Dental professionals are committed to delivering high-quality dental care, and each member of the dental team plays a crucial role. California’s rigorous laws and requirements can put your dental license at risk if a patient complains, a medical error occurs, or an administrative procedure is overlooked. The Dental Board of California (DBC) and Dental Hygiene Board of California (DHBC) carefully evaluate allegations, including scope-of-practice issues and Department of Consumer Affairs (DCA) audits. These boards may view certain clinical errors or administrative mistakes as evidence of unprofessional conduct.
Our professional license defense attorneys at Orange County License Attorney provide focused legal representation for dental professionals facing investigations. We work to protect your career, credentials, and future from the beginning of the investigation through its resolution.
The Regulatory Jurisdiction of the DBC and DHBC
The dental profession is dual-regulated in California, with dentistry and dental hygiene being distinct professions. The Dental Board of California (DBC) and Dental Hygiene Board of California (DHBC) are both under the Department of Consumer Affairs and work to protect the public. This focus could lead boards to prioritize public safety over the licensee’s interests if a situation arises in which a violation may have occurred.
The Dental Board of California is responsible for regulating dentists and dental assistants and enforcing the Dental Practice Act. It handles licensing, exams, and investigations involving clinical incompetence, fraud, or professional misconduct. Dental hygienists are regulated independently by the Dental Hygiene Board of California, which monitors their specialized education and responsibilities.
Determining which board has authority over a matter is an essential first step in responding to an investigation. Both boards have enforcement authority, including the power to request records, issue subpoenas, and conduct inspections to ensure compliance with state requirements.
Dentists are expected to provide a certain level of care to their patients at every appointment. This standard is based on the skill, knowledge, and judgment that a reasonably careful practitioner would exercise in the same situation. A provider’s actions are compared to this standard to determine whether negligence or incompetence has occurred.
Disputes can arise when patients or insurance companies believe the care provided was inadequate. Boards examine various aspects of the care, including diagnosis, treatment decisions, and procedures, to assess patient safety. When there is no serious harm to patients, a lack of professional skill can lead to disciplinary action. Keeping good records is one of the best ways to protect against allegations. The documentation of treatment decisions, reasoning, and patient care reflects a professional’s careful and responsible action.
Scope of Practice Violations in California Dental Offices
Many dental practices operate as a team, but delegating duties beyond a worker’s scope of practice is a major liability. The duties each dental professional may perform are clearly outlined in California law, depending on their license or permit.
Even if a dental assistant has experience or the office is busy, they cannot do everything a registered dental hygienist can. The state enforces these boundaries strictly to safeguard patients and prevent the unauthorized practice of dentistry.
For example, if a dental assistant uses an ultrasonic scaler to remove plaque, it may be considered an unlicensed practice violation because this task is reserved for a licensed dental hygienist. The person carrying out the procedure and the supervising dentist could be held liable. The dentist should verify staff credentials before assigning clinical tasks.
Mismanagement of RDH and RDA Task Assignments
Registered Dental Assistants in Extended Functions (RDAEFs) are trained to perform additional functions but should work under the direct supervision of a licensed dentist. This means the dentist should be in the room during some procedures.
If an RDAEF performs restricted procedures when the dentist is not present, this may violate state rules and constitute a lack of supervision. A dentist’s license and an assistant’s registration are safeguarded with proper supervision.
Scope-of-practice violations can affect everyone involved. The dental boards may take disciplinary action even when the violation was unintentional, because dental professionals are expected to comply with all legal and regulatory requirements.
Administrative Discipline for the Supervising Dentist
Dentists can be liable for their employees’ actions. The Dental Board of California could charge the dentist with enabling unlicensed practice if the assistants perform procedures without authorization. Possible consequences include fines, public discipline, professional monitoring, and damage to your reputation.
If dental assistants and hygienists practice without authorization, they may face administrative penalties and criminal sanctions. A conviction may result in continued reporting requirements at the time of license renewal, so dental practitioners should stay within their scope of practice.
Common Violations that Lead to Board Investigations
Dental board investigations are not restricted to clinical errors. Administrative issues, ethical concerns, and professional behavior can also be the subject of scrutiny.
Unprofessional Conduct and Financial Misdeeds
Dental boards use the term “unprofessional conduct” to cover a wide range of misconduct. This can involve billing errors, unethical practices, and patient relationships. Financial misconduct is a key issue for regulators. “Upcoding,” or claiming for a more costly service than was delivered, and making claims for services not rendered, can lead to significant investigations.
These actions are deemed unprofessional and can result in severe disciplinary action, including license loss. Ethical and accurate billing is crucial to a dental professional’s career.
Gross Negligence and Infection Control Violations
Gross negligence is a very high level of carelessness. It occurs when a clinician fails to observe basic safety measures or conduct treatments that are definitely not indicated for the patient’s condition. High-volume clinics are frequently scrutinized for poor performance trends that signal a systemic problem in clinical judgment. These risks can be reduced by prioritizing patient safety over clinic throughput and maintaining high diagnostic standards.
Infection control is a part of modern dentistry that the boards are watching more closely, and it is non-negotiable. The California Code of Regulations has a sterilization requirement that, if not followed, can result in the immediate suspension of your dental facility.
Weekly spore testing of autoclaves is required to ensure the autoclave sterilization equipment is functioning properly. These tests should be kept for at least three years to meet the requirements of an investigator’s audit.
Also, dental unit water lines need to be shocked and tested to prevent the formation of dangerous biofilms. If an investigator determines that these processes are not documented, they will issue a citation for a violation of the Health and Safety Code. To maintain a sterile environment, these protocols should be consistently followed.
Having Unlicensed Dental Assistants Provide Help
All unlicensed dental assistants should complete an eight-hour infection control course before providing chairside assistance. If you permit an unqualified employee to use contaminated instruments or to participate in procedures, you violate the Business and Professions Code. The board assumes that the dentist will ensure that all team members are trained and certified.
Criminal Convictions and Off-duty Conduct
If you are convicted of a crime, your personal circumstances can affect your professional life. The boards have the authority to discipline you for convictions that are substantially related to your professional duties, as permitted under California law.
The board may suspend or revoke your dental license after a criminal conviction, pursuant to Business and Professions Code Section 490. You are required by law to report any arrest or conviction to the board within a specified period, typically 30 days. Not reporting a criminal matter is another offense, which may result in further disciplinary action being taken.
Assessing Threats to Public Safety and Professional Judgment
The board uses the substantial relationship test to determine if your criminal conduct affects your ability to practice safely. Drug, alcohol, or violence offenses are frequently investigated, as they may indicate a lack of judgment needed to care for patients.
As an example, if you are convicted of DUI, the board may suspect a substance abuse problem that may affect your clinical performance. The investigation is directed towards the underlying conduct and whether it is a risk to the patients you serve or to the public in general.
However, you could present evidence of rehabilitation to the board that is sufficient to defend your license. This means showing that you are attending treatment, doing community service, and giving character references from work associates.
If you take proactive steps to address the underlying cause of the conviction, the board may be more likely to consider probation instead of revocation. A strategic defense demonstrates that you are dedicated to change and a long-term fit for the dental profession.
Understanding the California Dental Board Investigation Process
Typically, an investigation starts when an investigator from the Division of Investigation calls your office. This is the most crucial time of your legal defense, as the information you give will dictate the outcome of the case.
DOI Investigations and Interviews
DOI investigators are sworn peace officers and have the power to carry firearms and issue legal subpoenas. They are likely to show up at your clinic unannounced for interviews or to check your sterilization records. They might appear friendly or casual, but they intend to collect evidence of a crime that will be presented against you in court.
Do not engage in a voluntary interview with an investigator in the absence of your legal counsel. What you say in a casual conversation may be interpreted in a way that is not intended and may be recorded in the final investigative report as an admission of guilt. You have the right to refuse to answer questions and to have a lawyer represent you at every stage of the process. Declining an immediate interview does not imply guilt; it is a way to protect your rights during the investigation.
The Management of Records Requests and Subpoenas
Investigators often request patient records to substantiate clinical claims or billing procedures. These requests should be balanced with your responsibility to cooperate with the board and your legal responsibilities to safeguard patient privacy.
Medical records cannot be released to an investigator without a valid subpoena or a signed patient authorization. If HIPAA or state privacy laws are also violated during the board investigation, additional legal consequences may arise.
When a formal subpoena is issued, you are required to comply, but you should provide the documents only in the order requested in the subpoena. An attorney can check the subpoena to ensure you are not providing too much information that might result in additional allegations.
Legal Proceedings After a Board Investigation
When the Board believes a violation has taken place, the matter is referred to the Office of the Attorney General for formal action. This change turns a private investigation into a public one that could impact your reputation forever.
Addressing an Accusation or Statement of Issues
An Accusation is a written document that names the charges against your license and the laws you are accused of breaking. New applicants use a Statement of Issues to deny the issuance of a license based on past conduct.
The Strict 15-Day Deadline for the Notice of Defense
After service of an Accusation, you have 15 days to file a Notice of Defense. The deadline is mandatory and binding as per the California Government Code. Failure to file this document in a timely fashion will waive your right to a hearing, and the board will make a default decision.
A default judgment usually means that your practicing license is automatically suspended. Immediate action is required to preserve your right to challenge the allegations in front of an administrative law judge. Not all cases will go to the Office of Administrative Hearings for an administrative hearing. Most discipline issues are resolved through a negotiated agreement with the board (a stipulated settlement).
Probation, Practice Monitoring, and License Revocation
A settlement means that you will retain your license but agree to certain probationary conditions. These requirements can be random office visits, ongoing education classes, or a practice monitor working with you. However, if a case proceeds to a hearing, the outcome may include more serious discipline, including license revocation. Revocation means losing your license and the right to practice altogether.
Probation can be difficult, but it is a more desirable option than facing a permanent revocation at a hearing. A strong legal defense will help you negotiate for the most lenient terms, and you demonstrate your commitment to compliance while continuing your dental career.
Find a Dental License Defense Attorney Near Me
Years of skill, dedication, and a solid professional record are crucial to a successful dental career. If your license is in jeopardy because of a board investigation or an accusation from the Attorney General, it is crucial to have an experienced attorney on your side. At Orange County License Attorney, we represent dentists, dental hygienists, and dental assistants accused of negligence, billing fraud, and scope-of-practice violations. Our license defense lawyers have experience with the issues and processes of DOI investigations and the Office of Administrative Hearings (OAH). We will fight to safeguard your reputation, license, and right to continue practicing. Contact us today at 714-782-6386 to schedule a consultation.
