After a year delay to allow applicants time to prepare, the 2018 class will be the first impacted by the new CE requirements.

The American Board of Dental Sleep Medicine (ABDSM) in October 2016 announced “an immediate change” to one of its 2017 dental sleep medicine exam eligibility requirements related to continuing education (CE) credits.

According to the ABDSM release announcing the change, certification guidelines previously released in the summer of 2016 stated, in part, that applicants must have earned the required CE hours from “a dental sleep medicine-focused, nonprofit organization or accredited dental school” in order to sit for the 2017 exam.

The decision to only accept CE credits earned from nonprofits was not unanticipated, as it was first mentioned in the Clinical Practice Guidelines for the Treatment of Obstructive Sleep Apnea and Snoring with Oral Appliance Therapy: An Update for 2015, jointly released by the American Academy of Sleep Medicine and the American Academy of Dental Sleep Medicine (AADSM).

However, “in order to provide applicants with sufficient time to prepare for this change,” the ABDSM board of directors put the requirement on hold for the 2017 exam, they said in the release, and allowed applicants to submit CE credits earned from for-profit providers. This makes the 2018 ABDSM exam for dentists seeking Diplomate status, for which the application deadline closes Oct 23, 2017, the first to enforce the new CE requirements.

Steve Scherr, ABDSM president, DDS, Diplomate, said via e-mail that the decision to only accept credits earned from nonprofit providers for the 50 required CE courses is to make certain dentists seeking Diplomate status have met the strictest criteria.

“The requirement that CE hours must come from a nonprofit organization or accredited dental school helps ensure that courses are credible and well-respected by industry peers, physicians, and patients, and that ABDSM Diplomates gain fundamental and unbiased knowledge of the industry,” Scherr told Sleep Review.

“While for-profit courses can help dentists learn about tools of the trade, any organization that stands to profit from teaching attendees to use a specific device or service cannot provide unbiased, educational instruction,” Scherr continued. “This change was also implemented to ensure that the eligibility criteria for the ABDSM exam are consistent with the Qualified Dentist qualifications outlined in the joint AADSM and American Academy of Sleep Medicine clinical practice guideline for oral appliance therapy.”

The ABDSM is an independent board of examiners established in 2004, which replaced the Certification Program of the AADSM. It is a professional organization for dentists who treat snoring and obstructive sleep apnea with oral appliance therapy. Currently, there are more than 325 Diplomates of the ABDSM.

Beyond earning the required number of CE hours, applicants must meet other requirements including submitting letters of recommendation from 2 board-certified sleep physicians and completing observation hours at a sleep center, according to

The change is likely to have a negative impact on for-profit dental CE providers, including oral appliance manufacturers whose ADA CERP [American Dental Association Continuing Education Recognition Program] and AGD PACE [Academy of General Dentistry Program Approval for Continuing Education] courses were accepted toward Diplomate status until now. No manufacturers that Sleep Review contacted were wiling to speak on the record about the change’s impact on their course offerings.

Though complicated, for-profits and non-profits can be linked, reports Inc. magazine and other sources. Inc. states, “In some cases, one is a subsidiary of the other; in others, the two entities are bound by long-term contracts in which one entity fulfills a basic need for the other and vice versa.” CharityLawyer reports that joint ventures between nonprofits and for-profits are most common in the healthcare sector. So dental sleep medicine may see manufacturers link themselves with nonprofit education ventures as a result of the CE change. However, the IRS can typically take up to a year (or, occasionally, even longer) to determine whether an organization will be granted nonprofit status.

Longtime ABDSM Diplomate, Anthony Dioguardi, DMD, DABDSM, supports the move to credits earned in for-profit CE provider courses no longer counting toward the ABDSM exam. “For-profit organizations, including companies that provide CE and other services, exist to, among other things, maximize profit,” he said via email. “This profit motive might create a bias with regards to the contents of that CE. This bias might be expressed in the form of screening protocols, equipment, imaging, services, or anything else that may or may not be recognized as necessary or appropriate by the medical community.

“This bias is not exclusive to CE. We all understand the difference between a public service announcement and an infomercial. In my opinion, an unbiased education in dental sleep medicine is necessary to provide a foundation to at least objectively evaluate the information presented.”

In addition to courses hosted by the AADSM, CE courses taken at public colleges, universities, and other nonprofits will still count toward Diplomate status, ABDSM’s Scherr confirms.

“ABDSM accepts credits from a wide variety of organizations, including ADA CERP-recognized or AGD PACE-approved continuing education credits in dental sleep medicine or sleep medicine courses that are provided by a nonprofit organization or accredited university,” Scherr said. “Dentists can visit the Qualified Dentist page on the AADSM website for a list of educational opportunities offered by dental sleep medicine focused nonprofit organizations and accredited dental schools.”

Dioguardi calls upon dental schools nationwide to do a better job of providing students with dental sleep medicine education. “Here at Yale, our dental, oral surgical, and pediatric dentistry residents come to our program with little to no background in sleep medicine. I see this as a serious deficiency in our dental school education system,” said Dioguardi, who founded the Yale-New Haven Department of Dentistry’s Section of Dental Sleep Medicine “to at least minimally address their lack of training in this field.”

“I believe it is time for dental schools to step up and provide far more graduate and post-graduate education in dental sleep medicine,” he said. “Until then, I’m grateful that the AADSM is there to provide resources to dentists who are interested in dental sleep medicine.”

To confirm that a particular CE provider is a nonprofit organization, the ABDSM recommends visiting where a comprehensive list of all IRS-designated nonprofit organizations is published.

Chuck Holt is a Florida-based freelance writer and editor.