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Journal of the American College of Dentists Schools’ Role in Access Winter 2008 Volume 75 Number 4 Journal of the American College of Dentists A publication advancing excellence, ethics, professionalism, Mission and leadership in dentistry he Journal of the American College of Dentists shall identify and place The Journal of the American College of before the Fellows, the profession, and other parties of interest those issues Dentists (ISSN 0002-7979) is published that affect dentistry and oral health. All readers should be challenged by the quarterly by the American College of T Dentists, Inc., 839J Quince Orchard Journal to remain informed, inquire actively, and participate in the formulation Boulevard, Gaithersburg, MD 20878-1614. of public policy and personal leadership to advance the purposes and objectives of Periodicals postage paid at Gaithersburg, the College. The Journal is not a political vehicle and does not intentionally promote MD. Copyright 2008 by the American College of Dentists. specific views at the expense of others. The views and opinions expressed herein do not necessarily represent those of the American College of Dentists or its Fellows. Postmaster–Send address changes to: Managing Editor Journal of the American College of Dentists 839J Quince Orchard Boulevard Objectives of the American College of Dentists Gaithersburg, MD 20878-1614 HE AMERICAN COLLEGE OF DENTISTS, in order to promote the highest ideals in The 2008 subscription rate for members of the American College of Dentists is $30, health care, advance the standards and efficiency of dentistry, develop good and is included in the annual membership Thuman relations and understanding, and extend the benefits of dental health dues. The 2008 subscription rate for non- to the greatest number, declares and adopts the following principles and ideals as members in the United States, Canada, and Mexico is $40. All other countries are $60. ways and means for the attainment of these goals. Foreign optional airmail service is an additional $10. Single-copy orders are $10. A. To urge the extension and improvement of measures for the control and prevention of oral disorders; All claims for undelivered/not received issues must be made within 90 days. If B. To encourage qualified persons to consider a career in dentistry so that dental claim is made after this time period, it will health services will be available to all, and to urge broad preparation for such not be honored. a career at all educational levels; While every effort is made by the publishers C. To encourage graduate studies and continuing educational efforts by dentists and the Editorial Board to see that no and auxiliaries; inaccurate or misleading opinions or state- ments appear in the Journal, they wish to D. To encourage, stimulate, and promote research; make it clear that the opinions expressed E. To improve the public understanding and appreciation of oral health service in the articles, correspondence, etc. herein are the responsibility of the contributor. and its importance to the optimum health of the patient; Accordingly, the publishers and the Editorial F. To encourage the free exchange of ideas and experiences in the interest of better Board and their respective employees and service to the patient; officers accept no liability whatsoever for the consequences of any such inaccurate G. To cooperate with other groups for the advancement of interprofessional or misleading opinions or statements. relationships in the interest of the public; For bibliographic references, the Journal H. To make visible to professional persons the extent of their responsibilities to is abbreviated J Am Col Dent and should the community as well as to the field of health service and to urge the acceptance be followed by the year, volume, number and page. The reference for this issue is: of them; J Am Col Dent 2008; 75(4): 1-68 I. To encourage individuals to further these objectives, and to recognize meritorious achievements and the potential for contributions to dental science, art, education, Publication Member of literature, human relations, or other areas which contribute to human welfare— aa the American Association by conferring Fellowship in the College on those persons properly selected for of Dental Editors de such honor. Editor David W. Chambers, EdM, MBA, PhD 2008 ACD Annual Meeting Managing Editor 4 An Ethics War Stephen A. Ralls, DDS, EdD, MSD ACD President-elect’s Address Max M. Martin, Jr., DDS, FACD Editorial Board Bruce J. Baum, DDS, PhD 8 Responding to a Culture-Based Health Need Norman Becker, DMD Convocation Address Fred Bremner, DMD Francisco G. Cigarroa, MD D. Gregory Chadwick, DDS Eric K. Curtis, DDS 11 2008 ACD Awards Kent W. Fletcher 15 2008 Fellowship Class Steven A. Gold, DDS Theresa S. Gonzales, DMD, MS, MSS Bruce S. Graham, DDS Donna Hurowitz, DDS Schools’ Role in Access Frank J. Miranda, DDS, MEd, MBA Laura Neumann, DDS 20 Dental Schools and Access Disparities: What Roles Can Schools Play? Ian Paisley, DDS Howard Bailit, DMD, PhD, FACD Don Patthoff, DDS Marcia Pyle, DDS 24 Dental Pipeline Program: A National Program Linking Dental Schools Cherlyn Sheets, DDS with the Issue of Access to Care Allan J. Formicola, DDS, MS, FACD Design & Production Annette Krammer, Forty-two Pacific, Inc. 29 California Pipeline Program: Phase II Paul Glassman, DDS, MA, MBA, FACD Correspondence relating to the Journal should be addressed to: 35 East Carolina University School of Dentistry: Impact on Access Disparities Managing Editor D. Gregory Chadwick, DDS, MS, FACD and James R. Hupp, DMD, DDS, Journal of the American College of Dentists JD, MBA, FACD 839J Quince Orchard Boulevard Gaithersburg, MD 20878-1614 42 The Role of Dental Schools in the Issues of Access to Care Caswell A. Evans, DDS, MPH, FACD Business office of the Journal of the American College of Dentists: Tel. (301) 977-3223 Fax. (301) 977-3330 Issues in Dental Ethics Officers 47 The Intersection of Dental Ethics and Law Max M. Martin, Jr., President David J. Owsiany, JD Thomas Wickliffe, President-elect Thomas F. Winkler III, Vice President W. Scott Waugh, Treasurer John M. Scarola, Past President Departments Regents 2 From the Editor Herb H. Borsuk, Regency 1 Loose Talk Robert A. Shekitka, Regency 2 T. Carroll Player, Regency 3 55 Leadership Dennis A. Burns, Regency 4 Practice Bert W. Oettmeier, Regency 5 Patricia L. Blanton, Regency 6 64 2008 Manuscript Review Process Paul M. Johnson, Regency 7 65 2008 Article Index R. Terry Grubb, Regency 8 Kenneth L. Kalkwarf, At Large Jerome B. Miller, At Large This issue is supported by the American College of Dentists Foundation. Linda C. Niessen, At Large Cover Photograph: As practitioners, it is important that we help patients approach their oral Eugene Sekiguchi, At Large health one step at a time. Addressing their neglected oral health can seem intimidating. Lawrence P. Garetto, ASDE Liaison ©2009 Nikada Photography/iStockphoto.com Editorial From the Editor Loose Talk oose talk creates distance between Pellegrino observed that it is unethical to people. When we hear something say something just because you want it Advertisements are Lthat does not seem to square with to be true without actually believing it to our views, it is human nature to build in be so. This is not a First Amendment examples of loose talk; a bit of safety space. We want to know issue. Just because one has a right to say they are “drive-by” why a dentist is critical of a colleague’s something does not mean that it is right work, why that blog is still getting hits, to say it. This thought came to mind last claims that refuse to and the foundation for the rumors that year when Columbia University invited engage in conversation. are circulating about a candidate for Mahmoud Ahmadinejad to address office in the state association. We reserve the school community. President Lee that space for an explanation, and Bollinger publicly insulted his guest; the when explanations are not forthcoming president of Iraq returned the favor, and this distance creates looseness in the the whole business was passed off as an professional community. exercise in free speech. I think of loose talk as statements What is necessary to participate in that do not come with reasons. They the rational community (to avoid loose are attempts to tell me what to believe talk) is a willingness to discuss reasons without giving me the little kit that for the claims one puts forward. explains how this new claim is supposed Informed consent is a code of honoring to be hooked up to my current under- requests for reasons. standing. Advertisements are examples It would be tedious to accompany of loose talk; they are “drive-by” claims every statement with a reason, and we that refuse to engage in conversation. only have to be prepared to bring forth So is the snide, third-person insinuation our reasons when asked. If the dentist at the committee meeting that “there says, “Agent X is the only acceptable are many questions this proposal leaves deep pocket irrigant,” that is a pretty unanswered”—leaving unanswered loose way of talking. The challenge what those questions might be or who might come, “I have been wondering is raising them. Manuscripts have been about that. Why do you say Agent X is turned down for publication based on the only alternative?” “It is approved by suspicions that “they might be biased” with the FDA” and “I only use it on patients no hint about what that bias could be. where it is indicated” fill in the picture in In a rational community, members different ways: the first response is wimpy; are expected to take responsibility for the second is highly idiosyncratic. what they say.

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