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Presentation by VI Board of Dental Examiners to the Legislature Good afternoon Honorable Senator Ray Fonseca, Chairman of the Committee on Health, Hospitals, and Human Services; Good afternoon also to Committee and non-Committee members and the viewing and listening audience. Thank you for the opportunityto present a formal update on the operations, challenges, and strategic objectives of the Virgin Islands Board of Dental Examiners. | have been asked to make a presentation with respect to the activities of the Virgin Islands Board of Dental Examiners and it is my pleasure as Chairman to offer the following overview. A. Current Operations (i) Board Composition The Virgin Islands Board of Dental Examiners is a seven-member body comprised of three dentists representing the St. Thomas/St. John District, two dentists representing the St. Croix District, one dental hygienist and one lay member. The current members are Dr. Olutayo Delano (Dentist), Dr. Chase Greep (Dentist), Ms. Lauren Gewinner (Dental Hygienist), and myself, Dr. Trevor Connor (Dentist). | serve as Chair of the Board, with Ms. Gewinner serving as the Secretary. | wish to take this opportunity to acknowledge the service of Dr. Donald Pomeranz (St. Thomas) and Dr. Stanford Fabio (St Croix), both of whom are now retired, for their valuable contributions and dedicated service to the Board. Mrs. Deborah Richardson-Peter serves as the Director of the Office of Professional Licensure and Health Planning, which oversees the Board’s daily operations. (ii) Board Meetings The Board convenes on a quarterly basis, holding its meetings virtually through the Microsoft Teams platform. During these sessions, the Board undertakes the review Presentation to Legistature/Dr TrevorA C Connor DDS/ Chairman of VIDBE/28 October 2025 and deliberation of license applications, complaints, and requests, in addition to addressing other regulatory matters within its purview. Decisions are rendered through majority consensus of the members present. The meeting agenda is prepared by the Director of the Office of Professional Licensure and Health Planning (PLHP), while the minutes are duly recorded and disseminated by the Secretary of the Board subsequent to each meeting. While the Board convenes on a quarterly basis, an electronic review mechanism has been established to facilitate the timely review and approval of licensure applications upon submission of all required documentation. This measure ensures the efficient administration of licensing functions and promotes uninterrupted access to professional dental services within the Territory. Initial licensure applicants are afforded priority consideration to expedite their entry into practice. In the adjudication of complaints, licensees are granted due process, including the opportunity to review and respond to any allegations. Matters requiring legal interpretation or enforcement are referred to the Department of Justice for advisory opinion, prosecutorial guidance, or other appropriate action in accordance with applicable laws and regulations. . Challenges There are no particularly acute challenges to the operations of the Board. However, there are two areas that require attention. (i) Vacancies The first challenge is that it is necessary for the Legislature to fill the two vacant positions that currently exist, on account of the retirement of twa previous members of the Board. Although a quorum still exists at this point for the Board to be able to function, it does mean that the Boarad’s functions can be stalled if there are any challenges with the participation of any one member. As such, this is one area that requires immediate attention. Presentation te Legisiature/Dr Trevor A € Connor DDS/ Chairman of VIDBE/28” October 2025 Pade 2|8 (ii) Dedicated Legal Representative The second challenge is that from time to time the Board does require the assistance of the Department of Justice as its legal representative to advise particularly in the area of licensure and complaints. The Board believes that it would be beneficial if there could be a dedicated legal representative assigned to assist the Board which would facilitate complaints being addressed expeditiously. . Strategic Objectives (i) The Board’s ongoing activities and initiatives to uphold dental practice standards The Board’s activities center around meetings for consideration of new applications, renewals and complaints. In the Virgin Islands, each dental practitioner is required to renew their license every two years. To ensure that dental practice standards are maintained, the Board requires that each dental practitioner complete 30 hours of continuing education before renewal. In conjunction with upholding standards, The Virgin Islands Dental Board is a member of the American Board of Dental Examiners (ADEX). ADEX is the body that approves and administers the licensure exams for dentists and dental hygienists. There has recently been a development where this body, ADEX, has merged with another, to create one umbrella examining body referred to as the American Board of Dental Examiners (ABDE). The Virgin Islands Board of Dental Examiners will be associated with this new organization and will be a full member of the American Board of Dental Examiners. (ii) Licensing and compliance procedures that are in effect The Board licensure period is biennial, starting 1% October on even numbered years. The next renewal cycle starts 1* October 2026. The statistics for the Territory show the following: (a) 86 Dentists renewed their license by the 30" September 2024 deadline; Presentation to Legislature/Dr TrevorA C Connor DDS/ Chairman of VIDBE/28!" October 2025 (b) 16 applications for Dentists’ licenses were approved since 1* October 2024 (the start of the biennial licensure cycles); (c) 43 Dental Hygienists renewed their license by the 30" September 2024 deadiine; and (d) 14 new Dental Hygienists applications were approved since the start of the biennial licensure period. With respect to new applications, the Board’s review begins immediately upon receipt of a completed submission and includes a background check. Any red flags identified during this process are evaluated by the Board in accordance with the Dental Practice Act and the applicable Rules and Regulations before rendering a final decision. In relation to the renewal process, this has been successfully automated for the past two renewal cycles, allowing PLHP staff to review and approve license rencwals efficiently. Plans are currently underway to extend this automation to the intial licensure process for dentists and dental hygienists. The process for renewals was successfully automated for the last four (4) years, that is, two (2} renewal cycles. This platform allows PLHP staff to review and approve license renewals efficiently. Plans are on the way to automate the initial license application process for dentists and dental hygienists. In the area of complaints, when a complaint is submitted, the Board first reviews it to determine its validity. Once deemed valid, a copy of the complaint is forwarded to the provider for review, response, and submission of supporting documentation. Decisions are made in accordance with best practices, the Dental Practice Act, and the applicable Rules and Regulations. The Board gathers all necessary information to guide and inform its decision-making process. In cases of uncertainty, matters are referred to the Department of Justice for legal guidance and resolution. Presentation to Legislature/Dr Trevor A C Connor DDS/ Chairman of VIDBE/28" October 2025 (iii) Resource & Legislative needs for effectiveness As outlined previously in this presentation on current challenges, the Board respectfully seeks the Legislature’s support in addressing two critical areas. As mentioned previously, priority should be given to filling the two existing Professional Licensure vacancies, which are essential to the effective functioning of the Board. Secondly, we also respectfully seek the assignment of a designated legal representative to the Board to provide timely legal guidance and support as circumstances require. Additionally, the Draft Rules and Regulations prepared in 2016 were intended to modernize and strengthen the legal framework established by the 1996 Rules and Regulations governing the Dental Board. However, the 2016 draft was never finalized. The Board now requires the assistance of a qualified legal expert to review the 2016 draft to ensure its continued relevance and adequacy, and to facilitate its advancement through the necessary legislative approval process. 0] Plans for professional development, community outreach and inter- agency collaboration within the broader healthcare sector In the area of community outreach, the Board collaborated with Dr. Tai Hunte-Ceasar, Chief Medical Officer, in a community outreach initiative conducted in 2024. The Department of Health’s Wellness Fair, organized in partnership with the Department of Defense’s Innovative Readiness Training (IRT) Program, facilitated the provision of dental services to members of the community. The selection criteria for patients was inclusive, allowing participation without the requirement of identification or insurance verification. A total of 51 providers - primarily military dentists - participated in delivering care. In total 5,036 patients received dental treatment, with services valued at approximately $801,270. Regrettably, due to fiscal constraints, the Department of Defense was unable to support the summer initiative this year and is not expected to do so in 2026. Nevertheless, the Board remains committed to supporting Dr. Hunte-Ceasar in advancing future community-based dental health outreach initiatives. Presentation to Legisiature/Dr TrevorA C Connor DDS/ Chairman of VIDBE/28" October 2025 Page 5/8 The Board was also able to offer support to a community outreach program spearheaded by the Seventh Day Adventist Church in 2024 that focused on the provision of dental services to residents on St Croix. The Professional Licensure Division successfully convened two inter- and intra- agency Board conferences aimed at fostering collaboration among key stakeholders and addressing cross-cutting issues that are most effectively resolved through direct dialogue. The first conference, held in the St. Thomas/St. John District, was attended exclusively by Board members and focused on internal coordination, procedural improvements, and strategic planning. The second conference expanded its scope to include representatives from the Office of the Governor, the Department of Justice, the Virgin Islands Legislature, and the Department of Licensing and Consumer Affairs, thereby promoting stronger inter- agency cooperation. Professional Development As it pertains to the area of professional development, | wish to highlight a longstanding initiative that | have championed for several years, even prior to my appointment to the Board. | have shared this with my fetlow Board members, and they have also recognized its value and potential impact. The initiative proposes the establishment of a Dental Hygiene Training Program to strengthen the territory’s dental workforce, enhance the quality of care, and expand access to oral health services. By providing locally accessible training, the program would support the retention of skilled professionals and contribute to long-term improvements in oral health. Dental hygiene is a vital component in elevating the quality of dental health care in the Virgin Islands and throughout the Caribbean. Drawing on my 30 years of experience as a practicing dentist in the Virgin Islands and neighboring territories, | have observed a persistent shortage of dental hygienists across the region. This shortage often requires dental practices to recruit professionals from the mainland to meet service demands. Presentation to Legislature/Dr TrevorA C Connor DDS/ Chairman of VIDBE/28 October 2025 Page 6[8 In my view herein lies the opportunity, since | have seen considerable interest from local young people desiring to pursue careers in dental hygiene. However, the financial and logistical barriers associated with relocating for education often prevents them from following this path. Establishing a local Dental Hygiene Program would address this workforce gap while delivering broad community benefits. Some of the benefits that this program would bring to the community include: (i) Regular prophylactic care provided by dental hygienists will encourage the population to undergo routine dental evaluations, ideally at least twice per year. Early detection of oral health issues prevents minor problems from developing into more serious and ultimately more costly dental treatment. Dental hygienists assist the dentist in the critical role of identifying problems at the earliest stages. The hygienist is also able to support the dentist in educating the patients on the connection between oral health and overall well-being. A reliable supply of trained hygienists would significantly enhance the oral healthcare of our community. Furthermore, early intervention through treatment and education helps to reduce the cost burden to public programs, such as Medicaid, while at the same time improving long-term health outcomes. By strengthening the dental workforce and promoting preventative care, a local Dental Hygiene Program would go a long way in uplifting the quality of healthcare in the Territory. The production of locaily trained hygienists will not only reduce the burden of recruitment but will encourage more of our young people to remain at home and serve their local communities. Our young people will also be attracted to the profession as a result of the presence of local role models with whom they canrelate. This is currently not the case since there are less than 0.5% of local Virgin istanders who are practicing hygienists in our Territory. We are fortunate to be able to have the University of the Virgin Islands right on our shores. There are several academic programs that we could tap into to allow our Territory and UV! to become a center of excellence for fostering a new pathofjob creation. Presentation to Legisiature/Dr TrevorA C Connor DDS/ Chairman of VIDBE/28 October 2025 Page 7[8& The academic pathway to become a Hygienist is approximately two (2) years for an Associate’s degree or four (4) years for a Bachelors degree. This new educational opportunity would allow the Territory to uplift itself and also train and service our other Caribbean sisters and brothers since there are only two other educational institutions in the Caribbean that provide this training. lam encouraged that Dr George the new President of University of the Virgin Islands has shown interest in the concept of a program of this nature, and together we will shortly be engaging in further discussions to see how this project can be advanced. Should the Legislature consider this initiative as a priority, it would be a transformational path in uplifting the health of our community while offering our young people a rewarding and sustainable career right here at home. Thank you for receiving me and for your attention. | am available to answer any questions. Yours respectfully, Trevor AC Connor, DDS Chairman Presentation to Legisiature/Dr TrevorA C Connor DDS/ Chairman of VIDBE/28"* October 2025 Page 8/8