This page contains correspondence regarding CME planning for Dental Sessions at AMWC 2025 If you want to help, please contact This email address is being protected from spambots. You need JavaScript enabled to view it.  or telephone +1-650-542-8442    AAMS plans to issue Dental credits.

See also https://amicnow.org/273

 Creating a national oral health program for Armenia

 updated 19 March 2025

 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?

• Fluoridation

• Preventive health

• Dental training in Armenia

• Electronic medical records for dental care?

• Training for dental assistants and hygienists

• Establishing oral health as a public health priority

Planning session 14 December 2024 via Zoom call:

Meeting summary

Participants: 

• Berdj Kiladjian, Dentist, Boston, Hand in Hand project
• Armond Kotikian, Maxillofacial surgeon, Los Angeles, Armenian American Medical Society
• Irina Lazarian, New York, Howard Karegheusian Foundation
• Jerry Manoukian, Physician, San Francisco, Armenian Healthcare Assoc of Bay Area
• Georges Mosditchian, Dentiste, Paris, Union Médicale Arménienne de France - Paris

Quick recap

The team discussed the challenges of expanding scientific knowledge within a large organization, the importance of collaboration, and the potential for collaboration with dental associations in Armenia. General topics were considered as potential discussion points.  Some may be amenable to Plenary sessions, while others are addressed in breakout sessions:

• Dental training, dental assistant/hygienist training
• Fluoridation
• Interaction between Diaspora and Ministry of Health (and other institutions
• Preventive dentistry, involvement of schools, parents, MoH

Lastly, they discussed the organization of a dental conference, focusing on preventive dentistry and policy changes, and the potential involvement of dental schools and professionals in the conference.

Next steps

• Berdj to send Jerry contact information for potential participants and Lazar's information.
• Armond to reach out to his contact at the Ministry of Health.
• Jerry to reach out to Lilian and update her on the progress made.
• Jerry to circulate the meeting transcript and put it online for reference.
• Berdj and Irina to summarize electronic dental records used by Hand in Hand and Karegheusian Foundation
• Discuss the project with other potential participants (see below)

Summary

Armenia Situation and Congress Discussion

Jerry Manoukian and Armond discuss the points Jerry raised about the situation in Armenia. Georges Mosditchian, who has difficulty speaking English, says Jerry's points are good and can be discussed during the Congress. Mosditchian is the only board member in Paris who can communicate with them and thinks Jerry's work on the topic is good. He does not see any problems with the points Jerry raised.

Organizing Dental Session for Congress

Georges Mosditchian, a clinician from Paris, was asked to organize the dental session for the upcoming congress. He has lined up three doctors to give high-level speeches on implantology. However, he is hesitant to invite speakers who do not share the goal of helping Armenia. Jerry Manoukian clarifies that the main purposes of the congress are for Armenians to work together, which aligns with AMIC's mission, and to address issues in Armenia.

Georges added that there is a French Union for Oral Health, and that we should find similar dental associations in Armenia.  Professor Lazar Yesayan is the president of the Armenian Dental Association and dean of the YSMU dental school.

Expanding Knowledge and Collaboration Challenges

Jerry Manoukian discussed the challenges of expanding scientific knowledge within a large organization and the importance of collaboration. He highlighted his role in ensuring the success of the conference and the need for a roadmap for future conferences. Berdj and Irina discussed the challenges of promoting preventive dentistry in Armenia, including the lack of interest from professionals and the need for better training. They also discussed the potential for collaboration, with a focus on creating a roadmap for future projects. The conversation ended with a discussion on the need for a common ground and the elimination of duplication in their respective projects.

Armenia Ministry of Health Outreach

The team discussed potential contacts within the Ministry of Health in Armenia to better understand the country's needs and challenges. They agreed to reach out to someone from the ministry before the upcoming Congress to gather insights and address potential roadblocks. The team also considered the possibility of collaborating with dental associations in Armenia to further their goals. The importance of preventive dentistry was emphasized, and the team agreed to reconcile any differences in approach between France and the US. The team also discussed the potential involvement of individuals (who have worked within the MoH) such as Shant Shekherdimian and Lorky Libaridian in finding a suitable contact within the Ministry of Health.

Dental Conference Planning and Involvement

The team discussed the organization of a dental conference, focusing on preventive dentistry and policy changes. They agreed on the need for a mix of roundtable discussions and abstract sessions, with a focus on preventive dentistry. The team also discussed the importance of involving the Ministry of Health and Ministry of Education in the planning process. They decided to prepare a document outlining their needs and expectations, and to circulate it among relevant stakeholders. The team also discussed the potential involvement of other dental professionals and organizations in the conference.  A few names and organizations include Raffy Chouljian, Cyril Tahtadjian, Myron Allukian, Ministry of Health, Ministry of Education, YSMU dental school, AUA School of Public Health

Armenian Dental Schools and Zoom

The team discussed the dental schools in Armenia, with Irina and Berdj confirming there are three main ones, including a private school. Jerry Manoukian expressed concern about the ratio of patients to doctors in Armenia, suggesting it might be as low as 300 to one. The team agreed to keep the use of Zoom flexible, possibly using it once a month, and to exchange ideas when the time comes to use it. Jerry Manoukian proposed to send a transcript of the meeting to everyone for reference. The team also discussed the possibility of putting the transcript online for future reference.

Our next meeting is planned for mid-January 2025, exact time to be decided.

 Meeting of February 22, 2025:

Key Points

📝 06:58 AM - Zoom meeting February 22 Notes

🕞 Started at 6:58AM on 22 Feb, lasted 3h 1m

• The mission of the conference is to get different healthcare organizations around the world to cooperate and work together, specifically to avoid duplication of efforts like setting up dental clinics in close proximity.
• There is a significant issue with the lack of shared statistics and records among healthcare organizations, which hampers effective collaboration and progress tracking.
• Early dental intervention, particularly preventive care for children aged 2-3, is crucial to reduce the need for more aggressive treatments like sedation or general anesthesia later on.
• The concept of utilizing salt fluoridation in areas without centralized water systems was proposed as a cost-effective preventive measure.
• The importance of standardized dental screening forms and electronic medical records for dental care was highlighted to improve record-keeping and data sharing.
• A new two-year dental assistant education program was launched at YSMU College, with the first graduates expected in 2026.
• The need for a mentorship program in pediatric dentistry was discussed to make the field more attractive to new graduates.
• A comprehensive prevention program for dental health in Armenia was proposed, including fluoride varnish and sealant programs in schools, to be presented to the Ministry of Health.
• The use of technology, such as Zoom, was suggested to increase participation in the dental session and reach a broader audience.
• The group agreed to meet again on March 15 to continue discussions and finalize plans for the upcoming Congress.

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

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

• What else?  Can a dentist who wants to volunteer find partners to work with?
• What are MoH's issues with dental care in Armenia?  What does the licensure process look like?

Projects relating to 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.

Per our colleage Zareh:

1- There is NO general strategy for the dental care in our Hayastan: number of dentists vs population. The generally accepted optimal ratio is usually 1500 patients per one dentist, whereas in Armenia it is 300/1 and yet they still graduate hundreds of young doctors at the university but also at “private” schools with doubtful qualifications and outcomes.

2- There are no SERIOUS graduate programs. Meaning there are NO REAL specialists. 

3- There’s no university CLINIC where students can learn and practice under supervision as it is done everywhere in the world.

4- licensing dentists and accreditation of dental schools.

 

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.

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