February 2008 Supplement ■ Journal of Dental Education 53 The Interrelationship of Accreditation and Dental Education: History and Current Environment Allan J. Formicola, D.D.S., M.S.; Howard L. Bailit, D.M.D., Ph.D.; Tryfon J. Beazoglou, Ph.D.; Lisa A.Tedesco, Ph.D. ; Lisa A. Tedesco, Ph.D. Lisa A. Tedesco, Ph.D. Dr. Formicola is Professor of Dentistry, College of Dental Medicine, Columbia University, andVice Dean of the Center for Com- Professor of Dentistry, College of Dental Medicine, Columbia University, and Vice Dean of the Center for Com- munity Health Partnerships, Columbia University Medical Center; Dr. Bailit is Professor Emeritus, Department of Community Medicine, University of Connecticut Health Center, and Research Associate, Department of Community Dentistry, College of Dental Medicine, Columbia University; Dr. Beazoglou is Professor, Department of Craniofacial Sciences, Division of Pediatric Dentistry, University of Connecticut Health Center; and Dr. Tedesco is Professor, Rollins School of Public Health, Dean, Gradu- ate School of Arts and Sciences, and Vice Provost for Academic Affairs, Graduate Studies, Emory University. Direct correspon- dence and requests for reprints to Dr. Allan Formicola, Vice Dean of the Center for Community Health Partnerships, Columbia University Medical Center, 630 W. 168 th Street, P&S Box 100, New York, NY 10032; 212-304-5214 phone; 212-544-1938 fax; ajf3@columbia.edu. T he dental school accreditation system plays a critical role in maintaining the quality of dental education and, in turn, the vitality of the dental profession as a learned, self-regulating profession. One of the purposes of accreditation is to ensure that contemporary developments in science, technology, and society are incorporated into educa- tional polices and processes. This article reviews the history of the dental school accreditation system and suggests that accreditation processes and standards need to be revised in order to address the challenges facing dental education. History of Accreditation In 1918, at the request of the surgeon general of the Army, the Dental Education Council of America set up a system to classify dental schools as A, B, or C. The council was an independent organization made up of representatives from three national associations: examiners, teachers, and practitioners. Concerned with ending commercialism in dental education, the council classified proprietary schools as a C, because they lacked “educational and professional reputability.” In 1916, twenty-one of the nation’s fifty dental schools were privately owned, but by 1924 only four were proprietary. In 1920, the council ruled that “a dental school organized and conducted for-profit, either to individuals or to a cor- poration, whether in the form of unduly large salaries or rentals or of profit for direct distribution, does not meet the standard of fair ideals, as interpreted by the Dental Education Council of America.” 1 Class A schools were required to have a four- year curriculum of 4,400 hours and to have buildings and equipment valued at $300 or more per enrolled student. Further, if 25 percent of graduates failed the licensing examination for two successive years, a school lost its Class A rating. In 1938, the American Dental Association (ADA) became the parent organization for the Dental Education Council, and in 1975, the Commission on Dental Accreditation (CODA) was formed. Mem- bership of the commission was expanded from the original three groups—examiners, educators, and practitioners—to include a public member, repre- sentatives from dental specialty organizations and from dental hygiene, assisting, and technology, and a student representative. From 1940 to the present, schools have been classified based upon site visits and compliance with the accreditation standards. The current classification system includes “initial accreditation” for developing programs and two types of approval for fully operational programs: approval with and without reporting requirements. The latter designation indicates deficiencies that must be cor- rected in eighteen months. The commission routinely conducts validity and reliability studies on the accreditation standards and considers revisions with input from the commu- nities of interest, including dental schools. Hearings on proposed standards revisions are conducted at the annual meeting of the American Dental Education