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Washington State Dental Association

Meet your candidate: Dr. Mary Krempasky Smith for ADA President-elect

There are powerful forces threatening dental ethics, education, financing and the delivery of dental services; denial will not make these threats go away. As dentists, most of us have successful businesses and we have a tendency to concentrate on short-term goals. For nearly 70 percent of the population, what we are doing works. The question that needs to be answered is: will we be able to meet the unmet need that clearly exists and maintain our current delivery system?

From our experiences in Alaska, we learned that as a national organization we need to be adaptable in this ever-changing political climate. Our ability to adapt and change will be paramount to the success of our profession. A new and evolving workforce is not unique to dentistry, it is a global phenomenon. The changing demographics and emerging technologies, including information technologies, are resulting in sociological changes unparalleled in history. It has been suggested that the top five jobs of 2015 dont even exist today. The key to our success will be how we influence the development of the dental workforce as it adapts to advances in technology.

My experiences as trustee have run a very wide course. As a district we were central in the Dental Health Aide Therapist (DHAT) lawsuit and subsequent settlement. This was a turning point for our profession. Alaska dentists were correct when they stated the DHATs will not be walled-off in Alaska. That was my introduction to the board. The diverse opinions of the board and the ensuing discussions have been educational.

Understanding the political and cultural differences among our members, and the acceptance of those differences, is what makes us a unique organization. We should be proud of a profession that has the prevention of disease as its cornerstone yet continues to seek innovations in the provision of quality care. My second year on the board started with the departure of the executive director and chief operating officer. The search for a new executive director has occupied much of the boards time over the last 14 months. It was an exhaustive process, but I am very pleased with our choice, Dr. Kathleen OLoughlin. Her extensive background in all areas of dentistry and her recent business experiences will serve her well as she begins as our executive director in June.

Why do I want to run for ADA Pres-elect? Leadership is a role of responsibility. I have responsibly represented our membership, promoting the policies that are important to us, and facilitating change when needed. I do not back down from controversy. The issues currently facing the ADA are issues with which I am well acquainted.

Healthcare Reform

I do not believe we will be part of the first round of healthcare directives, but we need to be present at the table. As my ADA trustee predecessor, Dr. Mike Biermann of Oregon, said, If you dont have a seat at the table, you are probably on the menu. To secure a seat at the table we as an Association, nationally, statewide and locally, need to demonstrate concern for the issues, offer pragmatic solutions and form meaningful coalitions. I have demonstrated leadership in times of adversity, and possess an ability to focus on the future and determine long range values. Only through clear communication, delegation and collaboration will we be seen as the voice of dentistry.

Mid-Level Providers

My introduction to the WSDA was testimony on your behalf before state legislators on unsupervised practice. Along with Dr. Terry Grubb, I served on the Joint Select Committee on Dental Access (Washington State Legislature) which discussed among other issues, mid-level providers. When I-678 was on the ballot, I stepped up as a spokesperson against the initiative that would have resulted in unsupervised dental hygiene. We were successful in defeating this initiative at a time when it was thought it would pass. My first year as your ADA trustee was the year of the Alaska Settlement. I have first-hand knowledge of the ANTHC DHAT program and the ADA lawsuit. As I look to the future, this will be a state determined program. The role of the ADA will be to develop accredited educational programs for alternative providers, provide assistance for state legislative action teams, provide training for spokespersons, and on-going monitoring of emerging issues.

We, as members, need to understand that there really are unmet dental needs. It is not an argument about whether it is a case of mal-distribution or a shortage of providers, the reality is there are people who do not receive necessary dental treatment. There are dramatic changes occurring that threaten our ability to provide the best dental care to our patients. But ignoring these facts will not make them go away. I want to help shape the change in a positive direction for our profession.

Third Party Issues

I served as the Eleventh District representative to the ADA Council on Dental Benefits for four years. Following that, I was appointed to the AGD Dental Care Council. The experience I gained in these positions and the subsequent years lecturing on insurance and codes, HIPAA, and OSHA, have prepared me to speak to the issues facing our members regarding third party issues and government regulations.

Electronic Health Records

Serving on the original ADA Task Force on NHII (National Health Infrastructure Initiative), and now on the ADA Electronic Health Record Committee, has given me the background to address the emerging Electronic Health Record. With the national movement to increased involvement in healthcare delivery an extensive understanding of the developing EHR is a necessity.


I am seeking the position of ADA Pres-elect. I believe I have the vision, resilience, and tenacity for the job. I ask for your support. As Charles Darwin said, Its not the strongest who survive, not the most intelligent . . . but, those most responsive to change.

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