Coalition for Modernizing Dental Licensure sunsets after achieving portability goals
Work continues through ADA, partner organizations
After accomplishing its primary goals of eliminating reliance on single-encounter patient examinations and making licensure more portable, the Coalition for Modernizing Dental Licensure disbanded in September.
"CMDL demonstrated what is possible when the profession comes together around a common purpose,” said JoAnn Gurenlian, Ph.D., coalition executive committee chair and American Dental Hygienists’ Association appointee to the coalition. “Dentists, dental hygienists, educators, students, specialty organizations and many others worked collectively to reimagine the future of licensure.”
The American Dental Association, American Dental Education Association and American Student Dental Association launched the coalition in 2018 in response to a report by their joint Task Force on Assessment of Readiness for Practice that called for changes to licensure exams and portability. The ADHA joined shortly thereafter, and the coalition eventually grew to more than 130 partner organizations across the dental and dental hygienist professions, education, and other public interests.
In the past, dental licensure often depended on one-time procedures performed on a patient. However, this model was vulnerable to random error, lacked strong scientific validity and raised ethical concerns, according to a final report from the coalition.
Through coordinated advocacy by the coalition across education, practice and regulation, the national licensure landscape now includes alternatives to the patient clinical exam. These alternatives — manikin-based assessments and objective structured clinical examinations — evaluate candidates under more controlled conditions and assess a broader range of competencies than a single patient encounter. Currently, 49 states and Washington, D.C., recognize at least one initial dental or dental hygiene licensure pathway that does not require a patient exam, according to the report.
The coalition’s efforts to modernize dental licensure extended beyond licensure exams to include licensure portability as well, helping to address workforce shortages and improve access to care while maintaining state authority and public protections, the report stated.
The Dentist and Dental Hygienist Compact was activated in spring 2024 when Maine became the seventh state to join, offering a practical framework for qualified dentists and dental hygienists to practice across state lines. It currently includes 13 states: Arkansas, Colorado, Iowa, Kansas, Maine, Minnesota, Nebraska, Ohio, Oklahoma, Tennessee, Virginia, Washington and Wisconsin.
With the coalition sunsetting, the ADA Council on Dental Education and Licensure will continue to track licensure trends, historical data and state-level relationships. The ADA, ADEA and ADHA will continue to work with state dental and dental hygiene associations to advocate for licensure reform.
Specific efforts that remain include pushing for updates in the 14 states that still maintain statutory or regulatory language recognizing procedure-based live-patient exams, expanding the compact to include more states and broaden the reach of professional mobility, and continuing to evaluate and refine clinical assessments as education, technology and best practices evolve.
“Although it is difficult to say goodbye to a coalition that has meant so much to so many, we celebrate the remarkable progress that was made and the lasting legacy created through collaboration, trust and a commitment to doing what is best for patients and the profession,” Dr. Gurenlian said.
