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Letters: Portable national dental exam

January 08, 2018 I have been a loyal card-carrying member of the ADA for 42 years. I understand the issues of pathway to licensure from both sides of the coin. Being the proud father of two recent dental school graduates, I watched them both go through the mental anguish of such a high stakes exam. I understand the importance as one of my children has practiced in five states in five years due to the complexity of a job change for her husband. On the other side of the coin I currently serve as a CDCA (Commission on Dental Competency Assessment, formerly NERB) examiner. In addition to examining, I am also involved in the direction of the organization as I sit on the executive board as its vice-chairman and have served for nine years on the Indiana State Board of Dentistry.

The question in my mind is why the ADA has unilaterally decided to pursue a path that will be extremely costly, upward estimates of $5 million dollars of current members’ dues, when what they are looking to offer is already being reviewed by the examining agencies. If the end game is portability then one would have to look no further than the ADEX exam, currently offered by CDCA and CITA. Go to the website for the CDCA,, and you can see the map and recognize that 44 states — soon to be 45 — have already embraced the ADEX exam in addition to some of the U.S. territories and the Commonwealth of Jamaica. For much less money, the ADA could concentrate its lobbying efforts on the few remaining states to accept the ADEX exam and we would have the long awaited national dental exam and portability in the profession. The regional testing agencies are coming upon their 50th anniversary. It has taken almost this entire time to get the states and dental boards on board to this point. I can’t imagine how long it would take the ADA to accomplish the same thing with their proposed exam. The time, effort and expense are mind boggling to me.

The second major issue is the ethical treatment of patients on these exams. Much progress has been made on the ADEX exam to include the treatment performed for the patient being part of an overall treatment plan. The policy of no patient leaving with a temporary restoration and the schools following up for post-operative care address the ethical questions. The second issue is the decision that is made by each state’s legislature as to whether have performance on a patient as part of the exam. If at some time the individual states, choose to adopt a nonpatient based exam, the examining community will respond appropriately.

As my professional organization for 42 years, I respectfully request the ADA to focus its attention and resources to servicing the needs of its current members who have been loyal dues paying members for these past, in my case, 42 years. If the ADA feels compelled to enter the pathway to licensure arena, I suggest it would be more productive if they do it as lobbyists to attract the remaining five states to accept the ADEX exam. This would fully resolve the issue of portability. If the state licensing boards would choose to move to a nonpatient based exam then I suggest it would be more appropriate to let the nonprofit, independent third-party exam administration experts, CDCA, CITA, CRDTS, SRTA and WREB, respond to that mandate. The American Dental Association, the world’s leading oral health’s professional organization, should concentrate on serving its current members, most of which already have their license. It should allow the examining community to serve the mandates of the state licensing boards providing an ethical pathway to portability in licensure.

Harvey Weingarten, D.D.S.
South Bend, Indiana

Editor’s note from Drs. Robert Bitter and Cecile Feldman, co-chairs of the Task Force on Assessment of Readiness for Practice: The CDCA administers the ADEX exam and has a financial interest in seeing the exam succeed.