Fall 2001 Executive Director's Report

While some California PCSO members are aware of the many ongoing political activities affecting their practices, members outside the state may not. Hopefully, these issues won’t "migrate" to the rest of the nation. Here’s a brief update.

Prop. 65

In 1986, California voters approved a ballot initiative that required businesses with 10 or more employees to post signs warning of on-site hazardous materials. We’ve all seen the signs outside restaurants warning of the risks to pregnant women of drinking alcohol.

As part of the law, the State identified over 250 hazardous materials, some of which are found in some orthodontic appliances. The penalties for non-compliance can reach up to $2500 per day.

Last year, attorneys served notice on 80 California dentists, requiring them to post a sign warning of the risks of mercury, nickel and other materials.

These activities received the immediate attention of the Calif. Dental Association, which has since been representing the 80 dentists and negotiating with the attorneys who brought the actions.

A number of California members with over ten employees have posted the signs, although to our knowledge there is no scientific evidence to prove harm from orthodontic appliances.

Last year, lawsuits were filed against some orthodontic appliance manufacturers. The result was the placement of warning labels on some of the products you purchase.

In May, the Calif. Assn. of Orthodontists (CAO) obtained from the Orthodontic Manufacturers Association a scientific toxicology report that provides strong evidence that the levels of nickel in appliances is not significant and falls well below the risk standards set by Prop. 65.

Negotiations between the CDA, the Attorney General, and consumer groups are about to reach their conclusion. I will report the final agreement in the next issue.

California Dental Board Activities

Last summer, the Dental Board (DB) voted down a proposal to adopt license by credential regulations in the state. Some in the California Legislature have strongly objected to the DB’s decision and legislation has been proposed to "sunset" all Board members and staff, as of July 1, 2002. There is little to suggest that this legislation won’t be approved.

Dental Auxiliary Duties

For several years now, an ad hoc committee of auxiliary and dentists have been meeting to revise the duties performed by the various categories of dental auxiliary. Perhaps because the committee was formed under the agency that oversees auxiliary activities, dentists were outnumbered 6 to 5.

In the end, although much progress had been made on changing duties to streamline treatment, especially for orthodontists, the auxiliary had their way, dumping the committee work of several years and recommending the formation of a separate Board for auxiliary. The recommendation includes a proposal to place into statute (law) parts of the Dental Practice Act, making those parts more difficult to modify.

CAO and all the other dentists on the committee voted against the recommendations, which now go to the Committee on Dental Auxiliary, before moving on to the Dental Board for a final hearing. Ah, politics.

Sterilization Regulations

Current California regulations require that critical and semi-critical instruments be bagged before, during, and after sterilization, and remain so until ready for use. This includes instruments such as pliers and mirrors, in addition to those with a more invasive intent! Some California orthodontists have completely overhauled their sterilization process and equipment, at great cost.

Another ad hoc committee has been meeting this year to evaluate the regulations and make recommendations to the Dental Board. Progress is being made, although a final report will not be completed until later this year.

Earlier this year, CAO asked the Dental Board to appoint this committee and is represented at all meetings. We are unaware of any scientific evidence that shows that patients are at less risk when semi-critical instruments are kept bagged until used.

CAO continues working with others to simplify the sterilization process, although it’s an uphill battle.

Licensure by Credential and Specialty Licensure

It seems a foregone conclusion that the California Legislature will approve some form of licensure by credential, this year or next. Presently, dentists with licenses from other states may not practice in California without a California license.

CAO is preparing to participate on yet another committee to study and make recommendations on specialty licensure. In meetings with the state’s dental specialty organizations, we have learned that there is a strong difference of opinion on the matter. CAO has not yet formed a position, but will be doing so soon.

Those are the major issues. The difficulties between the Legislature and Dental Board are particularly troubling. CAO has developed relationships with many of the Board’s members and maintains a strong voice in the state’s dental politics as they effect CAO/PCSO members. An entire new Dental Board, which may be re-constituted, possibly with fewer dentists, will require a renewed effort to get to know and influence.

For the latest update on these issues, visit the CAO website (www.caortho.org).

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