Constituent Dental Care/Practice Chairperson’s Resource Manual September 2010 Originally Published: August 1992 Revised: November 1994 Revised: February 1997



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Accreditation and Recognition of Non-Specialty Areas


2005:5-H-7

“Resolved, that the AGD adopt the following position regarding the accreditation and recognition of non-specialty areas of general dentistry:
AGD Position on

the Accreditation and Recognition of Non-Specialty Areas


The AGD supports excellence in general dentistry and the pursuit of professional development through lifelong learning.  Advanced education should meet independent standards so that the education is valid and provides the framework for excellent patient care. General dentistry is not just treating patients – it is being the educated gatekeeper of oral health so that the patient is provided with all the available options for treatment. The knowledge of when to treat and when to refer, and to whom, is the responsibility of the general dentist. The general dentist’s emphasis is on primary care.  They guide patients to efficient, cost effective treatment while maintaining continuity of care.
AGD supports the responsibility of the Commission on Dental Accreditation (CDA) to develop accreditation standards for all formal education programs in dentistry, whether they are in an ADA-recognized specialty, in general dentistry or in a non-specialty area of general dentistry. This is not changing the scope of practice for general dentists and dental specialists, nor is it adding new specialties.   If non-specialty areas that provide formal advanced education can seek accreditation then the public will benefit.
The general dentist is the coordinator of care and as such should be able to inform the patient of all available treatment options. The general dentist should have access to education in all areas of dentistry, including advanced education programs and continuing dental education.
The specialist is a partner in dental treatment that is dependent upon patient referral from a general dentist. If general dentists have had additional education and training they are able to provide better patient care, treatment planning and know better when to refer to a specialist or another general dentist. This will strengthen the profession.
It is not as important an issue that the public understand the scope of practice between practitioners as it is that they understand how oral health affects their overall health. Clear messages about why it is important to see the general dentist twice a year would be powerful messages to the majority of the public who are interested in their health. Whether the public sees a specialist or a general dentist should be on the recommendation of their general dentist
The ADA is uniquely poised to promote the image of modern dentistry to the public. It is not the role of the ADA to make patients aware of how to select a specialist – that is the role of the referring general dentist. The ADA should focus on getting the public to the dentist and in working within the legislative arena to see that access to care is improved.
As CDA accredits advanced education programs in general dentistry, the ADA should consider mechanisms for recognizing board certification in general dentistry areas, including the American Board of General Dentistry.”



ADPAC
ADPAC donation on dues statement

*87:52-H-7


RESCINDED




Advertising of Credentials
Advertising of Credentials


2008:314R-H-7

“Resolved, that the AGD adopt Announcement of Credentials to the Public: A Position Paper as its policy on the announcement of its FAGD and MAGD credentials.”


Advocacy Fund


2009:315R-H-7

“Resolved, that the AGD create an Advocacy Fund.”


American Dental Association
Advertising campaign, no AGD position on

98:19-H-7


“Resolved, that the AGD take no formal position on the ADA’s institutional advertising campaign and accompanying assessment.”




Liaison with

*76:34 H 1


RESCINDED




Requirement by AGD for membership in

79:15 H 6

REVISED

HOD 7/99



“Resolved, that it shall continue to be AGD policy to encourage membership in the American Dental Association, the Canadian Dental Association, or the National Dental Association.”


Anesthesiology
Cost of providing benefit


2002:29-H-7

“Resolved, that the Academy of General Dentistry believes patients with physical, developmental, emotional, or medically compromising conditions may require sedation/general anesthesia in private office, hospital, or surgical center settings for the safe and effective treatment of dental disease and/or injury, and be it further


Resolved, that sedation and/or general anesthesia and related facility costs for the treatment of dental disease and/or injury in these patients should be a covered benefit in all group medical benefit policies and Medicaid.”
Training availability

90:54 H 7


"Resolved, that the Academy of General Dentistry work with the American Dental Association and the American Dental Education Association to recommend that dental schools and hospital affiliated teaching institutions establish anesthesiology programs so that dentists seeking in depth education in anesthesiology will have such training available."





94:14.2 H 7


"Resolved, that educational opportunities be available so that general dentists will have adequate opportunity for training in dental anesthesiology in order to provide optimum pain and anxiety control for the public."




Annual Meeting
ADEA, report to House by Legislative and Governmental Affairs Council

94:22.2 H 7


"Resolved, that the Legislative and Governmental Affairs Council annually report to the Academy of General Dentistry's House of Delegates on the activities of dental schools and other organizations as they relate to the political concerns of general dentistry."





Contracts

Contract analysis service

88:47 H 7


AMENDED HOD 2008






2008:110-H-7

“Resolved, that Policy 88:47-H-7 be amended so that it reads:
“Resolved, that the Academy of General Dentistry offer to its members a contract analysis service, and be it further
Resolved, that members be encouraged to seek the advice of their own attorney before deciding to sign a contract, and be it further
Resolved, that the Dental Care Council develop means to educate Academy of General Dentistry members about the ramifications of provider contracts.”



Dental Anesthesiology

94:14.1 H 7


RESCINDED HOD 2007






2007:302-H-6


“Resolved, that the HOD Policy 94:14.1-H-7, which recognizes anesthesiology as a specialty, be rescinded.
94:14.1-H-7

Resolved, that the Academy of General Dentistry supports the recognition of dental anesthesiology as a dental specialty”




Dental Auxiliaries
Advanced Dental hygiene Practitioner Position Statement


2008:322-H-7

“Resolved, that the AGD adopt the Position Statement on the Advanced Dental Hygiene Practitioner (ADHP) Concept.”



Dental team concept

86:30 H 7


"Resolved, that the Academy of General Dentistry supports the dental team concept as the best approach to providing the public with quality comprehensive dental care, and firmly supports direct supervision of the practice of dental hygiene, and be it further


Resolved, that this policy be conveyed to the American Dental Association, the American Dental Hygienists Association, and state and provincial boards of dental examiners, and be it further


Resolved, that Policy #85:25 H 7 be rescinded."
Duties which will not perform to be defined

73:23 H 10


"Resolved, that those states permitting expanded duties by dental auxiliaries define those duties which dental auxiliaries will not be permitted to perform in compliance with individual state dental practice acts."




Office personnel manuals

77:10 H 6


RESCINDED




Perform under direct supervision of general dentist

73:24 H 10


"Resolved, that all duties performed by any dental auxiliary must be done under the direction and control of the dentist and that he or she be directly responsible for the actions of his or her auxiliaries performing those duties."





Recruitment strategies

91:48 H 7


"Resolved, that the Academy of General Dentistry believes that its individual members can make a significant contribution to resolving the dental auxiliary shortage by attempting to recruit potential dental team personnel, and be it further



Resolved, that the AGD play a key role in solving the dental auxiliary shortage by:


1. Encouraging AGD members to recruit dental auxiliaries each year, using materials provided by the ADA.
2. Educating AGD members to properly manage dental auxiliaries through:
a. a request that the AGD editor publish an appropriate article in Impact.

b. a request that the Council on Annual Meetings and International Conferences establish a course on this subject

c. Suggesting to the AGD Foundation to offer an appropriate practice management course showing dentists how to properly manage and therefore retain dental auxiliaries.

d. Asking AGD constituents to publish appropriate articles on this subject, tailored to local needs."


Salaries

77:9 H 6

RESCINDED



Training, education, and utilization of

73:25 H 10


"Resolved, that definite educational requirements be instituted for the proper training of dental auxiliaries in expanded duties and the AGD should study existing ADA approved programs to determine the appropriate educational requirements."




74:13 H 11


"Resolved, that in the training, education and utilization of dental auxiliaries for the purpose of assisting the dentist in providing high quality dental care through performance of expanded functions, it shall be the recommendation of the Academy of General Dentistry that such auxiliaries be permitted to perform under the direct supervision of the dentist those functions which do not require the professional skill and judgment of the dentist and are in compliance with laws of states which have provisions for expanded functions, and be it further


Resolved, that the dentists, and only the dentist, is responsible for the examination, making the diagnosis and formulating the plan of treatment, performing surgical or cutting procedures on hard or soft tissue, fitting and adjusting corrective and prosthodontic appliances, prescribing therapeutic agents and making impressions for other than study casts, and be it further


Resolved, that final decisions related to dental practice and utilization of dental auxiliaries rest with the state society and the state board of dentistry, and be it further
Resolved, that the AGD recognize the necessity of effectively utilizing dental auxiliaries to maximize the efficient use of the dentist's time and skills."

Dental Practice
Amalgam, position statement supporting


2002:24-H-7


“Resolved, that based on current scientific evidence, including the Food and Drug Administration’s February 2002 Consumer Update on Dental Amalgam, the Academy of General Dentistry maintains that amalgam is safe and effective as a dental restorative material.”


Analyzed health care data
Methodology and source of funding must be disclosed if used for Benefit determination

2000:24-H-7



“Resolved, that if information gathered from analyzed healthcare data is used for either benefit determination or dentist preferential selection, then the methodology and source of funding involved in the analysis must be publicly disclosed and verified by a process that ensures the quality, integrity, and validity of the analysis methodology.”




Uses for, procedures must be publicly disclosed

2000:23-H-7


“Resolved, that the Academy of General Dentistry supports the concept that if health care data is analyzed, it should only be used to advance scientific knowledge or improve the oral health of the patient, while still allowing for professional judgments by practitioners, and be it further


Resolved, that the procedures involved in the analysis must be publicly disclosed and reviewed by the affected communities of interest in order to ensure the quality, integrity, and validity of the analysis methodology.”


ANSI MD 156, AGD representative on

97:25-H-8


“Resolved, that the Academy of General Dentistry recognizes the problem of providing the general practitioner with meaningful information upon which to base purchasing decisions, and be it further



Resolved, that the following strategies be implemented in order to accomplish this purpose:


1. Maintain an AGD representative on ANSI MD 156.
2. Recommend members to participate on ANSI subcommittees through the Dental Care Council Chairperson.
3. Relay to the ADA AGD's concerns with regard to having the practicing dentist more informed in order to make proper purchasing decisions.
4. Obtain feedback from our members on materials with which theyve experienced problems.”
Appropriate charges made for administrative work

75:28 H 10


"Resolved, that the AGD recognize that it is ethical and proper for appropriate charges to be made when a dentist completes a claim form, a narrative report or other paperwork requiring secretarial, clerical, and professional time as long as the fee is identified."




Benefit coverage for dental surgery performed in office

79:35 H 6


"Resolved, that AGD support the inclusion of clauses in hospitalization and surgical benefits contracts that provide for coverage for dental surgery in the office setting if such surgery would normally be covered were the patient hospitalized for the procedure."




Biophosphonate therapy


2007:27R-H-8

“Resolved, that the AGD communicate the potential serious oral sequelae of bisphosphonate therapy, including osteonecrosis, to the medical and dental communities, and to inform patients of such risk and encourage patients to seek dental care prior to initiating bisphosphonate therapy."


Bleaching trays, license should be required for fabrication of


2001:27-H-8

“Resolved, that the Academy of General Dentistry believes that supervising or providing materials or methodology for consumers to make intraoral impressions constitutes the practice of dentistry, which requires an appropriate license in the state or province where the individual is being treated, and be it further

Resolved, that directing a dental laboratory to fabricate intraoral appliances and devices (including bleaching trays) constitutes the practice of dentistry, which requires an appropriate license in the state or province where the individual is being treated, and be it further


Resolved, that in order to protect the health of the public, the Academy of General Dentistry believes that the fabrication of intraoral appliances and devices (including bleaching trays) by dental laboratories requires a proper prescription by a dentist licensed in the state or province where the individual is being treated.”
Botulinum toxin and cosmetic dermal filler procedures, education in and performance of

2010:308R-H-7


“Resolved, that the AGD supports general dentists receiving education on, and the performance of botulinum toxin and cosmetic dermal filler procedures.”




Childs first visit to dentist, position on

98:24-H-7


“Resolved, that the Academy of General Dentistry officially endorse the position that a childs first visit to the dentist should occur within six months of the eruption of the first tooth.”




Claims, prompt payment of


93:22 H 7

"Resolved, that the Academy of General Dentistry ascribes to the American Dental Association's policy on the prompt payment of dental claims, which reads:

'Resolved, that the appropriate agencies of the American Dental Association, and its constituent dental societies, be urged to seek legislation which would require all public and private third party payers to reimburse dental claims within (15) business days from receipt of the claim by the third party payer or be penalized for failure to do so.'"


Closed panel, opposed to


*72:9 H 10

RESCINDED HOD 7/99


Code of procedures, endorsed by AGD

74:12 H 11


"Resolved, that the AGD endorse the principle of one code of procedures for dentistry, and be it further


Resolved, that whenever the ADA Council on Dental Benefit Programs or one of its sub committees considers revisions in the ADA code the Academy of General Dentistry be permitted direct input into such revisions by having representation at those meetings, and be it further


Resolved, that the AGD urge the American Dental Association to take steps to assure that the approved code is used throughout the purview of the Academy of General Dentistry."
Consultant, ground rules for claims denial

93:27 H 7


"Resolved, that when a third party dental consultant applies an alternative benefit provision to the treatment plan submitted by the provider dentist, or when a third party dental consultant denies benefits for reasons other than contract exclusions, the dental consultant must sign the report and provide his/her telephone number, and be it further


Resolved, that the AGD promote this concept to the American Dental Association, the Canadian Dental Association and third party payment groups."


Co payment and overbilling, waiver of

93:23 H 7


"Resolved, that the Academy of General Dentistry adopt the American Dental Association's policies regarding waiver of copayment and overbilling, which read:


'Resolved, that constituent dental societies be urged to pursue enactment of legislation that:


1) prohibits systematic non disclosure of waiver of patient co payment/overbilling by a dentist and

2) prohibits bad faith insurance practices by third party payers, consistent with Association policy, and be it further


Resolved, that third party payers be urged to support this legislative objective.'"
Corporate Guidelines and Mandates


2009:319S-H-7

“Resolved, that the AGD is opposed, as unduly burdensome to general dentistry and the patients it serves, to all corporate mandates that require specified quantities of utilization of the corporation’s products in patient’s dental treatment, without any qualitative assessment of each dentist’s proficiency with the products and without substantial clinical evidence of patient harm as a result of utilization in less than the specified quantities, as prerequisites for continued access to the use of the corporation’s product.



Date of manufacture of dental equipment and devices

81:26 H 7


"Resolved, that AGD encourage that ADA specifications for dental materials and devices include an expiration date where applicable, and when not applicable a date of manufacture or packaging, and be it further



Resolved, that the type of date utilized be clearly indicated and separate from a lot or serial number."


Dental health education for the public

81:33 H 7


"Resolved, that AGD support the concept of having public funds used to support dental health education for the public."






2006:23R-H-7

“Resolved, that AGD seeks to educate the public about the potential financial & health risks, due to lack of legal and contractual insurance recourse when medical & dental care is sought outside of the United States and Canada.”


Dental hygienists, authority of State Boards of Dental Examiners

92:34 H 7


"Resolved, that because of the nature of dentistry and the manner in which it is delivered to the public, it is the policy of the Academy of General Dentistry that dental hygiene should remain under the authority of the various state boards of dental examiners and that dental hygiene education should remain under the purview of and be accredited by the Joint Commission on Dental Accreditation."




Dental Implants


2008:317-H-7

“Resolved, that the AGD policy shall be that dental implants are an accepted modality of treatment.”




2009:301S-H-7

“Resolved, that the AGD support legislation requiring insurance carriers to cover reimbursement for surgical implant placement and restoration.”




2009:306-H-7

“Resolved, that, when one or more dentists are involved in dental implant therapy, there should be mutual agreement of the restorative objectives by all parties, including the patient, before any invasive therapy is undertaken.”




2009:307-H-7

"Resolved, that the AGD adopt the Educational Objectives for the Provision of Dental Implant Therapy.”


Dental insurance plan to include all facets of dentistry

82:32 H 7


"Resolved, that the AGD recognize that an optimum dental benefits plan includes all facets of dentistry."





Dental materials, products, and/or medications, use in oral healthcare


2010:306RS1-H-7

“Resolved, that HOD Policy 99:36-H-7 and HOD Policy 2002:25-H-7 be rescinded and be it further,

Resolved, that the AGD take appropriate action when necessary to ensure that safe and effective dental materials, products, and/or medications remain approved for use in oral healthcare.”




Dental research, public funding for

81:35 H 7


"Resolved, that the AGD support the concept of using public funds if available for dental research."




Dentistry's position on a National Health Program

80:25 H 7


"Resolved, that AGD's Guidelines for Dentistry's Position on a National Health Program and other relevant AGD and ADA policy be reviewed in relation to any future legislation mandating dental benefits."




Dentist's right to collect a larger fee from patient

77:14 H 6


"Resolved, that the AGD is opposed to any administrative procedure by a third party payment mechanism which interferes with the dentist's right to collect from a patient a fee greater than that allowed by the carrier's benefit structure except when a dentist has agreed to become a participant in a benefits program that utilizes a usual, customary, and reasonable method of reimbursement as payment in full.”





Diagnosis and supervision needed for dental treatment


2003:16-H-7

“Resolved, that dental treatment, including the placement of dental sealants and fluoride varnishes, is most effectively and successfully accomplished following a proper diagnosis by, and under the supervision of a licensed dentist in compliance with the regulations of the state or province, and in a dental office setting that ensures optimal treatment outcomes.”


Diagnostic tests, dentists right to prescribe and perform


97:26-H-8

“Resolved, that the Academy of General Dentistry recognizes that dentists have the right to prescribe and perform any diagnostic tests deemed necessary providing that:

1. The test is required for the oral diagnosis of or treatment planning for the patient, or the management of a percutaneous injury in a clinical setting.


2. The patient has given informed consent.
3. The test is accompanied, where appropriate, by adequate pre- and post-counseling.
4. There is provision for appropriate referral to a physician responsible for the comprehensive medical care of the patient.”
Environmental “best management” practices


2003:12-H-7

“Resolved, that the AGD urge dentists to employ environmental “best management” practices as supported and/or promoted by the American Dental Association and in Canada by the Canadian Dental Association, and be it further

Resolved, that AGD constituents be encouraged to work with their counterpart dental societies to adopt and promote environmental best management practices.”



Evidence-based dentistry
Definition of

2000:22A-H-7


“Resolved, that the Academy of General Dentistry believes that evidence-based dentistry is an approach to treatment planning and subsequent dental therapy that requires the judicious melding of systematic assessments of scientific evidence relating to the patients medical condition and history, the dentists clinical experience, training, and judgment, and the patients treatment needs and preferences.”




Use of

2000:22B-H-7


“Resolved, that evidence-based dentistry be utilized to promote the delivery of the most effective care for the patient and not for the determination of dental benefits.”




Fees, adjustment of


93:25 H 7

"Resolved, that the Academy of General Dentistry recognizes that dentists may, upon occasion, adjust fees to classes of individuals, such as relatives, clergy, staff, senior citizens, the indigent, and be it further

Resolved, that any occasional fee adjustments should not be reflected in determination of UCRs by third parties, and be it further


Resolved, that the Academy of General Dentistry recommends that this be properly recorded in the dentist's records."
Fees; i.e., usual, reasonable, customary: definition of

93:24 H 7


"Resolved, that the Academy of General Dentistry adopt the American Dental Association's definitions of and policies regarding 'usual, customary and reasonable fees,' which read:


'Usual fee' is the fee which an individual dentist most frequently charges for a specific dental procedure.


'Reasonable fee' is the fee charged by a dentist for a specific dental procedure which has been modified by the nature and severity of the condition being treated and by any medical or dental complications or unusual circumstances, and therefore may differ from the dentist's "usual" fee or the benefit administrator's "customary" fee.
'Customary fee' is the fee level determined by the administrator of a dental benefit plan from actual submitted fees for a specific dental procedure to establish the maximum benefit payable under a given plan for the specific procedure."
First Dental Visit Timing and Establishment of the Dental Home (AAP Policy Proposal)


2002:22-H-7

Resolved, that the Academy of General Dentistry endorses the American Academy of Pediatrics Policy Proposal from the AAP Section on Pediatric Dentistry entitled “First Dental Visit Timing and Establishment of the Dental Home”, and be it further


Resolved, that the Academy of General Dentistry communicate this endorsement to the American Academy of Pediatrics.”
Flexible Spending


2008:308-H-7

“Resolved, that the AGD support the expansion of Flexible Spending Account (FSA) reimbursable health items to include oral health items.”


Fluoridated public water supplies, public funding for

81:32 H 7


"Resolved, that the AGD support the use of public funds to assist local and state governments in seeing that their public water supplies are adequately fluoridated."




Fluoride in water supplies and toothpaste, position statement


2002:21-H-7

“Resolved, that based on the Center for Disease Control’s Recommendations for Using Fluoride, the AGD adopt the following position statement:


When used appropriately, fluoride is safe and effective in preventing and controlling dental caries. Regular use throughout life will help protect teeth against decay. All water supplies, including bottled water, should have appropriate fluoride levels. All fluoridated items, including toothpaste, should be used as recommended by your dentist.”
Freedom of choice provider


94:30 H 7


"Resolved, that the Academy of General Dentistry actively support "freedom of choice" legislation permitting patients to freely choose their dentist while continuing to utilize their full dental benefits, and be it further


Resolved, that the Academy of General Dentistry actively support "any willing provider" legislation to allow dentists to enroll at any time and to freely participate in dental third party programs."


Health care reform


2009:316-H-7

“Resolved, that the Academy of General Dentistry participate in any legislative discussions regarding health care reform.”



Health care reform criteria

93:28 H 7


"Resolved, that it is the policy of the Academy of General Dentistry that if dentistry is to be included in any government health care program reform, it must:


1) Be adequately funded to provide broad access;

2) Permit freedom of choice of dentists;

3) Be based on fee for service; and

4) Assure high quality dental care.
and be it further
Resolved, in any case where dentistry is included in health care reform, the AGD support the following six recommendations set forth by the American Dental Association:
1. Maintain the advantages of the current dental care and dental benefits system, which would not require inclusion of dental benefits for population groups currently receiving regular dental care, and which would not require public sector participation and subsequent cost transfer. The Association strongly opposes any change in the tax deductibility of current dental benefit coverage.
2. Continue existing policy support for a separate, restructured program of publicly funded dental benefits for indigent persons. Priority consideration should be given to programs for children. The Association urges that these programs be administered in the private sector wherever possible.
3. For population groups currently not receiving regular dental care the Association supports the opportunity for a) small employers purchase dental plans in the private sector, b) development of cooperative dental benefit purchasing alliances administered in the private sector.
4. The Association recommends that preventive services and educational programs for children be included in any health system reform proposal. Preventive services may include but are not necessarily limited to, fluoridation of community water supplies, oral prophylaxis and application of topical fluorides and sealants; dietary fluoride supplements; restoration of carious teeth; maintenance of space resulting from the early loss of primary teeth and patient education.
5. The Association recommends that in the event that a more comprehensive program is enacted, preventive, diagnostic, emergency services and basic restorative and periodontal care be included for children and the elderly.
6. The Association believes that if the Medicare program is expanded to include coverage for additional dental health care services, we would endorse the inclusion of a defined dental benefit plan for the elderly population. These services would be expressly focused on those elderly who are in long term residential care or home bound. Delivery of these services should not be compromised by discrimination by category of provider (physician or dentist)."
Issue priorities for government funding

*79:27-H-6


RESCINDED





*81:30-H-7


RESCINDED





94:20 H 7


"Resolved that the following policies be rescinded:





77:20 H 6


Superseded by 1992 House Resolution





79:27 H 6


Outdated




81:30 H 7


Outdated




75:37 H 10


Outdated





91:49 H 7

Superseded by 1992 House Action on reform


Licensing
Criteria for eligibility


2002:28-H-7


“Resolved, that the Academy of General Dentistry believes that to be eligible to apply for an initial license to practice dentistry in the United States or Canada, the candidate must have:


  1. Graduated from a dental college with training that is equivalent or higher than that provided by a dental college approved by the American Dental Association’s Commission on Dental Accreditation or the Canadian Commission on Dental Accreditation,

  2. Passed Part I and Part II of the National Board Exam (or the National Dental Examining Board Exam in Canada), and

  3. Passed a state or provincial licensing examination, or its equivalent, as determined by the state or provincial board of dentistry, and any additional requirements.”


Uniform standards for


2002:27-H-7

“Resolved, that the AGD actively support a uniform standard for licensing dentists in all U.S. states and Canadian Provinces, and be it further


Resolved, that access to oral health care for underserved populations should be addressed by maintaining uniformly enforced licensing standards that would prevent an unequal and unacceptable two-tier level of care, and be it further

Resolved that the AGD believes that access to care in underserved areas should be solved by instituting adequate financial incentives or loan forgiveness to properly licensed dentists.”


Voluntary/Temporary Licensing


2009:311-H-7

“Resolved, that the AGD approve the policy Supporting Issuance of Volunteer/Temporary Licenses for Dentists Licensed in Different States”
“Resolved, that the AGD supports the issuance of a temporary license to do volunteer dentistry by dental licensing boards to dentists who are licensed in another state or province when such dentists are seeking such license in order to provide volunteer or charity care.”


Manpower problems


*79:34 H 6

RESCINDED HOD 7/99



Medically compromised dental patients
Disclosure of relevant information


88:54 H 7

"Resolved, that all legislation and regulations to protect confidentiality of information on medically compromised or handicapped patients provide for disclosure of relevant information to members of the individual's direct care giving team."


Policy statement on treatment of


88:48 H 7

"Resolved, that the AGD adopt the following policy:

AGD POLICY STATEMENT ON TREATMENT

OF MEDICALLY COMPROMISED DENTAL PATIENTS
With the aging of the population and the spread of infectious diseases, dentists will encounter growing numbers of medically compromised patients, including those with infectious diseases. The general dentist, as primary dental care provider, plays the key role in providing and coordinating dental care for such patients.
In this role dentists have responsibilities to all patients, staff and other parties which they are ethically bound to fulfill.
Responsibilities to the Medically Compromised Patient
o To treat the patient with kindness and compassion, regardless of the nature of the patient's condition.
o To be sufficiently educated to evaluate the dental health of a medically compromised patient and to consult with physicians, when necessary, regarding the patient's medical status.
o To provide appropriate treatment within the dentist's realm of competence.
Responsibilities to Dental Staff
o To ensure that staff are trained in emergency care, the management of special health conditions and the management of medically compromised patients.
o To advise staff of the health status of each patient so they may employ appropriate procedures and avoid procedures that may place themselves or the patient at unnecessary risk.
o To ensure that all staff members are properly educated so they understand that infection control measures, including barrier techniques are in place and practiced routinely to protect them against disease. With this understanding they can properly render compassionate care to a medically compromised patient.
Responsibility to Other Parties
o Dentists must observe state and/or federal laws and regulations that require providers to protect the confidentiality of the patient.
Ethical Considerations for Treating HIV Positive Patients
The AGD believes that dentists are obligated to observe the American Dental Association's Principles of Ethics and Code of Professional Conduct in the treatment of all patients including those who are medically compromised, of which HIV positive patients are a part."
Medically indigent, support programs for

77:18 H 6


"Resolved, that every effort be made to have indigent dental care programs structured so that they take into consideration the current cost basis involved in providing the dental services."





81:31 H 7


"Resolved, that AGD support viable programs to provide dental care to the needy elderly and medically indigent."





81:34 H 7


"Resolved, that the AGD support the concept of using public funds if available to provide dental care for the medically indigent."




Medicare, amendment to reimburse dentists for rendering same service as a physician

79:28 H 6


"Resolved, that the AGD support the concept of amending Medicare so that a dentist shall be reimbursed for a dental service rendered under this program if a physician would have been reimbursed for rendering the same service."




Nutrition and oral health


2004:14-H-7

“Resolved, that the Academy of General Dentistry encourages dentists to maintain ongoing knowledge of nutritional recommendations such as in the Dietary Guidelines for Americans published by the U.S. Department of Agriculture and the U.S. Department of Health and Human Services and their Canadian counterparts, as they relate to general and oral health and disease, and be it further

Resolved, that the Academy of General Dentistry encourage dentists to effectively educate and counsel their patients about proper nutrition and oral health, including eating a well balanced diet and limiting the number of highly cariogenic between-meal snacks, and be it further,


Resolved, that the Academy of General Dentistry encourage constituent academies to work with school officials to ensure that school food services, including vending services and school stores, provide nutritious food selections, and be it further
Resolved, that the Academy of General Dentistry opposes targeting children in the promotion and advertisement of foods low in nutritional value and highly cariogenic foods and beverages and be it further
Resolved, that the Academy of General Dentistry encourages continued federal support for programs that provide nutrition services and education for infants, children, pregnant women and the elderly, and be it further,
Resolved, that the Academy of General Dentistry encourages the appropriate government agencies to prevent the distribution of non-nutritious and highly cariogenic foods and beverages under federal nutrition service programs.”
Oral Conscious Sedation, position statement


2005:2R-H-7

“Resolved, that the AGD position on Oral Conscious Sedation is:

1. The Academy of General dentistry believes that the general dentist must have access to appropriate training in the area of anxiolysis and oral conscious sedation. The AGD further believes that continuing education opportunities must continue to be developed to make these courses available to the general practitioner.


2. “Anxiolysis” means removing, eliminating or decreasing anxiety. This may be accomplished by the use of medication that is administered in an amount consistent with the manufacturer’s current recommended dosage and/or judgment on the part of the clinician with or without nitrous oxide and oxygen. When the intent is anxiolysis only, the definition of enteral and/or combination inhalation-enteral conscious sedation (combined conscious sedation) does not apply.
3. The Academy of General Dentistry supports the rights of the general dentist to use professional judgment in deciding the appropriate dose for each patient situation, respecting safe dosing parameters.
4. The Academy of General Dentistry believes that each constituent should be in close contact with their licensing boards to communicate the AGD’s position on this issue.”



Parameters of care, ADA

91:46 H 7


"Resolved, that the Board be directed to take a firm position that protects and accurately represents the interests of practicing general dentists on the development of parameters of care prior to consideration by the ADA House of Delegates after weighing all available evidence on the issue, including input from the Chairman of the AGD Dental Practice Council."




Parameters of care, criteria for


93:26 H 7

"Resolved, that any parameter of care established for the entire dental profession should be:

1. Condition based;


2. Equally applicable to all dental care providers;
3. Universally accepted with the dental profession; and
4. Developed by the American Dental Association with appropriate representation by the affected communities of interest, including the AGD as the representative of general practitioners; and be it further
Resolved, that the AGD's Dental Practice Council shall continue to monitor the status of parameters and attempt to achieve AGD representation in the development of parameters, and be it further
Resolved, that the AGD reserves the right to develop its own parameters should the need arise."


94:32 H 7

"Resolved, that any parameter of care established for the entire dental profession should be:

1. Condition based;


2. Equally applicable to all dental care providers;
3. Universally accepted within the dental profession; and
4. Developed by the American Dental Association with appropriate representation by the affected communities of interest, including the AGD as the representative of general practitioners; and be it further
Resolved, that the AGD's Dental Practice Council shall continue to monitor the status of parameters and attempt to achieve AGD representation in the development of parameters, and be it further
Resolved, that the AGD reserves the right to develop its own parameters or oppose the development of parameters should the need arise."
Preferred Provider Organizations

84:26 H 7


"Resolved, that the Academy of General Dentistry use whatever means are available to ensure that the following provisions are included in and made a part of any state and/or federal law mandating and/or regulating preferred provider organizations:


A. Patients' freedom of choice of provider must be guaranteed.


B. Preferred provider policies or contracts and preferred provider subscription contracts shall provide the same benefits level to the patient whether rendered by non preferred providers or preferred providers.
C. No dentist willing to meet the terms and conditions offered by a PPO shall be excluded.
D. All types of licensed health care providers whose services are required shall have the same opportunity to qualify for payment as a preferred provider under any such policies.
E. The terms and conditions of any PPO policies or contracts shall not discriminate against or among health care providers.
F. A preferred provider subscription contract should be defined as a contract which specifies how services are to be covered by the plan when rendered by non participating providers and by preferred providers.
G. Preferred provider policies or contracts should be defined as insurance policies or contracts which specify how services are to be covered by the plan when rendered by preferred and non preferred providers.
H. When preferred provider organizations are promoted to the public, they cannot do so with any implications of superiority, and all promotional materials used by PPOs must state if a preferred provider is a reduced fee contract.
I. The PPO shall make provision for a periodic adjustment in level of reimbursement based on the Consumer Price Index or some other equitable basis.
And be it further
Resolved, that the Academy of General Dentistry encourage its Constituent Academies to work toward building these safeguards into any state and/or federal law mandating and/or regulating preferred provider organizations.
And be it further
Resolved, that the Academy of General Dentistry transmit this position to the American Dental Association's Dental Practice Council Programs."
Prepayment plans
Bill payer system

78:24 H 6


"Resolved, that the AGD recognize the 'bill payer system' (direct reimbursement) as one of the acceptable forms of dental prepayment."




Exclude certain contract language

77:12 H 6


"Resolved, that in the interest of providing the best possible level of dental care for the patient, the Academy of General Dentistry is opposed to the inclusion of 'least expensive but adequate treatment', 'alternate mode of treatment', or similar contract language, in prepayment dental plans, and be it further


Resolved, that such language be eliminated from prepayment contracts wherever possible, and be it further


Resolved, that this type of language in existing dental contracts be implemented in such a manner so as not to impugn the integrity of the attending dentist or intrude upon the patient dentist relationship by either informing or implying that an alternate mode of treatment is appropriate, or influence the patient in any way in his choice of the attending dentist's treatment, and be it further
Resolved, that the 1976 House of Delegates' substitute resolution for #35 be rescinded."
Include all phases of preventive dental services

81:29 H 7


"Resolved, that the AGD recognize the necessity of having all phases of preventive dental services in the dentist's office included in dental prepayment plans, and be it further


Resolved, that AGD request the appropriate agencies of the American Dental Association to consider the development of a position statement that would serve to accomplish this purpose."


Structuring of dental prepayment programs

77:17 H 6


"Resolved, that third party mechanisms, including government programs, take these differences into consideration in structuring dental prepayment programs, and be it further


Resolved, that dental prepayment programs for the non indigent have a provision whereby the patient will pay the differences between the fee authorized under the program and the normal fee charged."


Public information available to public of dental office safety

92:30 H 7


"Resolved, that the Academy of General Dentistry believes that any advertisement of the HIV status of the dentist or any member of the dental team is misleading to the dental consumer



and be it further


Resolved, that all members and dental personnel are encouraged to work to educate the public and all patients on the safety of dental procedures and the precautions taken by dental professionals to safeguard patients' health in the dental office."
Resource Based Relative Value Scale


89:53 H 7

"Resolved, that the Academy of General Dentistry opposes use of the Resource Based Relative Value Scale as a method of determining payment for services provided by dentists."


Rights of employers to provide health care benefits


80:24 H 7

"Resolved, that AGD agrees in principle with the traditional rights of all employers to provide health care benefits for their employees, and be it further

Resolved, that AGD continue its dialogue with the ADA to clarify any proposal to provide dental benefits to federal employees."


School curricula – oral health education


2002:23-H-7

“Resolved, that the Academy of General Dentistry advocates incorporation of oral health education into primary and secondary school curricula with measurable outcomes, as a proven and cost effective disease prevention and universal health promotion program.”


Soft drink consumption/pouring rights contracts


2004:13-H-7

“Resolved, that the Academy of General Dentistry, through its appropriate agencies, continue to review the supporting data concerning the oral health effects of the increasing consumption of beverages containing sugars, carbonation or acidic components. These products are commonly referred to as “soft drinks,” including but not limited to juice drinks, sports drinks and soda pop, and be it further

Resolved, that the Academy of General Dentistry encourages its constituents to work with education officials, pediatric and family practice physicians, dietetic professionals, parent groups, and other interested parties, to increase the awareness of the importance of maintaining healthy vending choices in schools, and to encourage the promotion of fluoridated water and beverages of high nutritional value, and be it further
Resolved, that the Academy of General Dentistry opposes contractual arrangements, including pouring rights contracts, that influence the consumption patterns that promote increased access to ‘soft drinks’ for children.”
Supervision, definitions of for dental hygienists and other dental auxiliaries


85:27 H 7

"Resolved, that the Academy of General Dentistry believes that a dental hygienist or other dental auxiliary, in accordance with their training and education, and state law, shall, under a dentist's supervision, perform those aspects of treatment delegated by that dentist; and be it further

Resolved, that the setting in which a dental hygienist or other dental auxiliary may perform legally designated functions shall be a treatment facility under the jurisdiction and supervision of a licensed dentist; and be if further


Resolved, that the AGD shall use the following definitions of 'supervision':
General Supervision means that the dentist has authorized the procedures and they are being carried out in accordance with his/her diagnosis and treatment plan.
Indirect Supervision means that the dentist is in the dental office, authorizes the procedure and remains in the dental office while the procedures are being performed by the auxiliary.
Direct Supervision means that the dentist is in the dental office, personally diagnoses the condition to be treated, personally authorizes the procedure and before dismissal of the patient, evaluates the performance of the dental auxiliary.
Personal Supervision means that the dentist is personally operating on a patient and authorizes the auxiliary to aid his/her treatment by concurrently performing a supportive procedure."


2008:321-H-7

“Resolved, that the AGD define and incorporate into existing policies the definition of dental auxiliaries to include midlevel practitioners and all other individuals who are not licensed dentists, but otherwise provide oral health care.”



Surgeon General's Report on Oral Health
Implementation plan


2001:26-H-8

“Resolved, that it is the role of the Academy of General Dentistry to implement the Surgeon General’s Report on Oral Health by:

1. Expanding the demand for and availability of dental continuing education opportunities that:


a. Address the management of the oral health needs of at-risk toddlers, children, special needs, and geriatric patients.
b. Expand the knowledge of practicing dentists in the areas of oral medicine and the relationships between oral health and general health.
2. Working with other health care organizations to expand and elevate the knowledge of health care professionals, policy-makers, and the public (with an emphasis towards underserved communities) about:
a. The relationships between oral health and general health.
b. Oral disease prevention measures including home care, nutrition, fluoride, sealants, and tobacco cessation.
c. Promoting oral health in school curricula.
3. Advocate the development and implementation of appropriate proactive measures that will improve access to dental care (such as student loan forgiveness, tax credits and/or incentives to induce recent dental school graduates to practice in underserved areas).”
Third party mechanisms
ADA's role in problems with

81:27 H 7


"Resolved, that the AGD recognize the American Dental Association's appropriate role in communicating with third party payment mechanisms for the purpose of upholding prepayment standards which have been agreed upon by the profession, and be it further


Resolved, that all complaints involving third party payment mechanisms taking more than 30 days to reimburse patients or dentists for dental services rendered be referred to the ADA so that appropriate dialogue may be instituted with the third party on behalf of the public and the dental profession."


Claim contested by dental consultant of

75:30 H 10


"Resolved, that should a patient's claim be contested by the third party's dental consultant, patient, or the patient's dentist, it shall be submitted to the local level of organized dentistry's peer review system and the third party, the patient, and the dentist should agree that the action of the peer review system is binding."




Considerations in deliberating dental health insurance programs

74:8 H 11


"Resolved, that the Academy of General Dentistry take into consideration the needs of the public, the various third party pre payment mechanisms, and the entire dental profession in deliberating on dental health benefits programs which might be of concern to the general dentists which compose its organization."




Consultant of, should make no representation to patient regarding dentist's service or fee

75:29 H 10


"Resolved, that when a patient's claim is considered for modification, and/or review, the third party dental consultant should contact the patient's dentist to discuss the matter fully rather than making any representation to the patient with respect to the dentist's services or fees."




Diagnostic imaging

94:15 H 7


"Resolved, that the Academy of General Dentistry supports third party reimbursement for all forms of diagnostic imaging determined to be medically necessary by the treating dentist and supported by appropriate clinical criteria."




Differentials in levels of reimbursement in

77:13 H 6


"Resolved, that the Academy of General Dentistry is opposed to differentials in levels of reimbursement in third party programs based on whether or not a practicing dentist is a 'participating' or 'non participating' dentist in such a program, and be it further


Resolved, that this resolution be communicated to the ADA, Delta Dental Plans, and all of the participating Delta Dental Plans in every state in the United States."



86:34 H 7


"Resolved, that the AGD is unequivocally opposed to any type of separate fee schedules for reimbursement to general practitioners and specialists for the same or similar services; and be it further


Resolved, that AGD policy #76:53 H 11 be rescinded." (Second and Third Clauses rescinded HOD 2007:301-H-7, see rescinded policies)


Fee Determination


2009:317RS-H-7

“Resolved, that third party payers should not determine fees for procedures not covered and/or not reimbursed in their policies. And be it further,
Resolved, that the appropriate AGD agencies be directed to help AGD constituents develop legislation that will prevent third party payers from setting fees for non-covered and/or non-reimbursed procedures.”


Fee schedules based on utilization reviews considered arbitrary

2000:25-H-7


“Resolved, that the Academy of General Dentistry believes that any fee schedule by third party dental benefit administrators or other entities that separates dentists into different payment levels as determined by statistically based ‘utilization reviews’ is arbitrary, discriminatory, and not consistent with appropriate patient care.”





Guidelines for handling members problems with

75:33 H 10


"Resolved, that the AGD adopt the following guidelines for handling communications from members on their problems with third party programs:


a. All complaints must be placed in writing and be sufficiently documented.


b. The executive director, in consultation with the Dental Care Council chairman, shall be charged with the responsibility of corresponding directly with those carriers that are acting in opposition to policy previously established by the AGD.
c. The AGD should seek the help of the American Dental Association on those complaints involving a violation in ADA policy."
Not to interfere with dentist's diagnosis and treatment

75:32 H 10


"Resolved, that the AGD recognize a third party payment mechanism's responsibility to determine its liability and extent of dental benefits but is unalterably opposed to any administrative procedure that interferes with the attending dentist's diagnosis and treatment plan."





86:33 H 7


"Resolved, that alternative payment systems for all dental care delivery should not infringe upon the right and responsibility of the licensed practicing dentist to diagnose and treat patients according to the proper standard of care."




Overpayment recovery practices


2003:13-H-7

“Resolved, that the Academy of General Dentistry seek and support efforts opposing third party overpayment recovery practices, except as contractually obligated, when the overpayment was the result of a mistake made by the insurer and accepted by the dentist in good faith without prior or reasonable knowledge of the error, and be it further

Resolved, that the Academy of General Dentistry seek and support efforts to prevent third party payers from withholding fully assigned benefits to a dentist when an incorrect payment has been made to the dentist on behalf of the subscriber with the same third party payer.”


Participation should not be contingent upon participation in government regulated programs

97:30-H-8


“Resolved, that retention of a license to practice dentistry and participation in third party plans should not be contingent upon participation in government regulated programs.”




Reduction/denial of dental benefits must be signed by licensed dentist

2000:26-H-7


“Resolved, that the Academy of General Dentistry believes that any third party reduction or denial of dental benefits on the basis of ‘not medically necessary or appropriate’ must be made on an individual basis and signed by a dentist licensed in the state or province in which the procedures are being performed, and be it further


Resolved, that the Academy of General Dentistry believes that any third party reduction of dental benefits on the basis of ‘least expensive alternative treatment’ be made on an individual basis and signed by a dentist licensed in the state or province in which the procedures are being performed, and be it further


Resolved, that the Academy of General Dentistry believes that any review of clinical records for the purpose of reducing or denying dental benefits must be made on an individual basis and signed by a dentist licensed in the state or province in which the procedures are being performed.”
Regulated by law or state governmental agency

85:23 H 7


"Resolved, that all third party payment mechanisms be regulated by law or through the appropriate state governmental agency to ensure fiscal responsibility and protection of the interests of the public."




Tissue biopsy


2006:25-H-8

“Resolved, that it is the position of the AGD that the decision whether or not to biopsy oral tissues lies within the purview of the treating dentist.”


TMD policy statement


86:29 H 7

"Resolved, that the Academy of General Dentistry support legislation and rules and regulations that would require third party mechanisms selling dental benefits programs based on UCR in a state, to use data that is not more than six months old on the date of filing, and so state this date in published material to users and prospective users of these programs; and be it further

Resolved, that the AGD communicate the problems being addressed by this resolution to the ADA's Council on Dental Benefit Programs to seek a viable solution; and be it further


Resolved, that the AGD's Dental Practice Council assess solutions being offered by the ADA to see if further action by the AGD is needed."


89:55 H 7

"Resolved, that the Academy of General Dentistry's TMD Policy is:

1. The existence of TM orders is undeniable and these disorders can be treated by the general dentist.


2. There are a variety of viable diagnostic and treatment modalities for TM disorders, as there are in the treatment of physiological disorders, back problems, and many other medical maladies.
3. Like any disorder or disease, the indication for TMD treatment is a doctor/patient decision. The criteria for this decision is both subjective and objective.
4. It is not possible to list all the effective (and thus reimbursable) TMD procedures. It is the application of clinical judgment which determines the appropriate treatment modality.
and be it further
Resolved, that the Academy of General Dentistry support the concept that comprehensive policies or certificates of health, medical, hospitalization, or accident and sickness insurance should provide reimbursement for the diagnosis and therapeutic treatment of temporomandibular dysfunction/myofascial pain dysfunction and associated diseases and dysfunctions and that benefit coverage be the same as that for treatment of any other joint in the body and be applicable if the treatment is administered or prescribed by a physician or a dentist, and be it further
Resolved, that Resolution 88:53 H 7 be rescinded."
TMJ
Medical care contracts should not discriminate against dentists

88:52 H 7


"Resolved, that in cases where dentists provide their expertise in treatment of temporo mandibular joint dysfunction and cranio mandibular disorders, medical care contracts should not discriminate in benefit payments based on the professional degree of the provider."




Medical care contracts should provide mandatory coverage for treatment of

*88:53-H-7


RESCINDED




Tooth numbering system


81:28 H 7

"Resolved, that the Academy of General Dentistry endorses the universal (1 to 32/a to t) tooth numbering system adopted by the ADA and encourage its immediate implementation through the American Dental Association and the American Dental Education Association and other segments of the dental profession."


Untoward responses to products, materials, and medications

98:23-H-7


“Resolved, that the Academy of General Dentistry encourage its members to be aware of possible untoward responses to products, materials, and/or medications used in the dental office, and that the use of these products, materials and/or medications will be up to the discretion of the treating provider.”




Workforce, adequacy of present dental workforce


2002:26-H-7


“Resolved, that the Academy of General Dentistry adopt the following statement relative to the adequacy of the dentist workforce in 2002:


The dentist workforce in the United States is sufficient to meet the needs of the public demand for dental services. Geographic imbalances exist in localized areas due to a variety of factors. Where these imbalances result in shortages, the affected regions must be examined and addressed individually for appropriate solutions. The development of a responsive, competent, diverse, and “elastic” workforce should address potential increases in demand for dental services.”
Work force issues, position statement



2005:3-H-07

“Resolved, that the Academy of General Dentistry’s position in response to work force issues is:


  • AGD believes that access to oral health care is an issue that needs to be addressed throughout the profession.




  • AGD believes that general and pediatric dentists, working in concert with the dental team, are the gatekeepers of oral health.




  • AGD believes that general dentists are uniquely qualified to help provide and maintain the optimal standard of care.”





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