Use of dental lasers and state board regulations - whatÌs the real deal?

Use of dental lasers and state board regulations - whatÌs the real deal?
September, 2007
by Gail S. Siminovsky, CAE
Dental Economics

Issues facing state regulatory agencies
The issues facing state regulatory agencies are compelling. First and foremost is the responsibility to protect its citizens. When defining educational standards, state boards must consider mechanisms to assure citizens that educational standards as defined by the profession are being adhered to. The second issue to consider is specifically how state boards will determine proper disclosure, or that a professional review process has been followed as defined by ADA CERP or AGD PACE.
Regulators are most concerned with defining levels of education as they consider whether or not to regulate the licensure of clinicians regarding the safe and effective uses of dental lasers. State regulators themselves want to be better educated prior to drafting any language into their state regulation about demonstrable measures of education.
In the past, one of two scenarios occurred. Either this issue did not come up, or some state boards chose to act without proper knowledge and defined limits on the use of laser devices, mostly by hygienists.
What is ALDÌs role?
The Academy of Laser Dentistry believes all providers of dental laser services (dentists, hygienists, dental assistants) should be properly trained in the use of lasers and recommends that laser practitioners complete, at minimum, a Standard Proficiency level of education as described in the Curriculum Guidelines and Standards for Dental Laser Education. The Academy does not endorse any restrictions placed on the use of lasers that do not equally apply to other devices and equipment.
When addressing the issue of which laser procedures should be allowed by providers of dental services, consider first the scope of practice as currently defined in the dental practice act of oneÌs state of licensure. We agree that practitioners must continue with intense model-specific training provided by each manufacturer, and Standard Proficiency is not that.
If a board chooses to implement a prerequisite for laser use, the Academy recommends that Standard Proficiency be used as the educational standard. Standard Proficiency is the minimum standard of education that practitioners should complete when considering laser use for patient care.
ALD, in its interpretation, defines Standard Proficiency as a laborious process with strict criteria regarding educational objectives, content, and educational outcomes which include multiple wavelengths, multiple devices, and broad-based information.
ALD has a mechanism in place that adheres to professional standards in dentistry. Most importantly ALD provides an unbiased review of course content. One key to doing all of this is separating the professional from the commercial when it comes to standards and the interpretation of those standards.
There is a proliferation of laser ÏeducationÓ available in half-day, multiple-day, and various hourly courses that do not in any way amount to the definition of proficiency that we believe a state board is seeking.
Further, so much of what is available is indeed infomercials or distortions of the available science intended in the end to ÏsellÓ a device. We, as a professional standard-setting organization, have a due diligence to provide balanced education by educators who are not working for a company, let alone not fully disclosing those corporate affiliations, including methods of remuneration.
The standards defined in the Curriculum Guidelines and reviewed by the Academy of Laser Dentistry, as an independent organization of professionals representing various stakeholder groups as indicated in ALDÌs mission, is the standard we believe state boards are seeking to provide.
What has happened in Nevada?
The Nevada State Board of Dental Examiners charged a working group to seek information about the role of dental laser education, standards, and certification and to provide language to guide the Board in defining minimum proficiency and educational standards for clinicians on the safe and effective uses of dental laser devices.
In December 2005, the Board passed language in Chapter 631 of the Nevada Administrative Code that requires educational criteria of the Curriculum Guidelines and Standards for Dental Laser Education as interpreted by the Academy of Laser Dentistry.