BILL ANALYSIS
AB 1524
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Date of Hearing: January 12, 2010
ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
Mary Hayashi, Chair
AB 1524 (Hayashi) - As Amended: January 4, 2010
SUBJECT : Dentistry: examination requirements.
SUMMARY : Establishes an alternative to the current dental
clinical exam for licensure in which dental students may
complete the clinical portion of the licensure exam throughout
dental school, instead of during a single examination.
Specifically, this bill :
1)Specifies that each dentistry licensure applicant must
successfully complete both Parts I and II written examinations
of the National Board Dental Examination (NBDE).
2)Deletes the English language requirement for the dentistry
exam.
3)Deletes the current Dental Board of California (DBC) clinical
exam and replaces it with a hybrid portfolio pathway
examination (HPP) which shall be conducted while the applicant
is enrolled in a dental school program at a DBC-approved
school located in California. This examination shall utilize
uniform standards of minimal clinical experiences and
competencies. The applicant shall pass a final assessment of
the submitted portfolio at the end of his or her dental school
program.
4)Requires an applicant to pay a $350 fee, to be deposited into
the State Dentistry Fund (SDF), and submit a letter of good
standing signed by the dean or the dean's delegate of his or
her dental school stating that the applicant has graduated or
will graduate with no pending ethical issues.
5)Requires DBC to monitor HPP and audit the standardization and
calibration of dental school competency instructors at least
biennially with DBC-appointed examiners, and requires the
DBC-appointed examiners to ensure standardization and an
acceptable level of calibration in the grading of the
examination.
6)Requires DBC to biennially audit each dental school's
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competency examinations.
7)Prohibits DBC from interfering with the dental school's
authority to establish and deliver an accredited curriculum.
8)Requires DBC to determine an end-of-year deadline, in
consultation with the current DBC -approved dental schools, to
determine when the portfolio examinations shall be completed
and submitted to DBC for review by DBC's examiners.
9)Requires DBC, in consultation with the current DBC-approved
dental schools, to determine the minimum number of clinical
experiences required for successful completion of the
portfolio examination in each of the following areas:
a) Comprehensive oral diagnosis and treatment planning,
with each case including a health history evaluation,
periodontal evaluation, hard and soft tissue evaluation,
smoking and tobacco product cessation, and treatment
planning for optimal restoration of dentition to form and
function;
b) Periodontics, including adult prophylaxis and
periodontal management, root planning, and periodontal
reevaluation;
c) Direct restoration;
d) Indirect restoration;
e) Endodontics;
f) Removable prosthetics; and,
g) Oral surgical procedures.
10)Requires DBC to verify, as specified, successful completion
of the following competency examinations that were performed
on a patient of record of a DBC-approved dental school:
a) Comprehensive oral diagnosis and treatment planning,
including:
i) Collection of the patient's medical and dental
history;
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ii) A comprehensive examination;
iii) Evaluation of data to identify problems;
iv) Development of alternative treatment plans; and,
v) Development of a final treatment plan and
documentation according to risk management standards.
b) Periodontics, including:
i) Performance of a comprehensive periodontal
examination;
ii) Diagnosis and development of a periodontic treatment
plan;
iii) Performance of nonsurgical periodontal therapy; and,
iv) Performance of periodontal reevaluation.
c) Direct restorations, as specified, including:
i) Restoration of a tooth containing a primary carious
lesion or lesions requiring a Class II restoration using
amalgam or composite;
ii) Restoration of a tooth containing a primary carious
lesion or lesions requiring a Class III or IV restoration
using composite resin; and,
iii) Restoration of a tooth containing a primary carious
lesion or lesions requiring a Class V restoration using
glass ionomer, composite resin, or amalgam.
d) Indirect restorations, including restoration of a tooth
with a crown or onlay according to approved procedures and
materials, with the case selected based on minimum criteria
for indirect restorations.
e) Removable prosthodontics, including:
i) Development of the diagnosis and treatment options
with the prognosis for removable prosthesis;
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ii) Restoration of edentulous spaces with removable
prostheses;
iii) Management of tooth loss transition with immediate
or transitional prostheses; and,
iv) Management of prosthetic problems and evaluation of
laboratory services for prostheses.
f) Endodontics, including:
i) Application of case selection criteria;
ii) Demonstration of pretreatment preparation;
iii) Performance of access opening, shaping, cleaning,
and obturation techniques;
iv) Completion of an endodontic case; and,
v) Providing recommendations for postendodontic
treatment.
EXISTING LAW :
1)Provides for the licensure and regulation of dentists and
associated professions by DBC through the Dental Practice Act.
2)Existing law requires an applicant for a license to practice
dentistry to complete various examinations, including NBDE, an
examination in California law and ethics developed by the
board, and a clinical and written examination administered
either by DBC or the Western Regional Examining Board (WREB).
3)Existing law prescribes the maximum amount of fees to be
charged for examination, licensure, and renewal, for deposit
into the SDF.
FISCAL EFFECT : Unknown
COMMENTS :
Purpose of this bill . According to the author's office, "DBC is
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seeking an alterative pathway to initial licensure because of
concerns about public safety and its failure to sample the full
range of competencies. This new pathway will permit California
dental students to prove their skills throughout their dental
schooling and eliminate the need and expense of securing a
subject for an anxiety-ridden final clinical examination.
"The goal of the new HPP is to include not only those types of
cases currently evaluated in the existing clinical exams, but
include other, more complex cases that cannot be assessed within
the present three day time constraint."
Background . California dental students are currently required
to take both a written and practical exam to become a licensed
dentist. The clinical exam may be administered by either DBC or
the WREB.
The present clinical examination is administered over three
days, costs each applicant over $2,000, and requires the
participation of a volunteer patient provided by the student.
According to DBC, finding a volunteer patient has been
especially problematic for dental students because of practical
and medical ethical issues. Additionally, concerns have been
raised about the reliability of judgments made about candidate
performance in "one shot" tests.
According to the sponsors, HPP assesses a dental student's
abilities throughout the dental school education. A portfolio
of the student's completed cases would be maintained by the
student and submitted to DBC for consideration as part of the
candidate's application for licensure. In addition to these
cases, the portfolio will include independent competency exams
supervised by DBC during the student's third and fourth year of
education. The cases submitted in HPP will be monitored by a
DBC-approved on-site evaluator to validate the treatment
rendered by the candidate. Successful completion of the dental
school curriculum does not ensure licensure by DBC, however.
HPP would only allow a candidate who has attended dental school
in California to obtain a license to practice in California.
The WREB exam is regional and is accepted in 29 states.
Suggested committee amendments :
Business & Professions Code section code 1630 was inadvertently
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deleted by the sponsors. Section 1630 shall remain, which
states, "The examination by the board of applicants for a
license to practice dentistry in this State shall be
sufficiently thorough to test the fitness of the applicant to
practice dentistry, and both questions and answers shall be
written in the English language."
REGISTERED SUPPORT / OPPOSITION :
Support
Dental Board of California (sponsor)
Opposition
None on file.
Analysis Prepared by : Sarah Huchel / B. & P. / (916) 319-3301