board of Dentistry BOARDS of DENTISTRY Mission - Protect the Public

Minnesota Board of Dentistry PROTECTING the PUBLIC Licensing Professional Development Complaint Resolution

Minnesota Board of Dentistry LICENSURE Determination of Minimum Standards Application (fitness to practice) – Education – National Boards – Clinical Examination

Minnesota Board of Dentistry PATHWAYS to LICENSURE (MINNESOTA) CLINICAL EXAM CRDTS WREB NERB SRTA CITA PGY-1 Completion of a Minnesota- based AEGD/GPR program CREDENTIALS Review of experience in other jurisdiction(s) LIMITED GEN’L LICENSE Foreign-trained (non-CODA) dentists NDEB EXAMS Limited to Canadian grads and recent Minnesota grads

Minnesota Board of Dentistry Years of trust established – Attendance at one another’s meetings – Reliance upon UofM faculty for licensee remediation – Mutual respect Proximity to UofM Board history/experience with NDEBs Formal agreement for Board to participate in critical UofM meetings/processes – Admissions – Education Policy (Curriculum) – Competency Review – Scholastic Standing – Calibration UNIQUE RELATIONSHIP

Minnesota Board of Dentistry Recent review of regional clinical examining agencies/setting priorities [June 2008] Commitment to shared NDEB goal of meeting a minimum established standard and ensuring the competency of initial licensees Board approached by Dean Lloyd to consider options TIMING

Minnesota Board of Dentistry Ensuring competence and fitness to practice of individuals being issued licenses Clinical objective patient-based examinations meet the Board’s standard; may consider equivalent alternatives Active Board involvement in the appropriate communities… including CRDTS, AADB, NDEB, and the University of Minnesota MINNESOTA’S COMMITMENT

Minnesota Board of Dentistry CRDTS Minnesota a founding member state Defensibility--- support of psychometricians Board members participate as examiners Critical failures noted on recent patient- based various CRDTS sites…

Minnesota Board of Dentistry COMMENT FROM AN ED “If you have ever attended an examination session, you would understand the public’s concern – it raises legitimate questions about the capacity of dental schools to ensure competence without a third-party evaluation.” --- Executive Director, East Coast State

Minnesota Board of Dentistry ADJACENT TOOTH DAMAGE

Minnesota Board of Dentistry SUBSTANDARD AMALGAM RESTORATION

Minnesota Board of Dentistry WRONG TOOTH SURFACE TREATED TOOTH #9

Minnesota Board of Dentistry PERIODONTAL LACERATION 4 mm (Improper Instrumentation)

Minnesota Board of Dentistry COMMENT FROM AN ED “[Our state] will consider non- patient based exams when dentists agree to only practice on manikins” --- Executive Director, Southern State

Minnesota Board of Dentistry LIMITATIONS State-by-state determination of licensure requirements Available only to recent UofM grads Limited portability Resistance from licensing & examining communities

Minnesota Board of Dentistry AADB EDITORIAL Number of Complaints Received by type for CURRENT fiscal year: Apparently, through their university and dental board, the citizens of Minnesota have essentially thumbed their noses at the “examination community” and embraced the Canadian National Dental Examining Board’s Objective Structured Clinical Examination (OSCE) which includes written and non patient-based modules. This will satisfy the state’s requirements for initial licensure in Minnesota. The school was excited about it and the board voted unanimously to accept the examination. Not that this instance from Minnesota is going to run rampant over the rest of the states, but I would suspect that other state agencies are looking at embracing this process.

Minnesota Board of Dentistry OTHER BOARDS’ COMMENTS “The boards issue licenses to dental school graduates to enter private practice where, unlike in dental school, there is NO SUPERVISION.” “Examiners typically are practicing dentists – not the teachers of the candidates.” “Third party examination is impartial, and not subject to teacher bias or dental school desire to retain students.” “Bottom line: The State, through its board, must guarantee the public that the dental school graduate has passed a complete and standard examination of competency to practice on the public.” “The Dental Board has zero use for anything other than a patient-based exam.”

Minnesota Board of Dentistry

BOARD MISSION PROTECT the PUBLIC!