Specialty recognition for oral and maxillofacial radiology: What does it mean?

In a recent editorial in this journal, Dr. Daniel Orr II discussed the process of recognition of specialties in dentistry and some of the issues and problems associated with this process. I am a member of the ninth specialty recognized by the American Dental Association (ADA), Oral and Maxillofacial Radiology (OMR) – but not actually in my state of Michigan, which lists by name those specialties it recognizes at the state level. It would require a change in the Public Health Code for me to be considered a specialist in Michigan. How did Oral and Maxillofacial Radiology become an ADA-recognized specialty, and what difference does it make to OMRs and dentistry as a whole? The story began many years ago, long before OMR was finally granted specialty status by the ADA House of Delegates. According to a history timeline published on the website of the American Academy of Oral and Maxillofacial Radiology (AAOMR; http://www.aaomr. org), the first oral radiology organization started in 1921 as the American Society of Dental Radiographers, only twenty five years after the first dental radiograph was made. This organization lasted only a few years before it folded, but a new organization, The American Academy of Dental Roentgenologists, was established in 1949. This organization still exists today as AAOMR, having undergone a number of name changes over the years. The members of the group were, and still are, actively involved in education, research and patient care. In 1968, the Academy filed its first application to the ADA for specialty status, but it was disapproved by the ADA Council on Dental Education. The second application in 1970 was also denied. Further applications for specialty status were then put on hold. Meanwhile, in 1979, the American Board of Oral and Maxillofacial Radiology (ABOMR) was formed. The first diplomates of the Board were recognized by credentials, but in 1983, the Board began administering certifying examinations. I passed the examination in 1984, becoming a Diplomate of the Board. What did this get me? At the time, nothing other than to prove to myself and those who cared that I knew a lot about all the facets of oral radiology: physics, biology, technique, safety, and interpretation. Because OMR was not a recognized specialty, diplomate status did not really change things for me. AAOMR was not ready to give up on the idea of specialty recognition, however. It submitted applications in 1993 and 1995. At the ADA House of Delegates in 1996, OMR became a specialty – for one day. However, the next day the issue was brought up again and the decision overturned. The same application was reconsidered in 1997 – and denied. In 1998, another application for specialty status was submitted, and this time, in 1999, it was approved by the ADA House of Delegates. On October 13, 1999, Oral and Maxillofacial Radiology became the ninth dental specialty recognized by the ADA. What has specialty recognition meant for OMRs and the profession of dentistry? At the beginning, not much was changed. Many dentists did not even realize that OMR had become a specialty. After all, dentists were used to being their own radiologists. The majority had intraoral x-ray machines in their offices, and many were adding panoramic radiography capability, and they felt comfortable with interpreting these images. Maybe not the panoramic view all the time, but then, there was always their old x-ray professor at the dental school they attended, so they could get another opinion – for free – if they needed it. At this point, the majority of OMRs were on the faculty of dental schools, involved primarily in education and research. Some of them established imaging services in their institutions, but in general