Every confident smile comes from a team of dedicated dentists working in harmony. Dentists create extensive treatment plans and complete complex procedures, while dental assistants run the clinic smoothly. Dental hygienists are the front line in the battle against periodontal disease. Your skilled hands help maintain oral health in communities throughout California.
However, a patient complaint, administrative error, or professional misunderstanding can jeopardize your hard-earned credentials in a flash. Years of hard work have gone into your career in dentistry. Do not risk it with an investigation.
If you are under a licensing board investigation or disciplinary action, you need a fighter who knows dental regulations. Protect your practice and your future today. Speak with experienced professional license defense attorneys at Los Angeles License Attorney for confidential guidance and protection of your license.
Understanding the Legal Framework of the DBC and DHBC
California’s dental profession is subject to oversight by two regulatory agencies:
- The Dental Hygiene Board of California (DHBC)
- The Dental Board of California (DBC)
Both are part of the giant umbrella, the California Department of Consumer Affairs (DCA). Public protection is the DCA’s primary responsibility and plays a significant role in both boards’ approaches to enforcement and disciplinary matters.
The DBC regulates:
- Dentists (DDS/DMD)
- Registered dental assistants (RDAs)
- Registered dental assistants in extended functions (RDAEFs)
- Orthodontic assistant permit holders
The board monitors from initial licensure exams to consumer complaints about the quality of care, unprofessional conduct, and substance abuse issues.
California established an independent regulatory board for dental hygienists, the DHBC, which separately oversees dental hygiene licensure and discipline. Registered dental hygienists (RDH) and registered dental hygienists in alternative practice (RDHAP) are not governed by the DBC and have their own regulatory board. The DHBC has its own license criteria, scope of practice, and disciplinary rules.
The complaint process may begin when a patient, employer, coworker, insurer, or other party submits a complaint via the DCA. Within the context of an investigation, the actions you take are evaluated against the strict requirements of the California Business and Professions Code (BPC).
Investigators will review whether you have provided care in compliance with the standard of care. This is the degree of skill, knowledge, and care that a reasonably prudent dental professional would have provided under similar circumstances. Failing to meet this standard, even through inadvertence, can result in formal complaints, public citations, or license revocation.
The Scope of Practice Violations in California Dental Offices
Efficiency is critical in a busy dental practice, but crossing the line would be devastating for your career. Dental teams are most often in trouble together when scope-of-practice issues are mismanaged. Each of your duties, from being a dentist to a registered dental assistant (RDA) is capped by a clearly defined legislative limit under the California Business and Professions Code (BPC). Any violation of these legal limits, for any reason, including for the patient’s efficiency and convenience, can lead to serious legal repercussions for all parties.
This friction is evident when clinical duties overlap or are improperly delegated.
- Dentists diagnose oral conditions, develop treatment plans, prescribe medications when appropriate, and perform restorative and surgical procedures.
- A registered dental hygienist (RDH) specializes in preventive oral healthcare, where you provide independent educational and therapeutic services, like subgingival scaling (removing plaque and calculus below the gum line) and root planing.
- As a registered dental assistant (RDA/RDAEF), you work in the clinic. You can perform certain tasks, including duties authorized by California law, like taking impressions and applying preventive agents when properly authorized, but not periodontal scaling.
One mistake you can make is having your office fall behind schedule. As a dentist, you have crossed a critical boundary if you let or encourage an RDA to perform an RDH task, for example, help out with a cleaning using an ultrasonic scaler. Likewise, if you are an RDA in Extended Functions (RDAEF), you can do more advanced functions, including making temporary crowns, but without the appropriate direct supervision (meaning the dentist must be physically located in the facility), it is a direct violation of the law.
If a scope-of-practice incident occurs, the California Department of Consumer Affairs (DCA) does not just punish the person who carried out the task. The boards may investigate and discipline both the supervising professional and the individual performing the unauthorized task:
- Supervising dentist — You may face allegations of aiding or abetting the unlicensed practice of dentistry and administrative discipline. The Dental Board of California considers this gross negligence and unprofessional conduct, and it will result in significant fines, practice monitoring, and/or license suspension.
- The assistant or hygienist — If you are the RDA, RDAEF, or RDH who was delegated the duty, but it was not authorized, you may be charged for the unlicensed practice of dentistry. You work outside your scope of practice, and therefore, the board may view the conduct as practicing beyond the authorized scope of your license. This is a criminal act and may result in misdemeanor charges, public citations, and cancellation of your state registration.
Cross-training should never result in employees performing duties outside their legal scope of practice. Only by making it a point to ensure that each team member works within their scope of practice will you be able to keep your clinic intact and prevent a potentially devastating board investigation.
Other Common Violations that Trigger Board Investigations
Although the scope of practice mistakes can cripple an entire office, the individual practitioner often finds the other frequently occurring dental board offenses coming back to haunt them. The Dental Board of California (DBC) and Dental Hygiene Board of California (DHBC) have an active monitoring system in place for clinical errors and administrative actions. If you know what the boards focus on in enforcement, you can protect your career.
The following are the issues the board focuses on:
Unprofessional Conduct and Financial Misdeeds
Under California law, unprofessional conduct is a general term that refers to any behavior that falls short of the professional standard. Of course, unprofessional conduct often involves dental malpractice or billing fraud. Financial irregularities are reported to the Department of Consumer Affairs (DCA) regularly, including insurance fraud, which involves:
- Upcoding — Claiming to insurance companies for a higher-level service than was given, for example, claiming a routine cleaning as a full periodontal cleaning
- Billing for services not rendered — Charging for treatments that never occurred.
In addition to financial fraud, the board considers gross negligence, which includes:
- Any procedure that has been performed in a significantly incorrect manner, and is far removed from standard and acceptable procedures
- Along with any allegations of sexual misconduct and/or boundary violations with patients
Infection Control Enforcement
One of the biggest weaknesses for dental offices is infection control, particularly with increased regulations. The board regularly conducts audits and investigations, either as a result of routine inspections or anonymous tips from its staff.
Some of the most common problems that can lead to disciplinary action against your license are:
- Failure to perform weekly spore tests on autoclave(s) and to properly keep log records
- Improper use of sterilizers for instruments
- Failure to shock or test dental unit water lines can lead to dangerous biofilm build-up
All unlicensed dental assistants are required to pass a two-part, eight-hour infection-control course approved by the board pursuant to California Business and Professions Code Section 1750 before being allowed to provide any basic supportive procedures in which there may be exposure to blood or saliva. Relying on an untrained assistant to help chairside constitutes an immediate violation.
Criminal Convictions and Off-Duty Conduct
One thing common among dentists is the belief that their personal life has nothing to do with their professional life. In fact, certain criminal convictions and disciplinary matters may trigger reporting obligations and board reviews.
Business and Professions Code section 490 authorizes boards to discipline licensees for qualifying criminal convictions when convicted of a crime that is substantially related to the qualifications, functions, or duties of your profession.
The law mandates an established, prescribed process for review and arrest or conviction. The first thing is that the conviction must be officially reported to your board. After the board receives notice of the conviction, a substantially related review process begins with an examination of the documents’ content. After this required notification under BPC 490, the substantially related review process begins with a review of the documents’ content. In this stage, enforcement investigators closely examine the nature of the conduct to determine whether the underlying conduct:
- Poses a threat to public safety
- Compromises your honesty
- Indicates a lapse in the professional judgment required to treat patients safely
Certain arrests and convictions may trigger an investigation into whether the conduct is substantially related to the professional practice of, or diversion of, controlled substances from the clinic, which will result in an intensive review. The board determines if the conviction shows a failure in professional judgment, negligence of public safety, or a failure to perform, which may affect patient care. A legal defense to navigate through a Section 490 review is key to demonstrating rehabilitation and to help avoid a seemingly minor error from becoming a lifetime ban.
What Happens During a California Dental Board Investigation?
The moment you discover your license is in jeopardy is rarely at a formal hearing. It begins quietly when you receive a letter in the mail or an investigator knocks at the door. The Dental Board of California (DBC) and Dental Hygiene Board of California (DHBC) have a unique process when handling complaints and cases.
Once a complaint is filed, it will usually be given to a sworn peace officer from the California Department of Consumer Affairs (DCA) Division of Investigation (DOI). These investigators are sworn peace officers with investigative authority, carry firearms, and have the statutory power to interview witnesses and serve subpoenas.
When you receive an inquiry letter or an unannounced inspection, it is a formal inquiry underway. The investigator’s task is to collect evidence to see whether you violated the California Business and Professions Code (BPC).
The biggest mistake you can make in a dental board investigation is agreeing to a voluntary interview without a lawyer. Investigators often have a casual, friendly tone. They will tell you that they are only interested in hearing your side of the story. They could use a statement like, “We just need the other side of the story so we can close this file.”
Do not accept an interview or give a written statement without thinking it over. Statements made during an investigation may become part of the investigative record and affect the disciplinary outcome of the case. You are entitled to a lawyer. Exercising that right does not make you look guilty. It protects your career. Let the investigator know in a polite way that your attorney will be reaching out to them to arrange for any additional communication.
You will probably be aggressively pressured or be issued a formal subpoena for patient records during the investigation. To tackle this request appropriately, you should adhere to state and federal regulations to not exacerbate your legal issues:
- The consent requirement — Under California law and HIPAA, you cannot simply hand over medical charts to an investigator just because they ask for them. You should insist on a release, subpoena, court order, or other lawful authorization, depending on the circumstances.
- The subpoena exception — If the investigator serves a formal subpoena, signed by a judge or administrative authority, you must adhere to the subpoena. However, just ensure you have the exact records indicated in the document. Over-sharing or volunteering unrequested files can constitute a separate actionable violation of patient privacy laws.
Always have a license defense attorney review the demand before providing a patient’s chart to ensure you meet the requirements and minimize your professional liability.
What Happens After a Dental Board Investigation Finds a Violation?
The California Attorney General’s Office takes the investigation further if it finds evidence of a violation and makes the case the subject of formal administrative litigation. They file an Accusation against current licensees to revoke or suspend their dental licenses. Applicants may receive a Statement of Issues seeking to deny licensure.
As soon as you receive an Accusation, a strict response deadline begins to run per California Government Code Section 11506. There is a 15-day deadline for filing a formal Notice of Defense. Missing this non-negotiable window waives your right to a hearing, allowing the board to issue a default decision that almost always results in the automatic revocation of your license.
If you contest the allegations, the matter may proceed to an administrative hearing before an ALJ (administrative law judge) at the Office of Administrative Hearings (OAH). But in most cases, a stipulated settlement is an alternative to a trial to avoid unpredictability.
Settlements may involve:
- Public reprimand
- Rigorous probationary terms from the dental board, including practice monitoring, random site inspections, and continuing education
Find a Professional License Attorney Near Me
The success of your dental practice, whether you are a dentist, dental hygienist, or dental assistant, depends on your years of hard work and accuracy. However, a single misstep, a scope-of-practice violation, or a patient complaint can quickly jeopardize your state license. You should not go to court or face the board without representation.
If you are being investigated or charged with a formal administrative accusation, call the attorney at Los Angeles License Attorney. We specialize in representing healthcare professionals, including dentists, dental assistants, and dental hygienists. Contact us at 424-554-1140 and let us defend your credentials and secure your future.
