Special Interest Groups

• WHAT IS ITS MISSION?
• HOW IS IT STRUCTURED?
• PRIMARY FUNCTIONS
• PROGRAMS
• FAST FACTS
• BUDGET INFORMATION
• HISTORY
• CURRENT POLITICAL ISSUES
• FUTURE DIRECTIONS
• GROUP RESOURCES
• GROUP PUBLICATIONS
• BIBLIOGRAPHY

ESTABLISHED: August 1859
EMPLOYEES: 400
MEMBERS: 143,000
PAC: American Dental Political Action Committee

Contact Information:
ADDRESS: 211 E. Chicago Ave. Chicago, IL 60611
PHONE: (312) 440-2500
FAX: (312) 440-2800
E-MAIL: publicinfo@ada.org
URL: http://www.ada.org
CEO: Dr. John S. Zapp

WHAT IS ITS MISSION?

The American Dental Association (ADA) is a professional association of dentists that seeks to serve the profession of dentistry and the public health. The ADA's mission is to promote the oral health of the public by working with member dentists to make quality care available to everyone and to promote the profession of dentistry by monitoring and defining the ethics of the profession, improving patient/dentist relationships, and offering information and resources to its members. Through education, advocacy, research, and the development of standards, the ADA works to accomplish these goals.

HOW IS IT STRUCTURED?

The national headquarters of the ADA is located in Chicago, Illinois. The board of trustees, the organization's administrative body, is composed of a president, president-elect, two vice presidents, and 16 trustees. Each trustee represents one of 16 geographical districts of the United States. The organization's executive director also sits on the board of trustees as an ex-officio member.

The House of Delegates, which acts as the organization's legislative body and convenes once per year, is made up of 423 delegates representing 54 constituent societies, namely ADA state or territorial branch associations. The House of Delegates also contains representatives from five federal dental services and the American Student Dental Association. The speaker of the House of Delegates attends meeting of the board of trustees but does not have voting rights.

The ADA has 16 councils and committees that recommend policy, each representing a particular field of special interest. Their members study issues related to these areas of interest and recommend policy and policy changes to the board of trustees and the House of Delegates. Areas of interest represented by councils and committees include dental practice, ethics, insurance and scientific affairs.

The ADA Health Foundation (ADAHF) was established in 1964 by the board of trustees as a means to provide charitable support. The ADAHF sponsors a variety of research and educational programs, offering student scholarships to dental students and grants to fund research studies. The ADAHF also sponsors national conferences such as the Annual Conference on Special Care Issues in Dentistry and the Dental Research Conference.

PRIMARY FUNCTIONS

The ADA is a multi-faceted organization that assists dentists, as medical professionals, in maintaining a high standard of conduct, ethics, and professionalism in dentistry. It also educates the public regarding oral hygiene and health.

The ADA offers many support services for member dentists. Some of the services most often used by dentists include the publications Journal of the American Dental Association (JADA) and the ADA News, insurance plans, continuing education programs, and ADA's Occupational Safety and Health Administration (OSHA) compliance information. The organization also offers members legislative newsletters, financial services, library resources, and infection control recommendations. Dentists also benefit from the ADA's involvement in the research and development of new technology. The ADA also lobbies Congress on behalf of dental professionals in areas such as Medicare and Medicaid, malpractice law, and health care reform.

To practice dentistry in the United States, one must first receive a license to practice from a state or regional authority. While not an official part of this accreditation process, the standards and tests that the ADA administers are widely used in the licensing process. A degree from an ADA-accredited college is accepted throughout the United States as proof of adequate dental education. The ADA's National Board Dental Examinations are also widely used to measure the skills and knowledge of an applicant for a license. As a condition of membership, every ADA member agrees to abide by the ADA Principle of Ethics and the Code of Professional Conduct (ADA Code). According to the code, members "recognize that continued public trust in the dental profession is based on the commitment of individual dentists to high ethical standards of conduct."

The ADA provides numerous educational tools to the public. Through its award-winning Web site, the organization offers free information on oral hygiene. In addition consumers can access information on topics such as tooth whitening, fluoridation, dental amalgam, bad breath, cleaning teeth and gums, and gum disease. The Web site also offers a Kids' Corner with information geared specifically towards children.

PROGRAMS

The ADA sponsors a number of programs that promote professional growth, patient information, and consumer awareness. Each year at the annual session of the ADA House of Delegates thousands gather not only to consider legislative matters, but also to participate in a plethora of educational experiences. Almost 30,000 dentists, dental assistants, dental hygienists, business assistants, and guests attended the 1997 annual meeting. Attendees were able to interact with almost 8,000 exhibitors and dental dealers during the three-day session. The ADA sponsors and co-sponsors various events geared toward dental professionals, among them the National Conference on the New Dentist, a two-day workshop titled "Dentistry as a Business: Money, Management, Marketing, and You," and a seminar geared towards accreditation in the dental office.

Since its inception in 1964, the ADAHF has held an annual Health Screening Program. Each year member dentists are offered free screenings of basic health tests. During the 1990s the ADA added two new tests to its screenings: latex allergies and HIV. Because dentists use latex gloves during treatment, allergies to latex can cause serious problems. Also dentists come into contact with patients' body fluids and operate with sharp instruments, thus raising their risk of exposure to the HIV virus.

The ADA assists consumers with choosing dental products through its Seal of Acceptance program, which boasts 350 voluntary participants. Publishing its first critique of toothpaste in 1866 and establishing guidelines for testing and advertising in 1930, the first ADA Seal of Acceptance was awarded in 1931. Approximately 1,300 products carry the ADA Seal of Approval; of these, approximately 30 percent are public consumables such as toothpaste, floss, and toothbrushes. The rest, such as antibiotics and dental restorative materials, are used by dentists.

BUDGET INFORMATION

Each year a preliminary budget is drawn up based on all budget requests by a committee consisting of the ADA's president-elect, treasurer, and executive director. The budget is then presented to the board of trustees for approval; once approved, it goes before the House of Delegates for final approval. For 1999 the ADA had a proposed budget of $65.3 million, with revenues anticipated to reach $65.1 million. A dues increase of $82 was proposed to balance the budget, fund renovations to the building housing ADA headquarters, and boost ADA reserves.

HISTORY

The ADA came into existence in August 1859 when 26 dentists met in Niagara Falls, New York, to form a professional society. The association was formed to improve communication regarding advances in technology, offer support and dialogue among dentists, and improve the consistency of care dental patients received. A year later the ADA formalized its newly structured organization by adopting a constitution and bylaws. By 1890 the organization was competing for members with almost 100 other dental societies, and in 1897 merged with the Southern Dental Association to form the National Dental Association (NDA). By 1899, already in existence for 40 years, the NDA had fewer than 250 members. In response, membership policies were revised to attract new members.

1900–1930

In 1908 the NDA published its first patient dental-education pamphlet. In the same year, with membership now growing quickly, the NDA also instituted the beginnings of a tripartite membership structure, in which members belong to a local association, a state or regional association, and the national association. In 1913 the NDA continued to strengthen its structural base by adopting a new constitution and bylaws and by establishing the House of Delegates and board of trustees.

During the early 1900s the NDA developed a relief fund, established group health insurance, and began publication of the Journal of the National Dental Association.

In 1928 the NDA worked with the National Bureau of Standards (NBS) to establish the National Board of Dental Examiners. The NDA changed its name to the American Dental Association in 1922 and by 1929 the newly renamed organization boasted a membership of 30,000. Its journal, now called the Journal of the American Dental Association, was hailed as the leading publication in dental literature.

1930–1960

During the 1930s the ADA's membership increased by 6,000, rising to a total of approximately half of all dentists practicing in the United States. In 1934 it joined the U.S. Public Health Service to give dental exams to 1.5 million children in 26 states. During World War II (1939–1945) the ADA worked to obtain preferential purchase of automobiles, gasoline, and dental supplies for dentists. In so doing, members were able to obtain supplies that were in short supply due to the war and not readily available to the general public. By the close of the 1940s 85 percent of U.S. dentists held membership in the ADA.

In 1950 the ADA lobbied Congress to declare February 6 as National Children's Dental Health Day. In the same year the ADA publicly endorsed the importance of fluoridation in dental health. Fluoride is a natural element that helps prevent tooth decay when consistently ingested or applied topically. In 1955 the ADA successfully lobbied the World Health Organization to establish a dental unit and began developing television advertisements and scripts. The 1950s also saw substantial improvements in dental equipment, with new and more effective X-ray machines and tooth repair materials being introduced into use.

In 1954 an ADA-NBS research team made an important advancement in dental instrumentation with the creation of the turbine contra-angle handpiece. Two years later research teams also developed panoramic X-ray equipment and glass-filled resin composites, the latter an improved substance used in the repair of teeth. Already involved in accreditation of dentists through its affiliation with the NBS, the ADA established accreditation programs in postgraduate training for dental laboratory technicians (1951), dental hygienists (1952), and dental assistants (1962).

1960 to the Present

During the 1960s the ADA stepped up its public health campaign, dedicating one-third of its funds to dental education activities. In 1964 the ADA Health Foundation, formed to support research and education, began its annual health screening program. The organization also became the first nonprofit agency to produce a color public service announcement for television.

In 1965 the ADA relocated within Chicago, Illinois to its new headquarters building on Chicago Avenue. The agency also moved the NBS testing and certification programs into the building. Two floors of the building were dedicated to laboratory facilities for ADA's research arm, the Research Institute. In 1966 the ADA Council on Dental Materials and Devices was established.

In 1970 ADA News was published for the first time. The ADA Council on Dental Practice (1978), the Commission on Dental Accreditation (1979), and the Division of Membership and Marketing Services (1980) were established. During the late 1970s the organization began budgeting funds for national print and television test marketing campaigns and discussing the growing interest in creating a branch office in Washington, D.C., which eventually opened in 1984. In 1989 the ADA Publishing Company (ADAPCO) was incorporated as a for-profit subsidiary of ADA. ADAPCO took over all publishing aspects of the ADA, including JADA and the ADA News.

With the opening of its Washington office, the ADA increased its lobbying efforts during the 1990s. Through legislative and legal means, the ADA aggressively battled the OSHA regulations and the National Practitioners Data Bank. Both agencies advocated laws and regulations that the ADA believed to be detrimental to both dentists in providing quality care and the public in receiving quality care.

CURRENT POLITICAL ISSUES

The ADA has long been involved in advocating for both the public's right to quality dental care and for the profession of dentistry. In the mid-1990s the high cost of health care, along with the complex statutes governing health insurance and health care providers, prompted many calls for reform. Debate raged in Congress and the media, a debate in which the ADA was heavily involved. The ADA has traditionally used its resources to lobby for legislative and regulatory reforms that would benefit member dentists and has often found itself standing against the insurance company lobbyists. While the organization advocates for increasing both the number of dental procedures covered by health insurance and the benefits paid for such procedures, insurance companies struggle to keep escalating health care costs in check by limiting allowable procedures and benefits to patients.

Case Study: The Patient Access to Responsible Care Act

The ADA's long-term health care reform goal, as stated in a February 23, 1998, "action alert" letter to dentists from ADA President David A. Whiston, is to create a "health care system that controls costs, allows patients to choose their own doctors, gives subscribers access to information to make smart choices, and offers appeals when coverage is denied." When Representative Charlie Norwood (R-GA) introduced House Bill 1415 in April of 1997, the ADA immediately moved to support it. This bill, better known as the Patient Access to Responsible Care Act (PARCA), was just what the ADA had been hoping for.

The ADA strongly supported several provisions of PARCA. The most significant changes proposed in the bill were in the area of a medical insurer's accountability to their clients. PARCA would grant patients new rights to appeal treatment decisions that they disagree with and to sue insurance companies for decisions which proved harmful. So-called "gag rules," which allow insurers to restrict medical practitioners from discussing certain treatment options, would also be banned. According to the ADA, these changes would allow patients more choice in treatment and hold insurers responsible for the consequences of their decisions to deny coverage for certain types of medical care. Importantly, the ADA insisted that PARCA could be implemented without major increases in the cost of medical insurance. According to a study sponsored by a pro-PARCA organization, if a patient's insurance premium was $160 per month under the existing laws, the increase in costs caused by PARCA would be no more than $4.16 per month, less than a three percent increase.

PARCA's Opponents

PARCA's opponents were numerous. Both the Health Insurance Association of America and Blue Cross/Blue Shield Association lobbied against its passage. Such organizations as the Self-Insurance Institute of America (SIIA) and the Association of Private Pension and Welfare Plans (APPWP) also joined together to wage a one million dollar advertising campaign against PARCA.

Opponents of PARCA claimed that by making insurance companies subject to many new and costly lawsuits, PARCA would force insurance companies to drastically raise their prices. According to the numbers put forth by PARCA's opponents, the act would increase health insurance premium costs by approximately 23 percent. They further estimated that with such a price increase, nine million people would lose insurance coverage because their employers would no longer be able to afford to pay for insurance benefits. Thus, while SIIA and APPWP both affirmed the need for better patient protection, they viewed PARCA as overly extreme legislation that would do more harm than good.

New Legislation

Eventually, PARCA's opponents won out. In June of 1998 PARCA was effectively abandoned by its sponsor, Representative Norwood. While Norwood supported another patient protection legislation developed by other House Republicans—the ADA criticized the new bill. In a statement released in June of 1998, ADA President David Whiston stated that the new legislation failed to make health insurers liable to their patients, and that the "proposal ignores the need for health plan liability and its patient choice provisions are so weak and riddled with exceptions that millions of Americans will still be denied real choice." Nevertheless, this bill went on to pass the House in July of 1998.

Public Impact

The health care debate continued to loom large on America's political and economic agenda as the nation moved into the twenty-first century, and the ADA still pushed for measures such as those proposed in PARCA. The organization has much to gain from the passage of legislation that impacts patient and provider rights. By working for these new laws, the ADA also works to fulfill its mission. If patients are offered more comprehensive services by insurance companies, dentists will be better able to provide quality services to more people. Also, if insurers covered more medical procedures and treatments, being pushed to do so under the threat of law suits should a patient be adversely affected by treatment being withheld, the profession of dentistry benefits from more patients with more coverage and more choices.

FUTURE DIRECTIONS

The ADA is seeking to serve its members better in a number of areas, including advocacy, practice support, information, and research. In order to become a better advocate for its members, the organization plans to increase its lobbying efforts on such issues as access to care and insurance coverage. In the area of practice support, the ADA has plans to promote education in several areas including dental reimbursement systems and debt management. Access to more information will focus on the use of new technology to increase information available to both member dentists and the public. The ADA also planned to use its research capabilities to push technology in such areas as a vaccine to prevent cavities and the use of lasers rather than drills to repair cavities.

GROUP RESOURCES

The ADA maintains a comprehensive Web site which can be accessed at http://www.ada.org. The site offers a number of informational resources for the consumer, the dental student, and the dental professional. For dentists, ADA Online features the ADA News Daily, select articles from JADA, legislative newsletters, ADA library information, and an event calendar. Dental students can find dental career fact sheets, information on dental schools and programs, and information on testing and financial planning. Patients and consumers will find numerous topics addressed, including a list of frequently asked questions and a Kids' Corner. Although most services offered at the Web site are available to everyone, some information requires ADA membership and is accessed only with an ADA membership number.

GROUP PUBLICATIONS

All ADA publications are produced and distributed by ADAPCO. JADA is the ADA's primary published resource and is distributed monthly to all members. Its mission is to provide dentists with information that will help dentists in practice and science. JADA is also published by ADAPCO in Spanish and Portuguese for distribution in Spain and numerous South American countries. The ADA News is published 22 times a year, and focuses on socioeconomic and political developments. The ADA Legal Adviser, which covers all legal issues affecting dentists, is published in conjunction with the ADA Division of Legal Affairs. It is a monthly newsletter available by subscription. The ADA Washington Report discusses the legislative and regulatory activities related to health care. It is distributed to key dental leaders and can be found in its entirety at ADA's Web site. ADAPCO also publishes several guides and pamphlets covering various topics related to dentistry. Information on all ADAPCO publications can be requested on-line at http://www.ada.org/adapco, by E-mailing ADAPCO at adapco@ada.org, or by phone at (312) 440-2867.