Disciplinary actions before the Texas State Board of Dental Examiners are covered by the Texas Occupations Code and the Dental Board’s own administrative rules. Common grounds for discipline include
- Criminal charges including arrests deferred adjudication probations and convictions including DWI;
- Substance abuse, chemical dependency or the intemperate use of controlled substances;
- Unprofessional conduct;
- Fraudulent billing practices;
- Non-therapeutic or over prescribing;
- Discipline by a peer group or other State Licensing Board;
- Standard of care violations including:
- Failure to obtain appropriate informed consent;
- Inappropriate or non-clinically indicated treatment;
- Failure to provide the patient with an appropriate treatment plan;
- Failure to obtain the patient’s clinical / medical history and obtain and document blood pressure and medications used;
- The provision of care and treatment that falls below the standard of care
The resulting sanctions for violations proved can be severe including an administrative penalty, public reprimand, probation, suspension, or the outright recommended revocation of a practitioner’s license.
A disciplinary proceeding begins with a complaint. Complaints can come from different sources: colleagues- who, under the Dental Practice Act, are required to report certain conduct to the Board- patients, disgruntled family members, peer assistance groups such as Professional Recovery Network, and other states’ licensing authorities. Upon receipt of the complaint, Board Staff will first decide whether they have jurisdiction over the matter, and if they do, initiate an investigation. During the investigation the license holder will be given a copy of the complaint and be asked to return a written preliminary response to the allegations. At this point the Staff will decide whether to publicly dismiss the complaint or pursue a disciplinary proceeding. If the Board determines during the investigation that the continued practice of a license holder constitutes a clear, imminent, or continuing threat to the public, the dentist’s license may be temporarily suspended before a hearing has been held.
After deciding that the complaint merits potential violations Board Staff has the authority to hold an informal settlement conference, draw up a proposed board order, or file a formal complaint with the State Office of Administrative Hearings. The informal settlement conference is an informal hearing before a Board committee where both parties will be permitted to present their case. First, the prosecuting Staff attorney will present the charges against the practitioner and may suggest some of the features of a potential order. Next, the licensee and their attorney, if one has been retained, will respond and offer mitigating or exculpatory evidence as well as present any steps the dentist has taken to avoid future violations or recover from any dependency issues. Then the Staff will question the license holder. Finally, the dentist and the Staff prosecutor will leave while the Board reaches a decision. The parties will then be recalled and presented with the Committees’ decision which may be a dismissal or resolution by an Agreed Order. After the informal settlement conference, the dentist does not have to accept the proposed order although refusal will almost certainly lead the Board to file formal charges and pursue a contested case at the State Office of Administrative Hearings.
A dentist being investigated by the State Dental Board of Examiners should seriously consider hiring an attorney. A lawyer with extensive experience in professional licensing and administrative law will generally help to secure better outcomes than a practitioner facing the Board alone. They will be better able to marshal evidence and present their case to the Staff, all the more important given the fact that the license holder is not in a good position to advocate on their own behalf. Further, during the investigation, the Board is barred from questioning the dentists directly if they have retained counsel. Such an attorney will be able to counsel the dentist against unwise admissions and choices that can have dire consequences on their future ability to practice.