The American Dental Association (ADA) is the oldest and largest dental organization in the United States. Founded in 1859, the ADA has a reputation as being the chief certifying authority for any dental care product, including tooth paste, tooth brushes, and mouth rinses. The ADA, however, has consistently resisted the responsibility of certifying dentists themselves. Instead, they primarily intervene to ensure the quality of dentists in two different ways. First, they accredit dental programs at universities. Second, their state organizations work with state licensing boards to ensure that every licensed dentist upholds the standards of the ADA.

In addition to the state organizations, the ADA also has recognized specialty organizations under its umbrella, and these specialty organizations make sure dentists claiming specialization in an area of dental practice are adequately qualified to perform the specialty with the highest degree of competence. These recognized specialty organizations are:

· American Board of Dental Public Health

· American Board of Endodontics

· American Board of Oral and Maxillofacial Pathology

· American Board of Oral and Maxillofacial Radiology

· American Board of Oral and Maxillofacial Surgery

· The American Board of Orthodontics

· American Board of Pediatric Dentistry

· American Board of Periodontology

· American Board of Prosthodontics

All of these boards can issue a certification that a dentist is a nationally-recognized specialist in the named field. But "cosmetic dentistry" is not among the list of dental specialties recognized by the ADA.

Consequences of Unrecognized Status

When a dental specialty is unrecognized by the ADA, you might believe it means that no dentist can claim to be a "cosmetic dentist," but the truth is exactly the opposite. When the ADA does not recognize a specialty, it means that any dentist can describe him or herself as a "cosmetic dentist," since the phrase has no professionally-defined characteristics. This means that patients choosing a cosmetic dentist have no certification board vouching for the quality of the cosmetic dentistry practiced by any dentist.

Dentists Oppose Recognition

The overwhelming majority of dentists in one unscientific survey vehemently opposed the creation of a cosmetic dentistry specialty. They listed a number of reasons for opposing the specialty, including the opposition of government regulation of the dental field, trying to avoid overspecialization, the subjective nature of cosmetic dentistry, and the purported ubiquity of cosmetic dentistry. In addition, some dentists fear that they could find themselves restricted from performing lucrative cosmetic procedures if the specialty became recognized.

Possible Benefits for Recognition

If cosmetic dentistry were to become a recognized specialty, it would be a boon for consumers as it would require that every dentist who advertised as a "cosmetic dentist" had a certain skill base and could be counted on to perform cosmetic dentistry procedures with a reasonable level of competence. It would ensure that patients get what they paid for in terms of experience and training.

In addition, the recognition of a cosmetic dentistry specialty would increase uniformity among the states in terms of regulating the industry. Currently, only 17 states require dentists to obtain a specialty license before announcing a specialty, meaning that in the other 33 states, a dentist can announce a specialty without any supporting training. In addition, because 35 states only allow dentists to announce credentials in areas of specialty recognized by the ADA, meaning that without ADA recognition, dentists with training in cosmetic dentistry cannot advertize their relevant training.

In comparison to the patient's right to knowledge, the majority of dentists' objections to the formation of a cosmetic dentistry specialty are relatively minor. Why should a dentist be allowed to perform a procedure for which he or she is only nominally qualified? And how can one say that cosmetic dentistry is entirely subjective when so many of its procedures are standardized? The preparation and application of porcelain veneers may have some subjective components, but it also has a very standardized procedure. And tooth whitening's results can easily be measured objectively.

But with the opposition of dentists, it may be a long time before the ADA recognizes and authorizes the cosmetic dentistry specialty. In the meantime, you must take a more active role in choosing the right cosmetic dentist for your procedure, which includes being more informed about the procedures.