The State Regulation of Dentistry

1. The State Regulation of Dentistry Law and Ethics

2. What is the State Dental Practice Act? • state law which controls the practice of dentistry • contains legal restrictions and controls • only applies to that particular state in which it is written; each state has its own dental practice act

3. What is the purpose of the state Dental Practice Act? • protect the public from being mistreated or misled by incompetent practitioners • The primary function of the state dental practice act is to define and regulate the practice of dentistry

4. Provisions of Dental Practice Act: • Licensure • Eligibility, methods, requirements for licensure • Grounds for suspension or revocation of license • Defines the practice of dentistry within the state • Provisions for establishing and maintaining an administrative board to supervise practice of dentistry • A means of controlling the assignment of duties, including extended functions to auxiliaries (DA, Dental Hygienist, Lab Tech)

5. What is the State Board of Dentistry? • aka: State Board of Dental Examiners • Administrative Board of the state in which it exists • responsible for administering and enforcing the Dental Practice Act • Examine applicants and grant licenses • Deal with misconduct, incompetence, and related matters • Establish and regulate the functions assigned to dental auxiliaries (clinical staff who have a supporting or supplementary role i.e. DA, dental hygienist or lab tech)

6. What is a License? • legal permission to engage in a profession or business • Licensure= the act of granting licenses expressly to practice a profession or business • Purpose: protect public from mistreatment by unqualified practitioners • To obtain a license in the dental field, one must: • Apply to the state Board of Dentistry • Meet the educational and moral requirements • Pass an examination in theory and practice as specified by the state Dental Practice Act

7. Who must be licensed? • 1) Dentists • 2) Hygienists • Both must be licensed by the state in which they practice • 3) Dental Assistants are not licensed, though some states do require registration (RDA)

8. a mutual agreement between two or more states to allow an individual who is licensed in one state to receive, without further examination, a license to practice in another state • **still need to apply for license in each state even if that is a reciprocal state**

9. State Board of Dentistry may: • Suspend:to temporarily stop or interrupt • Dentist cannot practice during this time • License is reinstated after specified time and dentist can resume practice • Revoke:to take away • Dentist is no longer licensed to practice dentistry in that state • Dentist may petition to have license reinstated

10. Professional licenses can be revoked due to: • Conviction of a crime • Unprofessional Conduct • Personal or Professional incapacity

11. Conviction of a crime • Being charged with a crime doesn’t automatically lead to suspension or revocation • Fraud: intentional misrepresentation of the truth in an effort to deceive • Misdemeanor: any offense other than a felony, is less than a felony • Felony: a serious crime, such as rape or aggravated assault

12. Unprofessional Conduct • Permitting unlicensed personnel to perform dental procedures normally restricted to dentists • Failure to supervise personnel properly • Sexual advances toward or involvement with patients • False or inaccurate patient records • Fraud involving reimbursement of patient expenses by insurance companies or government programs • Giving or receiving rebates related to patient fees (discounts) • Transmission of disease by improper infection control • Improper communication of confidential patient information • Improperly prescribing, handling or selling controlled substances (drugs) • Patient neglect or abandonment

13. Personal or Professional Incapacity • Addiction (abuse of narcotics or alcohol) • Severe physical or mental limitations that prevent adequate patient care

14. Certification • voluntary program that verifies standards for qualified DA • NOT a form of registration or licensure (requiredbylaw) • DANB certification is recognized in some states, but not in all of them

15. DA’s Responsibilities to Dentist • Always treat the dentist with respect • Support the dentist in any decision made for the patient • Perform only those tasks that are delegated to you by law • Conduct yourself professionally in the dental office.

16. Respondeat Superior“let the master answer” • Dentist/employer is held liable(responsible under law) for acts of his/her employees • If wrongdoing was committed within the scope of their employment • Not liable if wrongdoing not within scope of their employment • IF you do something wrong while working properly, Doctor is liable; if you are working improperly, you are also liable • Dentist/employer is liable EVEN if employee is a licensed individual

17. Why Respondeat Superior?? • Employer has the right to direct and control employee; must exercise this right and be responsible for employee’s actions • Employer has exposed patient to hazard of employees and must suffer for the negligent acts • Employer has the assets(financial resources) to compensate the patient for the injury.

18. If YOU are called into court

19. You may receive a subpoena • Court order commanding you to appear in court; cannot be ignored • You may have to give a deposition • Statement made by witness; you will answer questions under oath; takes place in lawyer’s office before the trial • You may have to give testimony • Evidence given by a competent witness under oath during a trial

20. What to do if the Dentist is sued • Say nothing: don’t discuss case with anyone without doctor’s permission • Be Supportive • Be Cooperative with dentist and lawyer • Ask before acting do not give information to any other lawyer or show the patient’s records to anyone without the doctor’s permission

21. You can still be sued! • Usually it is the dentist who is sued • The dentist’s liability insurance will not cover the auxiliary if she/he is sued for negligence • A dental assistant who is guilty of negligence is responsible for his or her own actions, and the injured party may sue both the dentist and the assistant • Some auxiliaries carry liability policies of their own • ADAA membership includes liability insurance but this does not cover negligence

22. Levels of Supervision: • 1) Direct: The dentist remains in the room while DA performs task • 2) Indirect: dentist remains in office while DA performs task • 3) General: dentist is not required to be present in office when task is performed

23. Expanded Functions for DA • aka: extended functions or EFDA • Assignment to DA of tasks of greater skill and responsibility which were formerly performed only by the dentist • Not available in all states (CT= no; MA = yes) • Governed by Dental Practice Act: • Allows dentist to delegate duties; very few states • Includes specific listing of functions; some states • State Board of Dentistry has authority to establish rules and regulations for EFDA; most states

24. Your responsibilities as a dental assistant: • Be careful! Do not allow yourself to do things which are improper or illegal. “a dental assistant who performs extended functions that are not legal is performing an illegal act: the unlicensed practice of dentistry” This is a CRIMINAL ACT. • if the dentist instructs the DA to perform this act, he/she is also guilty • if the dentist does not know of the act, he/she may still be liable • Know: • who is permitted to perform a particular function in your state • what education or training is required • what level of supervision is necessary