The Fulcrum Podcast

Episode 29 - The Drill, AUGUST 2026

Virginia Dental Association Episode 29

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SUMMARY: Ryan Dunn, CEO of the Virginia Dental Association, shares updates on VDA initiatives supporting professional development, practice success, and advocacy.

  • Virginia Dental Showcase: Sept. 18–19 at The Omni Homestead Resort, featuring networking, an exhibit hall, and 18 hours of CE covering finance, practice ownership, AI, caries/biofilm, wellness, and more.
  • Practice Success: Learn about CART (Confidential Assessment and Review of Treatment), a member benefit for confidential incident review and patient safety/quality assurance. He also highlights the Oct. 6 VDA–VCU Career Fair for practice recruitment.
  • Advocacy: New workforce laws expand duties for qualified dental assistants following required training. VDA is developing curriculum and raising awareness about hygiene workforce shortages.
  • Medicaid Update: The adult Medicaid dental spending cap remains unchanged for now. Provider input sessions are planned, and practices should wait for formal guidance before making changes.

HOST: Ryan Dunn is the CEO of the Virginia Dental Association. Ryan has played major roles in four national and statewide Associations while also working on Capitol Hill. When he’s not talking all things dental, he’s talking about his family and baseball–and sometimes both at the same time.

MENTIONED IN THIS EPISODE:

2026 Virginia Dental Showcase

CART – Confidential Assessment and Review of Treatment

VDA/VCU Career Fair

Workforce Updates

EPISODE CREDITS:

Producer: Paul Logan

Host: Ryan Dunn

Post-Production/Editor: Shannon Jacobs

Subscribe, share, and send your feedback and topic ideas to thefulcrumpodcast@vadental.org.

The information, opinions, and recommendations presented in this Podcast are for general information only, and any reliance on the information provided in this Podcast is done at your own risk. This Podcast should not be considered professional, medical, or legal advice. 

Music in this episode from Epidemic Sound

SPEAKER_00

Hello and welcome to another episode of The Drill. I'm Ryan Dunn, CEO at the Virginia Dental Association. And in each episode of The Drill, we break down just a handful of the items that the VDA is currently working on, and we stay within our three areas of focus from the VDA strategic plan. They are powerful advocacy, practice success, and professional development. And today we're going to get started with professional development. There is a great opportunity for you to continue to advance your professional development at the Virginia Dental Showcase, which is coming up September 18th and 19th. We're headed back to one of Virginia's most iconic destinations, the Omni Homestead Resort in Hot Springs, Virginia, for two days of great continuing education and networking. There's an exhibit hall, and quite honestly, there's going to be a lot of fun had. The Virginia Dental Showcase is designed to be more than just another CE meeting. It's an opportunity for you to get out of your office, bring your team, reconnect with friends and colleagues, maybe some folks you haven't seen in a long time, learn something new you can take back to your practice. Enjoy one of Virginia's great resorts while you're doing it. We've got an unbelievable lineup of CE from practice finance and the path to ownership to artificial intelligence and the future of dentistry, clinical specifics related to carries and biofilm. We also have CE related to wellness and how the mouth-body connection interacts with your overall health. And uh, you know, you've got 18 hours of CE to choose from, all included uh with your showcase registration. Whether you are an associate, a practice owner, a new dentist, there is literally something for everyone at this event. So if you have not registered, please go to the VDA website, make sure you take a chance to register, get all your CE needs, and catch up with all your colleagues for some fantastic professional development. And the next area of focus inside of the VDA strategic plan is practice success. And the VDA has developed a new member benefit called CART, which stands for confidential assessment and review of treatment. Here's the simple idea: things happen in a dental practice. Sometimes there are some events that happen adversely. Sometimes there are near misses, something goes wrong that doesn't result in harm, but something has not gone right. Every one of those situations can provide an opportunity for a practice to learn and to improve. And CART gives qualifying VDA member practices a structured process for reviewing those incidents and conducting quality assurance and patient safety reviews while taking advantage of the confidentiality protection available under the Virginia law for qualified reviews. This was added into the General Assembly a couple years ago. We were able to get dentistry and the VDA's plan put into statute. So it's now recognized. The VDA board of directors approved it. So think about CART as another tool in your practice success toolbox. Learn from what happens, improve your systems, promote patient safety, and take advantage of protections that may be available to you under Virginia law because of both the advocacy and the hard work of the Virginia Dental Association. Again, this is an exclusive VDA member benefit. So to participate, all dentists inside of the practice must be current VDA members. If you're a VDA member and you're interested in learning more about CART, you can go to the Virginia Dental Association's website, vadental.org, and we'll help you get started. And another example of showing value in the practice success area of the strategic plan is the VDA VCU Career Fair. It's one of the biggest challenges that everybody's facing, hiring talent, keeping the talent. Well, we're helping you, at least on one side of that equation, helping dental practices find great people. VDA partners with the VCU to bring dental students, residents, and other emerging dental professionals together with dental practices and employers from across Virginia. It's the VDA helping dentists solve yet another problem. So if you are looking to expand your team or fill your open positions, make sure to put the VDA VCU Career Fair on your calendar October 6th from 5 to 7 p.m. at the VCU School of Dentistry. Do not miss this opportunity. It sells out every year, and all of the students really look forward to an opportunity to meet their future employers. So take that opportunity. You can find all that information at the VDA website. Third area of focus is powerful advocacy. And the VDA has been very active. Just because the General Assembly ended in March does not mean that our advocacy efforts have been uh wrapped up for the year. It has continued to progress. And then all the work that you do during the General Assembly time creates more work for you to do and deliver on the things that actually happened during that session. So there are two big updates on workforce and one on the dental Medicaid cap that were a part of this past General Assembly. The BDA, like I said, had a very busy legislative session advocating for funding for dental hygiene education program expansion and measures to help address some of the workforce challenges that we know all of you are facing. Senate Bill 178 and House Bill 970 were signed by Governor Spanberger and went into effect in July 1, allowing trained and certified dental assistants with 1,800 hours of clinical experience to perform supergengible scaling and coronal polishing. At its June 12, 2026 business meeting, the Board of Dentistry adopted a motion to add supergengible scaling with hand and ultrasonic scalers certified by a dentist under the Virginia Code as a hygiene duty that may be delegated to dental assistants one and two under indirect supervision of a dentist to its guidance documents. That is a long way of saying it is moving forward. However, it is not already in effect, meaning a dental assistant cannot just start supergenitively scaling because they are going to need to take the training and certification programming. And there are three ways for them to get that. One, a licensed dentist or a dental hygienist implementing a curriculum provided by a statewide association. That would be us at the VDA. We will be currently working on that program. Another pathway for training and getting your certification is a federal program approved by or associated with the Indian Health Services, or while serving on active military duty. The third pathway includes an existing dental assistant education program. Well, the Virginia Dental Association is developing our curriculum, which I mentioned in option one. We're developing the curriculum in close coordination with the ADA Council on Dental Education and Licensure, which includes representatives from the ADA, the American Dental Education Association, and dental examiners. Developing this curriculum to fulfill that pathway is consistent with national standards and best practices, and it's really going to be focused on making sure that we do it in the most upstanding way that allows for patient safety and protection, but also is realistic in its usefulness and how it can be applied to alleviate some of the problems we're seeing in delivery and access to care. That curriculum is going to include educational materials for assistance, as well as for the members of the dental team conducting the training. The top consideration for developing this, like we said, is patient safety and standard of care. So that has been at the forefront all along the way. There's a scaling assistant interest form available on our website where an assistant can indicate that they are interested in attaining the certification when it becomes available. Some of the insights we have seen from those who have filled out the interest form up to this point, it's pretty fascinating. There's been no shortage of interest, which we are grateful for, and we had our finger on that pulse knowing uh that there was a big interest for this going into that past General Assembly. But of the people who have filled out the interest form, two-thirds of the dental assistants work in dental practices that treat rural patients, a big problem in Virginia that uh that we've been trying to address, and we're hopeful this will help. Also, half of the dental assistants who have filled out the interest form worked in practices that accept Medicaid, also something that is in need. Half of the dental assistants also have worked for 10 or more years in their field, well over the 1800 hours of clinical experience that is required in the law. So we have additional resources on our site for practices looking to learn more about these workforce measures. So please go to vadental.org backslash workforce. And some of those just include the next steps for dental workforce bills. Um you can get updated on all of those, the ethical perspective on emerging dental roles, insights from Dr. Al Rascala, the chair of the VDA Ethics Council, how this can be implemented in an ethical manner. Uh, dental assistant scaling certification form is also there. Should you, as the dentist or your dental assistant, be interested in finding out more, both are welcome. Staying on that workforce topic, uh, you have may have seen myself or some other VDA members in the news lately. We have been absolutely blitzing the media uh because there's a lot of interest, and people are shocked to find out the state of affairs as to how uh much of a need there is for dental hygienists across the Commonwealth. Uh, we've had more than 300 mentions of the VDA and the workforce shortage topic on TV and radio in Virginia. That is only in August so far. And August isn't even over as recording of this. Uh, your VDA team has worked hard to help the public understand how staffing shortages may affect your ability to get a timely appointment scheduled for those patients and the importance of the Virginia Community College system using their dollars to appropriate to these programs and expand the dental hygiene programs that just came through the General Assembly. So we are keeping the pressure on everyone, everyone involved. The legislature has made great strides this year in offering a lot of different solutions. There's been a continued investment. Uh, we are appreciative of Senator Todd Pillion, his impact. He is a dentist as well and understands the needs that we have. So he has been very advantageous and helpful in uh in making sure that the General Assembly members understand the plight of this workforce challenge that we face. So the VDA continues to know this is an area that we need to address. Uh, we are doing it in a pretty aggressive manner, and we will continue to advocate to make sure that the workforce needs for the dental offices is met. Uh, we really do appreciate all of those members who have participated in those interviews with the media, uh, have put themselves out there and have reached out to legislators, had conversations with them about the importance of expanding the hygiene programs, the need, and just explaining the need to a lot of people has helped in this process. So, all of you that have been involved or wrote your legislator or done anything to help move this needle, we do appreciate it. Our work is not done, but we will continue to push. Another major issue this past General Assembly and uh specifically in the budget, uh, Virginia's new biennial budget directs DMAS to implement an annual spending limit for adult Medicaid dental services, and the VDA and many other groups oppose this change. And we are still working on ways to reverse it and to mitigate the negative impact that it will have on Virginians. There are two important details that we want to make sure our members know about. One, nothing changes immediately. Current adult dental coverage remains unchanged until required approvals are obtained and DMAS issues formal guidance. So don't want to set any alarms off. Nothing has changed immediately. Second, dentists will have an opportunity to weigh in. Dentequest plans to hold sessions where dentists and dental teams can raise questions and identify some concerns with implementation and other problems they may see. Those questions and concerns will help shape the process. DentiQuest says it will bring provider feedback back to DMAS for consideration before any implementation decisions are made. Dentists should not change how they treat or bill adult Medicaid patients, yet, the providers should continue operating under the current rules until they receive official guidance. So for our members, we ask that you be prepared to provide the feedback when the time comes about how the CAP could affect patients and dental practices. The VDA will be actively engaged on this issue, and we will be sharing more in the weeks ahead. This continues to be a major topic. Obviously, this is stemming from some major budgetary constraints in the Virginia biennial budget. And so there was a lot of discussion about saving money related to the dental Medicaid CAD. And so, again, be on the lookout, be ready to engage when the time comes. And we do appreciate all of our members, whether it be on the Medicaid CAD or on the dental assistants being able to supertringitively scale. We are only as effective as our members and their willingness to reach out to legislators and to educate members of the public and the media and others about the needs and the priorities of dentistry. And that is what the dental association's everyday job is. And we enjoy waking up every day to make sure that voice is heard. So, with that, this wraps up another episode of The Drill. I'm Ryan Dunn, and wanting to make sure that you know the drill.

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