By Marc Ackerman 

Mission Statement of the Commission on Dental Accreditation:

The Commission on Dental Accreditation serves the public and profession by developing and implementing accreditation standards that promote and monitor the continuous

quality and improvement of dental education programs.

Adopted: August 5, 2016

Mission Statement of the American Board of Orthodontics

The mission of The American Board of Orthodontics is to elevate the quality of orthodontic care for the public by promoting excellence through certification, education and professional collaboration.

March 2018

The Existential Question

In 2018, why should the ABO exist? I can’t come up with any good reason. By eliminating the patient cases from the examination and in the process invalidating them as a testing methodology, the ABO Scenario-based certification exam is nothing more than a group of politically appointed orthodontists sitting around playing professor and grand inquisitor. News flash. The Commission on Dental Accreditation and the residency program faculty that graduated the orthodontist have already done the job.  Anyone who teaches full or part-time in an orthodontic residency would agree. Every aspect of clinical orthodontic care is examined ad nauseam during residency with many programs having a comprehensive oral clinical examination or objective structured clinical examination (OSCE) prior to graduation. Clinical proficiency has been measured over time and does not require another half day in St. Louis (see definition of redundant).

While many sophomore ABO fraternity members are lamenting the fact that the new pledge class doesn’t have to present cases at the clinical exam, they are ignoring the existential question. I graduated dental school in 1998 and in my 20 years in orthodontics the ABO has devised and implemented strategies/policies that have all failed to achieve the objective of increasing membership in one way or another. Many of us have offered advice over this time only to be rebuffed. With the most recent pivot, the ABO has hastened its race to irrelevancy.

In lieu of flowers, please send contributions to the ABO Director Retirement Fund:

ABO Executive Secretary

401 N. Lindbergh Blvd., Suite 300, St. Louis, MO 63141-7839

Historical Review

• 1997: the ABO convinced the Commission on Dental Accreditation (CODA) to require orthodontic program directors to be board certified. At this point in time only 25% of all orthodontists were board certified.
• 2005: the ABO introduced the Gateway Offer (5 years of board certification for $1880). In an AJODO (March 2005) publication, they presented this benefit of the new test design:
  • Board certification will become the norm rather than the exception and will serve as a means for continuous quality assessment. In the process, our dental colleagues and the public will be able to trust the system to provide information pertaining to the continued competency of orthodontists.
• 2006: Case requirement is dropped from 10 to 6.
• 2007: 6 cases that were treated (essentially by Faculty) in residency could be presented at the exam.
• 2010: The first Gateway Offer certificates expired. Less than 50% of Gateway diplomates do not recertify.
• 2016: The ABO influenced the CODA change requiring the program director and faculty must prepare students/residents to pursue certification by the American Board of Orthodontics.
• 2017: Only 33% of all orthodontists were board certified after 12 years of the new testing system. Greg Jorgensen published a critical editorial in the AJODO that implored the ABO to re-evaluate its examination.
• 2018: the ABO announces a new certification process called the Scenario-based clinical examination. It is essentially a rehash of what orthodontists were examined on in residency with emphasis on proficiency in ABO measuring tools (DI, OGS, CRE, CMF). On their website, they present the benefits of the new test design:
  • The most fair, reliable and valid testing methodology
  • Equally tests knowledge, skills, and critical thinking abilities in four core performance areas/domains
  • Demonstrates clinical proficiency in objective manner
  • Eliminates the challenges of using patient cases that may be shared or supervised during residency
  • Eliminates unnecessary barriers for residents and orthodontists in varied practice environments
  • Allows more residents and orthodontists that have an interest in becoming board certified to initiate the examination process

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