ADA advocates for removing stigmatizing questions from licensure applications

Leaders pen letter to state dental boards highlighting best practices, resources

The American Dental Association continues to advocate for removing stigmatizing questions related to mental health and substance use disorders from dental licensure applications.

In July, the ADA sent a letter to every state dental board to share best practices and resources, including the licensure reform toolkit it developed in 2024. The toolkit highlights several states that have already removed intrusive or stigmatizing mental health questions from their initial and renewal licensure applications that may deter a dentist from seeking care.

“As ADA Leadership, we want to follow up with each state to ensure that resources are readily available,” said President Brett Kessler, D.D.S.; President-elect Richard Rosato, D.M.D.; and Interim Executive Director Elizabeth Shapiro, D.D.S., J.D., in the letter. “We know that State Boards of Dentistry protect the public’s health. Supporting the health and well-being of dentists and dental team members contributes to that essential mission. By destigmatizing and communicating there will not be repercussions for mental health care, dentists and their staff are more likely to seek help.”

Two states — Idaho and North Carolina — were recently recognized as Wellbeing First Champions by the Dr. Lorna Breen Heroes’ Foundation. Established in honor of an emergency room doctor who died by suicide during the COVID-19 pandemic, the foundation seeks to reduce burnout among health care professionals and safeguard their well-being and job satisfaction. The Wellbeing First Champion Badge indicates to health care workers that a state will not require them to answer intrusive mental health questions as part of its licensure applications.

Both the Idaho and North Carolina state dental boards have updated their initial and renewal licensure applications to remove “have you ever” questions related to past mental health diagnoses or treatment. Instead, questions focus on an applicant’s current ability to practice safely.

"This will be a huge step forward in allowing the dental professional to address any personal mental health or substance use concerns in a safe and nonpunitive matter,” said Bill Claytor, D.D.S., executive director of the North Carolina Caring Dental Professionals, a nonprofit that helps to monitor and advocate for dentists and dental hygienists who struggle with substance use disorders, stress, depression, burnout and perfectionism.

These changes align with best practices, according to the ADA.

“The ADA has learned from colleagues in medicine (American Medical Association, Federation of State Medical Boards, Federation of State Physician Health Programs, and The Joint Commission) to focus questions on current impairment,” ADA leaders said in the letter. “Best practices are to avoid ‘Have You Ever?’ questions that could prevent dentists or other licensed dental providers from asking for help for a mental health challenge, including substance use disorders. Seeking professional help for these issues early can keep our patients and the public safer.”

In addition to its licensure reform toolkit, the ADA highlighted other resources in the letter, including its Dentist Well-Being Programs Directory, which allows users to search for wellness contacts and resources by state. The ADA also offers a licensed version of the Well-Being Index — an anonymous, validated self-assessment tool developed by Mayo Clinic that measures multiple dimensions of clinician distress and well-being — to all dentists, dental students and dental team members. ADA members and dental students also have free access to Talkspace Go and discounted access to Talkspace Therapy through December.

The ADA’s wellness resources are available at ADA.org/wellness.