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This page contains correspondence regarding

CME planning

for

Dental Sessions

at AMWC 2025


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AAMS plans to issue Dental credits.

 		    AMWC2025 logo

 Creating a national oral health program for Armenia

See also https://amicnow.org/273 which describes our initial plan to create a regularly scheduled educational series prior to the Congress to explore the various aspects of a national dental health program.

 See also https://amicnow.org/292 which is a planning document for the Dental Specialty sessions, covering implantology, orthodontics, oral tumors and respiratory issues.

See below for the CME planning data for the National Dental Health Strategy session

 updated 24 May 2025

the short story:

 

Creating a National Prevention Program for the Oral Health of Children in Armenia

educational needs

several challenges in Armenia:

  1. poor distribution of healthcare resources, with cutting-edge dental tourism on one hand and high rates of childhood dental decay with poor prevention strategies on the other.

  2. Lack of a satisfactory record keeping system for oral heallth. There is a similar parallel deficiency with medical records, but it is now widely observed that the 2 record systems should work together
  3. dental graduates are finishing the training program with minimal patient care, and need to learn their skills primarily after graduation
  4. Allied dental services (dental hygienist, dental technician) are underused

.
designed to change
  1. Review the epidemiology of dental disease in Armenian children and other age groups.
  2. create pathways for increased contact between dental trainees and the children who need it.  Create mental health programs in schools similar to it has been created in the US.
    -- Train pediatricians to participate in dental preventive health including application of sealants and varnishes to their patients who have not yet seen a dentist.
    --Adopt a national policy for salt fluoridation or other effective program to reduce dental decay
    --recommend a Sugar Tax and other social/marketing tools to reduce consumption of sweetened beverages by children
  3. Adopt a standard for dental record-keeping, similar to what has  been used by NGOs including OHFAR and Karagheusian Foundation.  Explore how these standards could be incorporated into the ArMed electronic record system.
  4. create protocols for dental students to perform screenings, varnishes and sealants, and silver diamine fluoride (SDF) application as needed.  Train pediatric residents in these same skills
  5. work with the Ministry of health to agree on protocols for treatments by Allied dental services

.

appropriate formats

 

.

 lecture  style presentation of our preliminary roadmap to a national prevention program, followed by roundtable discussion and question/answer

 

 competencies

 

.

 systems-based practice, professionalism, interdisciplinary teams, employ evidence-based practice, utilize informatics, quality improvement

 

 analyzes change

 

 

 the success of this program will be measured by creation of new training tools, adoption of new public health programs and increased partnership among NGOs, Diasporan associations and practitioners on the ground in Armenia

 
   
   
   
   
   

 the long story:

 clacking teeth

 

 Objective: 
Organize a Dental/oral health session and create a white paper detailing a road map for a comprehensive preventive oral health program for Armenia.  The summay to be presented and discussed during the 14th Armenian Medical World Congress (AMWC 2025)

Purpose/Vision:
Produce measurable change in Armenian dental health as a result of our collaboration (see the AMWC2025 Mission Statement, below)

  • Interested partners: 
    Armond Kotikian MD, DDS, FACS, Glendale California, maxillofacial surgeon, member AAMS 
  • Georges Mosditchian DDS, Paris France, dentist, member of UMAF-Paris
  • Jerry Manoukian MD Mountain View California, internal medicine, CME, member  AHABA
  • Berdj Kiladjian DDS, Boston, cofounder of Hand in Hand
  • Irina Lazarian, Alisa Badalyan DDS, Howard Karagheusian Medical Benevolent Public Organization
  • Dr Harmik Minassian DDS, dental surgery, implantology, Lyon, Hand in Hand
  • Bedros  Yavru Sakuk ChDF, DDS, Paris France, Représentant de l’Armenie  à la FDI (Fédération Dentaire Internationale), NYU Professor, Depts of Restorative Dentistry & Periodontics
  • Arnold Weiss DDS, Boston, Tufts Univ. Professor of Dentistry, Dept of Pediatric Dentistry
  • Myron Allukian Jr, DDS, MPH Harvard School of Dental Medicine
  • David Hovhannisyan Founder “White Castle” Dental Medical Clinic, perioprosthodentist
  • Gayane Malkhasyan

 Key Points

  • The discussion revolves around organizing pre-conference meetings to develop ideas for a comprehensive preventive oral health program for Armenia, with the aim of presenting these findings at the Congress in Madrid.
  • Creating a white paper detailing a roadmap for a comprehensive preventive oral health program is proposed
  • possibility of broadcasting the dental session at the Congress in Madrid to a larger audience in Armenia 
  • need to gather data on the oral health needs of the Armenian population, particularly in different age groups and geographic areas
  • fluoridation as a method to improve oral health in Armenia is discussed, with considerations for its implementation and potential impact.
  • importance of prioritizing the components of the oral health program based on their potential impact and the need for a government strategy to ensure the success and expansion of the program is highlighted.
  • The necessity of involving key decision-makers and stakeholders, including the state dental school and the Ministry of Health, in the development and implementation of the oral health plan is stressed.

Potential issues:

  • Collaboration among dental health providers, diasporans, Ministry of Health, others.  One of my (JM's) main goals for the session, one that we can and should achieve, is to get the oral health professionals to know each other, form collaborations and possibly avoid reinventing the wheel with each project.  Imagine building larger teams to achieve what smaller teams and individuals are struggling to accomplish now?
How can we share our projects with the AMIC community, share best practices and resources?
  • Fluoridation
Fluoridation of salt has been proposed (many times, over many years) and is very inexpensive.  Why is it not being done in Armenia?
  • Preventive health
Dental care is perceived as treating the problems when they become acute.  What is the status of preventive care, and how can it become the norm?  How can we get into the schools early to do sealants and varnishes?  In Cleveland, the dental students are brought in to schools to do this.
  • Dental training in Armenia
Armenia has 3 dental schools.  What is the quality of the training?  What are the needs for continuing professional development? an we train pediatricians and Family Med to do SDF since they will see the kid before a dentist does?  What training can we offer to mothers?
  • Electronic medical records for dental care?
Hand-in-Hand apparently had an electronic dental record system.  HKMBPO has recently created their own record system. 
ArMed is being used for medical records, and serves clinics providing services reimbursed by government insurance.  t doesn't sync with 3rd party dental applications.
  • Training for dental assistants and hygienists
Dental assistants and hygienists could rapidly expand the reach of dental care for lower cost than relying on dentists for all treatments.  • As of 2024, a two-year dental assistant education program has been launched at YSMU College, and our White Castle dental clinic serves as a student clinic for this project. We are also planning to collaborate with the college to introduce a dental hygienist training program. In the past three years, we have invited hygienists from Boston to Armenia and organized clinical courses for local specialists.
  • Establishing oral health as a public health priority
Need to clarify how dental care is paid as part of the health system.  Create national programs for brushing teeth, cutting out sugary drinks, fluoride treatments.  Make sure AMIC projects are aligned in our priorities and we are saying the same things to MoH

 

Regarding Continuing Professional Development credits
(CDE, CME, European and Armenian credits)

(A stroll through the CME process, for any who are interested)

Dear All

AAMS is helping the Madrid Congress planners with CME (continuing medical education) credit for the US, which will also help us plan for European and Armenian credits.  I am not a dentist but the CME process is similar for different specialties.

Mission

statement 

 → 

describe

the problem 

 → 

what results

do we want? 

 →  

what does success

look like? 

The current dental situation in Armenia is that there are highly skilled services available to the point where there is a viable dental tourism trade.  Of course, if it was perfect, then we wouldn't need a dental session at the Congress.  
Dental services are not evenly distributed among the population.  Preventive care is not routinely sought, and dental visits are often delayed until there is an abscess.  Dentistry in Armenia may also be experiencing a surplus of inexperienced dental graduates similar to what happens in the medical schools.
All changes to the dental services must work through the Ministry of Health.  AMWC2025 is a time to discuss the problems and possible solutions in the presence of the Health Minister.
Meanwhile the Mission of the Congress stresses collaboration among medical professionals and associations; the Mission Statement is pasted below.  It's more about the C's (collaboration, connection, communication, cooperation ...) than about scientific learning.  Here's where we can make a difference.  Consider how dental professionals wishing to volunteer in Armenia might find ongoing projects or form new collaborations.  
A quick Google search for dental projects in Armenia brought some familiar names such as COAF, SOAR, Paros.  Are these programs working together? or with Armenian medical associations?  
Think of some areas where we might have productive discussion.  Who can we enroll in this conversation? 
Let me know your thoughts.  Bachigner
Jerry
 
 
Example of CME planning using the old ACCME criteria 1-11
(New ACCME criteria are modeled on Criteria 2,3,5,6,11.)
1. the Mission Statement below describes how the Congress will succeed if it leads to networking and partnerships, as opposed to simple scientific learning.  It is AMIC's mission as well.
  • Mission statement
"Our mission at AMWC 2025 is to foster meaningful connections and collaboration between Armenian health professionals and international experts to drive tangible improvements in healthcare for Armenia. Through knowledge exchange, networking, and scientific discourse, we aim to translate cutting-edge medical insights into actionable strategies that enhance healthcare outcomes. By bringing together professionals from both the public and private sectors, we seek to create lasting partnerships and contribute to the sustainable development of Armenia's healthcare system, while also strengthening the global Armenian medical community."
 
2. Needs assessment/professional practice gap: 
  • describe the problem 
  • Dental services are not evenly distributed among the population. 
  • Preventive care is not routinely sought, and dental visits are often delayed until there is an abscess. 
  • Dentistry in Armenia may also be experiencing a surplus of inexperienced dental graduates similar to what happens in the medical schools. 
  • Need to create a fluoridation policy.
  • Dental assistants and hygienists are described as nurses and are not trained in any dental health procedures.
  • we need a map of the dental policy community -  who is in MoH, education, ADA

It is unclear whether fluoridation is currently being implemented in Armenia.  Fluoridation of salt is an inexpensive way to prevent tooth decay, although past Ministers of Health have been resistant to the idea.  A paper was published at AUA regarding the topic: 

 https://aua.am/chsr/UserFiles/File/new/Hayk%20Kanchinyan.pdf

 
3. Learning objectives/Designed to Change: 
  • what results do we want? 
These should include strategies for cooperation as per the Mission Statement.  Of course, pure scientific learning and abstracts/poster sessions are welcomed.  (Imagine an abstract that describes a creative way for member associations to collaborate!)
Collaborations started as a result of AMWC2025 would be a measure of our success.  Collaboration is a performance measure, and any benefits to patients could be an outcomes measure.
Regarding fluoridation, enabling our learners to counsel patients about fluoride could be a competence measure, and creating a program of salt (or water) fluoridation could be an performance or outcomes measure.
 
4. Target audience is dental professionals.  Consider a breakout session if it's not useful to the plenary audience.
Given the new nomination of RFK Jr as Health and Human Services secretary in the USA, a 20-minute point-counterpoint discussion of fluoridation may make an interesting and useful Plenary Session.
MoH should be involved in discussion of dental hygienist training.
 
5. Format may depend on the learning objective. What format will best help us reach this goal? For discussions of collaboration, it may be a round-table discussion.  Lectures have limited impact to change human behavior.

Skeletal discussion by organizing committee

pre-Congress sessions to develop several of these points

presentation of summary conclusions in Madrid with "last chance"

 
6. Competencies/Desirable Physician Attributes:  (for examples see this link)
Communication and Informatics are two attributes that could easily make this effort worthwhile, even if patient care or medical knowledge are not addressed.
  1. Patient care or medical knowledge is fairly obvious if that's what we discuss
  2. informatics may include upcoming changes to ArMed system
  3. Systems - based practice may discuss registration and payment systems in Armenia or a system of collaboration among Diasporan volunteers
  4. Fluoridation:  critical thinking and patient care
  5. (others are possible)
 
Standards (7,8,9,10) are set by ACCME which have to do with avoiding commercial bias.  Please fill out your financial disclosure form.  Click here for a copy of the financial disclosure form.  Don't accept any gifts or direct payment from an ineligible company (formerly called "commercial interest") for your participation in AMWC2025.  We will discuss more with you along the way.
 
11. Evaluating our success! 
  • what does success look like? 
Can we do something better than a survey asking people what they learned? 
  • Can we keep track of new collaborations or projects that arise out of our efforts?  Even one new collaboration as a result of this Congress will qualify as "Improves Performance". 
  • A fluroridation policy in Armenia would be a great step forward.
  • An agreement to develop training programs?
 
Commendation Criteria:  Certain tricks in CME planning and delivery can help AAMS gain an additional 2 years of CME accreditation.  These include simple ideas like including interdisciplinary participation in planning and deliver of the CME activity, creative methods of teaching and many others.  See also https://accme.org/rules/criteria/ 
We will discuss these along the way.
=o=o=o=o=o=o=
I am happy if you have read this far.
Random notes below are less critical, feel free to browse:
  1. Il y a des dentistes compétants en armenie, mais peut-etre il n'y a pas egalité.  Les personnes pauvres n'a pas acces aux soins dentaires.
  2. Il y a besoin pour soins préventifs 
  3. La Mission du congrès est (en anglais) cooperation, coordination, donc travaillerons ensemble.  C'est la raison d'etre de CIMA.  Comment pouvons-nous travailler ensemble ?
Here is the Mission Statement for the Congress:
"Our mission at AMWC 2025 is to foster meaningful connections and collaboration between Armenian health professionals and international experts to drive tangible improvements in healthcare for Armenia. Through knowledge exchange, networking, and scientific discourse, we aim to translate cutting-edge medical insights into actionable strategies that enhance healthcare outcomes. By bringing together professionals from both the public and private sectors, we seek to create lasting partnerships and contribute to the sustainable development of Armenia's healthcare system, while also strengthening the global Armenian medical community."
 
Et en français:
Notre mission à l'AMWC 2025 est de favoriser des liens et une collaboration significatifs entre les professionnels de la santé arméniens et les experts internationaux afin de générer des améliorations tangibles des soins de santé en Arménie. Grâce à l'échange de connaissances, au réseautage et au discours scientifique, nous visons à traduire les connaissances médicales de pointe en actions concrètes. stratégies qui améliorent les résultats des soins de santé. En réunissant des professionnels des secteurs public et privé, nous cherchons à créer des partenariats durables et à contribuer au développement durable du système de santé arménien, tout en renforçant la communauté médicale arménienne mondiale.
drapeau français
merci a Google Translate:
Chers tous
J'aide les organisateurs du Congrès de Madrid à obtenir des crédits CME (Continuing Medical Education) pour les États-Unis, ce qui nous aidera également à planifier les crédits européens et arméniens. En tant que tel, je propose ces réflexions bien que je ne sois pas dentiste.

La situation dentaire actuelle en Arménie est telle qu'il existe des services hautement qualifiés au point qu'il existe une entreprise de tourisme dentaire viable. Bien sûr, si tout était parfait, nous n'aurions pas besoin d'une séance dentaire au Congrès.

Les services dentaires ne sont pas répartis de manière égale parmi la population. Les soins préventifs ne sont pas systématiquement recherchés et les visites chez le dentiste sont souvent retardées jusqu'à ce qu'il y ait un abcès. La dentisterie en Arménie connaît peut-être également un surplus de diplômés dentaires inexpérimentés, similaire à ce qui se passe dans les écoles de médecine.

En attendant, la mission du Congrès met l'accent sur la collaboration entre les professionnels de la santé et les associations ; la déclaration de mission est collée ci-dessous. Il s'agit plus des C (collaboration, connexion, communication...) que d'apprentissage scientifique. C'est là que nous pouvons faire la différence. Réfléchissez à la manière dont les professionnels dentaires intéressés par le volontariat en Arménie pourraient trouver des projets en cours ou former de nouvelles collaborations.

Pensez à des domaines dans lesquels nous pourrions avoir une discussion productive. Qui pouvons-nous inclure dans cette conversation ?

Faites-moi part de vos réflexions. Bachigner
Jerry

 

 

Questions to consider  Answer 
 How many dentists are there in Armenia? 

 Generative AI estimates a few thousand

Knoema lists 1,943 in 2009

WHO lists density of dentists at 4.2 per 10,000 pop.
 What is the funding for dental care  
 What are the dental school programs in Armenia

Yerevan State Medical University (YSMU)
Yerevan Haybusak University (YHU)
The University of Traditional Medicine (UTM)

 
 who are potential collaborators
 Mobile clinics

 Armenian Dental Society of California (working with Paros Foundation)

 
   
   

 

 See also

 

 

Outline

Dental Session Planning for AMIC Congress

  • The session time has been increased from 1 hour 45 minutes to 5 full hours.

  • The group wants to develop a 'white paper' or 'roadmap' detailing a comprehensive preventive oral health program for Armenia.
  • This would be presented and discussed at the Congress.
  • There is a plan to have pre-Congress online meetings in May and June to develop ideas and invite dentists to participate.  We've decided not to pursue CE credits for these.
  • Georges Mosditchian has invited several implantology speakers, which they feel will be a major draw for dentists.  This needs to be balanced with time for the preventive health discussions.
  • There are concerns about having enough time for all planned speakers and topics within the allotted session time. 

Oral Health Needs Assessment for Armenia

  • The group identified a critical need to gather data on the oral health status and needs of the Armenian population.  This includes decay rates, number of cavities, and percentage of the population with no teeth for different age groups and regions.

  • Current dental workforce numbers, distribution, and training were discussed as essential information.  Existing government oral health programs and policies need to be reviewed.
  • Data from organizations like Karagheuzian Foundation on treatments provided should be included.  The group agreed this data is essential for developing an evidence-based national oral health plan.  Currently, there is a lack of comprehensive, up-to-date data.
  • There was discussion of potentially conducting new surveys or assessments to gather needed data.

 

Preventive Oral Health Strategies

  • School-based sealant and fluoride varnish programs, potentially utilizing dental students, were considered important strategies.

  • Salt fluoridation was discussed as an alternative to water fluoridation.
  • Training pediatricians, family doctors, and other primary care providers to apply fluoride varnish and silver diamine fluoride to young children was suggested.
  • Oral health education programs targeting mothers and young children were emphasized.
  • Expanding government programs that provide free dental care to children was proposed.
  • Developing a dental hygienist workforce to focus on prevention was seen as crucial.

 

Dental Education and Workforce Issues

  • Concerns were raised about the oversupply of dentists being produced by 9 private dental schools and 1 public school.

  • Questions about the quality and accreditation of some private dental schools were discussed.
  • Many dental graduates are unable to find employment as dentists.
  • There is no individual licensing of dentists, only of dental clinics.
  • There is a need to restructure dental education to focus more on public health and prevention.
  • Developing dental hygiene and dental assistant training programs was suggested.

 

Engaging Stakeholders and Government

  • Involving the Armenian Dental Association and dental school leadership was deemed necessary.

  • Identifying dental advisors/leaders in the Ministry of Health was recommended.
  • Potentially engaging the Prime Minister's dentist as an advocate was considered.
  • Working to make oral health a higher priority for the government was discussed.
  • Developing a comprehensive national oral health plan to present to government leaders was proposed.
  • Following up persistently after the Congress to maintain momentum was emphasized.

 

Congress Logistics and Planning

  • Uncertainty about how many dentists will attend the dental session was noted.

  • There is a need to coordinate abstracts and presentation topics for invited speakers.
  • Exploring options for recording/broadcasting sessions to Armenia was discussed.
  • Balancing time for prevention discussions versus clinical topics like implantology was considered important.
  • Coordinating travel, hotels, and social programs for attendees was addressed.
  • The group agreed to continue planning discussions at their next meeting on March 30th, with the goal of developing a clear roadmap to present at the Congress in Madrid.

 

 

 

See also https://amicnow.org/273 which describes our initial plan to create a regularly scheduled educational series prior to the Congress to explore the various aspects of a national dental health program.

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