The American Board of Orthodontics (ABO) was founded in 1929 as the first dental specialty and the third specialty in all health care. Acting as the president of the American Association of Orthodontists (AAO) at the time, Dr Albert Ketcham appointed an AAO Education Committee that recognized the importance of elevating the quality of orthodontic care for the public. Thus, Dr Ketcham along with 6 founding doctors developed a certifying body—the ABO.

At its inception, the stated objectives were “to elevate the standards of the practice of orthodontia; to familiarize the public with its aims and ideals; to protect the public against irresponsible and unqualified practitioners.”

These objectives are met by promoting excellence through certification, education, and professional collaboration. Dr Ketcham and his colleagues set in place a system that promotes a lifetime of self-evaluation and thus elevates the clinical competency of the orthodontic professional throughout his or her career.

The ABO’s goal has always been to advance the orthodontic standards of care by encouraging as many practicing orthodontists as possible to challenge themselves to become ABO certified. In a 1930 letter from Dr Ketcham to Dr B. F. “Tod” Dewel, Dr Ketcham stated:

We must keep in mind that the object of the Board is to elevate the practice of orthodontia. We should not make our requirements for examinations so high that the average orthodontist may not aspire to perfect himself.… We must adapt our examinations to the applicant, try to discover if he is safe, whether he has the technical skill and scientific knowledge, coupled with good common sense, good personality, and honesty of purpose, to ensure that he is a good “moral risk.”

The number of board-certified orthodontists and the correlating percentage of active members of the AAO continues to grow each year. Only 19% of the AAO’s active members were board certified 25 years ago. Currently, board-certified orthodontists make up 41% of AAO’s active membership. Moreover, 95% of graduating orthodontic residents are participating in the ABO’s written examination, and more than 50% are continuing on toward board certification by participating in the clinical examination. In 2014, 56 of 72 American Dental Association accredited orthodontic programs (78%) had at least 1 resident participating in the Initial Certification Examination, and there has been an increase in the participation rate each year since the inception of the Initial Certification Examination program.

To be inclusive and to achieve its goals, the ABO has revised its certification processes over the years and has instituted changes to keep current with objective testing norms and advances in technology. The number 1 goal of the ABO is to develop and administer a valid, fair, and reliable examination of the knowledge and clinical abilities of the examinee.

Contemporary society is increasingly mobile with a larger population of practitioners and patients. Advancing technologies and multiple developing health care delivery models are evolving and so must the ABO. Over the past several years, some of the ABO’s operational changes for enhancing certification and recertification examinations are the following.

• 1.

  Development of a state-of-the-art examination center in St. Louis, Missouri.

• 2.

  Launch of the remodeled ABO Web site, www.AmericanBoardOrtho.com . This site is a rich source of information for all components of the certification process and is updated on a continual basis.

• 3.

  Retention of Dental Educational Consultant and Psychometrician Consulting firm to enhance the objective testing techniques in both the written and clinical examinations.

• 4.

  Expanded options for the Initial Certification Examination for both the recent graduate and the clinical practitioner. Case requirements and banking opportunities are now the same for all examination participants. Only 1 case is required to be submitted to start the banking process. If 3 initially submitted cases are completed, including 1 case with a Discrepancy Index score of 20 or greater, the remaining 3 cases may be mailed rather than presented in person.

• 5.

  Offering certification options for full-time educators, as well as craniofacial practitioners.

• 6.

  Availability of electronic case submission for examinees who prefer not to bring physical records to the St. Louis testing center.

• 7.

  Acceptance of digital models for pretreatment, interim, and final records. High-resolution stereolithic models must accompany the final digital models.

• 8.

  A Web-based remediation examination is now available for examinees who receive an incomplete result on their initial attempt at the Board Case Oral Examination. Examinees no longer are required to return to St. Louis for another examination.

• 9.

  There are now options for the certification renewal process, which encourages lifelong learning and continued self-evaluation.

All orthodontists completing board certification after January 1, 1998, now receive a time-limited certificate with an expiration time frame of 10 years. Certification renewal requires “demonstration of self-evaluation and proof of continued learning.” Beginning in 2017, the Certification Renewal Examination will have 2 options for examinees: (1) submit 1 case with a Discrepancy Index of 10 or greater and submit 2 Continuing Education examinations from American Journal of Orthodontics and Dentofacial Orthopedics , or (2) complete 2 Board Case Examinations on the ABO Web site and submit 4 Continuing Education examinations from the American Journal of Orthodontics and Dentofacial Orthopedics.

The Board Case Examination option will now be conveniently accessible through the ABO Web site. Examinees will receive case records and patient history information and will be asked to diagnose and treatment plan the case on line in a similar format to the in-person Board Case Oral Examination component of the Initial Certification Examination.

ABO certification continues to be an evolving process and must be responsive to changes in the specialty. The ABO’s eyes are wide open and well aware that the orthodontic specialist’s environment is rapidly changing. The ABO believes that embracing change creates beneficial opportunities for the public and the specialty. The process of self-analysis and continued learning for ABO certification and certification renewal elevates the level of care for our patients and is a win-win for everyone: patients, doctors, and the specialty of orthodontics.