(The Center Square) – Legislation recently introduced in Pennsylvania would address the state’s dental workforce shortage while ensuring patient safety.
House Bill 787, the Interstate Dental & Dental Hygiene Licensure Compact, is backed by the American Association of Dental Boards and would allow dental professionals with Compact privileges to seek licensure in Pennsylvania while maintaining high standards – including hand skills examinations.
States must pass legislation authorizing their institutions to participate in the compact.
According to Rep. Robert Merski, D-Erie, the bill’s prime sponsor, between 2001 and 2021, the number of dentists per capita decreased by 7% in the commonwealth.
Requiring a practical hand skills exam in dental licensing aligns with public sentiment, as revealed by a recent national survey commissioned by the association.
The survey of 1,863 registered U.S. voters, conducted from Dec. 30, 2024, to Jan. 9, 2025, found that 82% of Americans believe hand skills examinations are necessary to assess a dentist's ability to perform procedures safely.
“The Interstate Dental & Dental Hygiene Licensure Compact supports high standards while promoting portability, which is especially important given the number of dental schools in Pennsylvania,” said Dr. John Erhard, III, former chair of the Pennsylvania State Board of Dentistry. “This compact ensures patient safety and maintains public trust in our profession by requiring practical hand skills tests and continuing education.”
Erhard told The Center Square he believes the government’s primary role in dentistry is to prioritize the protection of its citizens.
While dental licensing requirements across the U.S. are generally similar, they may vary to some degree. He explained that the main objective of the legislation is to enable professionals to easily move between states with consistent standards.
Dental professionals would continue to be licensed by their home states, but applying through the compact streamlines the process of obtaining licensure in other participating states.
Erhard noted there are only four states that currently do not require hand skills exams for licensure. Dental professionals from those states would need to retake the licensure exam if relocating to one that does.
He did, however, note a caveat: if an individual practiced successfully for five years without notable disciplinary actions, they could apply for their license by credentials.
“It’s important that these skills are tested independently,” he said. There are physical processes that involve sound operational technique and good hand eye coordination, “and being able to do these things in a mirror and in very limited space.”
He pointed out that states that do not require hand skills exams report twice as many malpractice cases as states that do.
Additionally, entering the compact would be especially helpful to members of military families who work as dental professionals due to their frequent moves, he said.
Erhard highlighted the differences between House Bill 787 and that of Senate Bill 81, recently introduced by Sen. Frank Farry, R-Langhorne.
The Senate version would have Pennsylvania join the Dentist and Dental Hygienist, or DDH Compact – a similar agreement, but with different and less stringent requirements.
The AADB Compact preserves state authority by prohibiting rule-making that overrides state law, requires the transfer of disciplinary actions, mandates hands-on skills exams, and maintains state board authority over licensing oversight. Each state nominates two individuals to serve on the commission.
Seven other states, including Texas, Oklahoma, Missouri, Maryland, Massachusetts, Mississippi, and Kentucky, have pending legislation that would opt them into the AADB Compact.
In contrast, the DDH Compact grants broader rule-making power and can override conflicting state law unless a majority of states reject a rule within a certain timeframe, limits state board oversight, lacks mandatory sharing of disciplinary actions, and does not require hands-on testing. Additionally, its commissioners are appointed – raising concerns about reduced state control and oversight.
To date, at least seven states – Iowa, Washington, Wisconsin, Tennessee, Virginia, Kansas, and Maine – have enacted the DDH Compact.
House Bill 787 has been referred to the House Professional Licensure Committee, while Senate Bill 81 is currently before the Senate Consumer Protection & Professional Licensure Committee for consideration.
