Dentistry has been a staple in the U.S. since Paul Revere practiced dentistry on the side in the 1700s. We have come a long way from the days of silversmiths moonlighting as dentists though. North Carolina has required occupational licenses for dentists since enacting NCGS §90-22 in the early 20th century. This statute, and article 2 as a whole, created the Board of Dental Examiners in North Carolina. The Board has established dentist license oversight. That oversight includes application for a dental license and the creation of rules of professional conduct under Title 21, Chapter 16 of the North Carolina Administrative Code. Our focus today is discussing the disciplinary proceeding process and ways for dentist to avoid Board discipline altogether.
Pursuant to 21 NCAC 16T .0103, dentists are required to have a patient’s consent before a specific procedure can be performed. Consent can only be given after a patient is properly informed of the condition to be treated. In addition, the dental professional must advise the patient as to the specific procedures and treatments to be provided; the anticipated results of the procedures and treatments to be provided; the risks and hazards of the procedures or treatments to be provided that are recognized by dentists engaged in the same field of practice; the risks of foregoing the proposed treatments or procedures; and alternative procedures or treatment options.
There is an exception to the above though. If the treatment involves an emergency AND the patient is incapacitated then informed consent is not required. After obtaining a patient’s informed consent, a dentist should be sure that the instruments they use are sterilized. Since dental instruments go into sensitive areas of the mouth, they are susceptible to causing infection if not properly sterilized.
Under 21 NCAC 16J .0103 the NC Board of Dental Examiners establishes the requirement that all instruments and equipment must be sterilized. Curiously the Board does not set forth any guidelines. Instead, the Board defers to the American Dental Association and requires dentists to follow their guidelines. The ADA does set forth guidelines, but you must be a member in order to have full access. Failure to abide by Board rules, like sterilization, will lead to disciplinary action by the Board. Discussed next are the disciplinary factors the Board considers when punishing a licensed dentist.
The Board breaks up disciplinary factors into three groups. The first is revocation if lesser discipline is insufficient to protect the public and factors under 21 NCAC 16N .0607(1)(a-c) apply. The second group is revocation or suspension of a license if lesser discipline is insufficient to protect the public and one or more factors in 21 NCAC 16N .0607(2)(a-k) apply. The third group is a catch-all but lists the most factors (22) for the board to consider in 21 NCAC 16N .0607(3)(a-v). It appears as though if a licensed dentist mitigates the violation by coming forward and trying to correct the error, then he/she will be more likely to have a lesser discipline imposed against he/she. There are even further requirements if a dentist incorporates anesthetics into his/her practice.
If dentists are to use an anesthetic, they must follow numerous requirements implemented by the Board. The dental facility must follow certain requirements. Those include storing and maintaining drugs a certain way. Dentists must have a permit in order to use anesthesia. Also required are written emergency and patient discharge protocols. Numerous records, including base line vital signs, must also be kept by the permit holder for 10 years. There are also inspections of the premises to ensure compliance and the facility must be staffed with at least two BLS certified auxiliaries. The aforementioned are but a fraction of what is required by the Board in 21 NCAC 16Q .0202.
The Board will send notice of a complaint prior to the initiating of a formal disciplinary action. The notice is a notification that an investigation is ongoing and provides the licensee the opportunity to file a response. If the Board’s investigation concludes that a Board rule has been violated, then the licensee has the right to a formal hearing under 21 NCAC 16N .0501. A licensee can also request a hearing if he/she feels like the Board’s action has affected their rights, duties, or privileges. The request for hearing is found under 21 NCAC 16N .0502. If, after a formal hearing, the Board concludes that discipline is warranted, the licensee has the right to judicial review. That means a Superior Court judge will determine whether or not the licensee violated a rule of professional conduct.
If you or someone you know has had a NC Board of Dentistry complaint filed against them contact our office at 919-521-8810. More information about professional license defense can be found at our website: www.northstatelawfirm.com.