The ADA has officially recognized orofacial pain (OFP) as the dental profession’s twelfth specialty. On March 31, 2020, the National Commission on Recognition of Dental Specialties and Certifying Boards granted specialty standing based on compliance with the ADA’s Requirements for Recognition of Dental Specialties.
The American Academy of Orofacial Pain (AAOP) defines OFP as “the specialty of dentistry that encompasses the diagnosis, management, and treatment of pain disorders of the jaw, mouth, face and associated regions.”
Also, the AAOP says, “OFP disorders include but are not limited to temporomandibular muscle and joint (TMJ) disorders, jaw movement disorders, neuropathic and neurovascular pain disorders, headache, and sleep disorders.”
“The most important outcome of this decision is the relevance and impact it will have on improving care for patients with orofacial pain disorders. This has been the main driver behind AAOP pursuing orofacial pain as a recognized specialty,” said AAOP president Dr. Jay L. Mackman.
“There are millions of patients with orofacial pain conditions that currently have poor access to care due to the limited number of dentists who focus their practices in this field. It is hoped that the recognition of the specialty in orofacial pain will bring expanded training and research opportunities leading to improvements in quality and access to care for these patients,” said Mackman.
In the struggle to gain specialty status for OFP, numbers of civil lawsuits were filed in various jurisdictions against state dental boards.
“I think it’s great that the ADA, the largest private trade association in dentistry, is finally loosening its grip on ‘specialty’ status,” said Frank R. Recker, DDS, JD, one of the principal attorneys for plaintiffs in expanding recognition of dental specialties.
“Changing the direction of a massive, slow moving ship isn’t easy or done quickly, but the internal political machinery of the ADA decided it was better to turn slowly than to hit the ‘iceberg’ ahead!” said Recker.
The AAOP presented an extensive application for OFP’s specialty status to the National Commission on Recognition of Dental Specialties and Certifying Boards. The application included two-year and mostly three-year postgraduate accredited residency programs at highly prestigious teaching institutes, as well as their design, scope, and parameters of care, in addition to the recertification process and continuing education.
The AAOP made a strong case that general dentists and longstanding recognized dental specialists frequently weren’t addressing patient problems with chronic and acute orofacial pain. The OFP specialty not only would directly aid these patients in need but also advance dental research, foster evidenced-based treatments, and elevate standards of care.
The ADA’s recognition of OFP as a dental specialty comes on the heels of its recognition of oral medicine on March 2. A year earlier, on March 11, 2019, dental anesthesiology gained specialty status with the ADA.
One area in particular continues to fight for specialty recognition with the ADA—implant dentistry. The American Board of Oral Implantology/Implant Dentistry is currently recognized by the independent American Board of Dental Specialties.
The efforts of various specialty organizations to gain recognition and standing for their members as dental specialists is wonderfully illustrated in a report by Dr. Riley H. Lund, editor in chief of The Journal of Craniomandibular & Sleep Practice.
“When asked if there will ever be a TMD specialty recognized in dentistry, my standard answer was that God had made too many orthodontists and oral surgeons to ever have one approved. Now, I recognize, in hindsight, that He made even more attorneys,” Lund prophetically said.
Dr. Davis practices general dentistry in Santa Fe, NM. He assists as an expert witness in dental fraud and malpractice legal cases. He currently chairs the Santa Fe District Dental Society Peer-Review Committee and serves as a state dental association member to its house of delegates. He extensively writes and lectures on related matters. He may be reached at firstname.lastname@example.org or smilesofsantafe.com.