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CODA-approved criteria could lead to accreditation of new dental team members

CODA-approved criteria could lead to accreditation of new dental team members
Dr. Edgar: "These are criteria and guidelines for groups that come forward with a new discipline in an allied area and seek to have educational programs in that area accredited."

In response to requests to consider accreditation of dental therapy and expanded function dental assistant educational programs, the Commission on Dental Accreditation approved criteria that will serve as guidance for initiating an accreditation process in new areas of allied dentistry.

"These are criteria and guidelines for groups that come forward with a new discipline in an allied area and seek to have educational programs in that area accredited," said Dr. Bryan C. Edgar, chair of the Commission on Dental Accreditation. "CODA is the only body that can set national standards, and these criteria reflect the evolving practice of dentistry."

CODA is now developing a set of guidelines that programs can use to respond to the criteria, and will review those guidelines at its February 2011 meeting.

Students in Minnesota are already enrolled in two dental therapy educational programs; however, the law passed by the Minnesota legislature in 2009 requires that an applicant for licensure graduate "with a baccalaureate degree or a master's degree from a dental therapy education program that has been approved by the board or accredited by the Commission on Dental Accreditation or another board-approved national accreditation organization."

After the state established dental therapists as a provider for underserved populations, the University of Minnesota School of Dentistry, the Minnesota Dental Association, the Minnesota Board of Dentistry and the Metropolitan State University of the Minnesota State Colleges and Universities System requested that CODA start an accreditation process for dental therapy and advanced dental therapy. At the same time, CODA was considering a request from the Dental Quality Assurance Commission of the State of Washington Department of Health to accredit EFDA programs. DQAC has approved four programs in the state, and each one has a CODA-accredited dental assisting or hygiene program at its institution.

"There were no criteria for initiating an accreditation process in these disciplines, so we formed a task force to evaluate the requests and determine the feasibility and process of developing accreditation standards for these types of educational programs," said Dr. Edgar.

The Task Force on New Dental Team Members, which met after February's full commission meeting, included task force members from various communities of interest that would be affected by these proposals. The group studied a variety of background materials and noted there was historic precedent for CODA to accredit new areas of allied dentistry, based on the fact that it currently accredits nonspecialty interest areas in general dentistry.

"The commission's mission is to serve the public by ensuring quality education and patient safety," said Dr. Edgar. "The accreditation review of programs in areas other than predoctoral dental and dental specialties is feasible and within its purview as evidenced by its review of programs in advanced general dentistry, dental hygiene, dental assisting and dental laboratory technology."

The task force found that the 2009 House of Delegates bolstered that conclusion through passage of Resolution 31H-2009, which included a clause stating that "the ADA recommends that any new member of the dental team be supervised by a dentist and be based upon a determination of need, sufficient education and training through a CODA-accredited program, and scope of practice that ensure the protection of the public’s oral health."

At its meeting Aug. 6, CODA approved the new document, Criteria and Principles for Determining Eligibility of Educational Programs for Accreditation, which leaves the door open for the possible future accreditation of dental therapy programs. The commission also determined that Washington's EFDA programs could be accredited since they meet the criteria and directed its Dental Assisting Review Committee to evaluate the current dental assisting standards and expand them to include optional EFDA educational activities.

"It is likely that states will continue to investigate different models of delivery of dental care," said Dr. Edgar. "When new groups come to CODA, we will now have specific criteria, questions to be answered and documentation they need to provide to determine the feasibility of accreditation."

Among other things, the document requests evidence on whether there is a demand for this type of practitioner by stakeholder groups; whether the discipline has been in operation for a sufficient period of time to establish benchmarks and measure performance; and whether there is a sufficient level of activity and expertise in the discipline—including individuals with academic or professional credentials—to establish standards and sustain a quality review process.

"The requests from Minnesota did not include sufficient information and evidence to warrant establishing an accreditation program and standards for dental therapy education programs at this time," said Dr. Edgar. "But the requesting groups can use the criteria as a guide and come back to CODA with new evidence for re-evaluation."