The accreditation testing process comprises three parts: a written exam, clinical case evaluations, and an oral exam. The written exam tests foundational knowledge in cosmetic dentistry and is administered at the Annual Scientific Session. Like me, you probably said that you would never take another written exam after dental school. But members routinely report that the examination is fair and the rate for passing is more than 90 percent.

The clinical case submissions are the heart of the testing process in which candidates demonstrate clinical and diagnostic excellence in all phases of cosmetic dentistry. Cases submitted must offer a balanced mix of cosmetic treatment options that candidates face in esthetic treatment planning. Case selection is critical to success in this phase of the accreditation process.

The five case types for clinicians are:

Case Type 1

This presentation involves six or more indirect restorations within the maxillary arch, treating at least the incisors and canines. The key to delivering an optimal case presentation is to ensure that a clinician’s ability to create an open, working, and successful rapport with the laboratory technician is evident from start to finish. Smile design elements weigh heavily with this case type. While the restorations can be crowns, three-quarter crowns, veneers, or any combination of these, it is critical that a practitioner demonstrate his or her ability to carefully and accurately address a patient’s condition, esthetics, and overall oral health.

Case Type 2

This case should involve one or two indirect restorations in the maxillary anterior region treating incisors, and the adjacent teeth must have no indirect restorations. The challenge with this case type is in evaluating the clinician’s ability to match the natural surrounding dentition. Smile design will be less significant in these cases, but it is critical for the clinician to deliver a natural-looking result that adheres to predetermined esthetic parameters.

Case Type 3

In this presentation, the clinician should demonstrate an ability to deliver esthetic results via a fixed partial denture or implant-supported restoration. The FPD should contain at least one pontic that replaces a maxillary incisor or canine. If an implant restoration is placed, it should include a root form implant into the maxillary anterior edentulous space, and a radiograph must be included to show the space or failing tooth prior to implant placement. This case provides the evaluators with an impression of the candidate’s ability to establish soft tissue esthetics within the edentulous space.

Case Type 4

This case consists of an anterior direct resin (Class IV or diastema closure) restoration in which the candidate’s ability to blend composite resin with the natural dentition is evaluated. In cases demonstrating diastema closure, the space should measure at least 1 mm. Two adjacent teeth (i.e., maxillary incisors or canines) must be treated. Class IV restorations should be performed to replace a minimum of 10 percent of the tooth structure on the facial surface of one or more maxillary incisors. Because the focus of this case is to evaluate the candidate’s ability to match the natural dentition in shape, size, and shade, the overall smile design may be less critical.

Case Type 5

This case involves six or more direct resin veneers treating at least the maxillary incisors and canines. Case Type 5 will test the candidate’s ability to create an optimal esthetic result using direct composite resin materials. The emphasis of evaluation is on smile design and tooth morphology. Care must be taken to develop a functional and esthetic result using a direct technique with composite resin.

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The oral exam completes the process in which the clinician reviews his or her cases with examiners and provides solutions to a hypothetical clinical case.

Because laboratory technicians play such a vital role in the success of the cosmetic dentist, the AACD has established an equally rigorous accreditation process for these key professionals. The accreditation process encourages the dentist and ceramist to work as a team toward their individual accreditations.

Challenging? Yes. While the standards are high, the AACD’s accredited members will tell you it was one of the best decisions he or she has made as a professional. You will enjoy the camaraderie and your practice will be stronger for the effort. To hear a few AACD accredited members talk about credentialing and the impact the process has had on their lives, visit the AACD Web site at www.aacd.com. Choose “Credentialing” for the video. If you prefer, contact the AACD at (800) 543-9480. I wish you the best in your pursuit of excellence.

Dr. Bradley Olson is a 1983 graduate of The Baltimore College of Dental Surgery, Dental School, University of Maryland. He is one of approximately 260 dentists internationally to achieve accreditation status in the American Academy of Cosmetic Dentistry. In addition, Dr. Olson has achieved the AACD’s highest credentialing honor by becoming the 39th member awarded fellowship in the academy. He was further honored by the Academy when asked to serve as a consultant and examiner for the accreditation process and is a past Chairman of Accreditation. He has lectured, been published, and won a photography award for his work in the field of cosmetic dentistry. Contact him at (301) 645-6611 or via e-mail at brad@smileimages.com.