only a single elective course, for example, or material information may be imparted via guest lecturers. Additionally, exposure to clinical experiences is lagging behind the didactic requirements. Of the students graduating in 2001, almost 20 percent did not feel prepared to care for the elderly population, and 25 percent felt the geriatric dental curriculum was inadequate (Mohammad et al., 2003).

The American Dental Association currently does not recognize geriatric dentistry as a separate specialty, and none of the 509 residencies recognized by the American Dental Education Association are specifically devoted to the care of geriatric patients; in contrast, specialty recognition and 71 residencies exist for pediatric dentistry. In fiscal year 2005, HRSA supported seven residency programs in pediatric or general dentistry; one program specifically requested funds to improve clinical and didactic curriculum in geriatric dentistry, but the residency is not focused on geriatrics (HRSA, 2005b). The VA’s Advanced Fellowship in Geriatrics program allows dentists (and other health care professionals) to pursue advanced research in geriatrics at one of 16 GRECCs (VA, 2007a). Previous VA fellowships in geriatric dentistry are no longer available. As mentioned previously, HRSA administers the Title VII Geriatrics Health Professions Program, which includes awards to institutions to prepare geriatrics faculty in dentistry, medicine, and behavioral/mental health.

The American Board of General Dentistry (ABGD) offers board certification in general dentistry following completion of a post-graduate residency; exam content does not explicitly require questions on geriatric care or on special-care dentistry, but it does explicitly require knowledge of pediatric dentistry (ABGD, 2007). Also, while the ABGD’s general dentistry certification process has minimum requirements for continuing dental education in several areas (e.g., periodontics, orthodontics, and pediatric dentistry), it has no minimum requirements for “special patient care,” although it is a listed category. The American Society for Geriatric Dentistry (ASGD), part of the Special Care Dentistry Association, offers fellowship status to ASGD members who meet requirements for post-graduate and continuing education and who pass an oral examination. The American Board of Special Care Dentistry further offers diplomate status to ASGD fellows based on time in practice and membership in the SCDA. The American Dental Association, however, does not recognize this specialty board.

Less is known about the geriatric education and training of dental hygienists, although dental hygienists are increasingly important in providing care to special populations, especially those in rural areas and long-term care settings. Dental hygienists usually earn associate degrees, but some programs grant up to a master’s level degree. Dental hygienists are licensed by individual states, must pass written and clinical examinations, and have variable requirements for continuing education. While all schools have in-



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