It's taken you years of study at the undergraduate and graduate level, hundreds if not thousands of hours of clinical practice, time spent preparing for and taking national dental examinations as well as a clinical examination, and completion of other application requirements, including a background check, all for you to earn your license to practice dentistry in the state of Texas.
That huge investment of time, money, and effort can all be placed at risk if the Texas State Board of Dental Examiners (TSBDE) notifies you that you're being investigated for misconduct. When that happens, you need an advocate, someone who understands the TSBDE's disciplinary rules and procedures, and who can help you defend your rights, your reputation, and your license. The Lento Law Firm Professional License Defense Team is ready to help you when your license is at risk; call us at 888.535.3686 or use our contact form to set up a consultation to learn more about how we can help.
Our experienced professional license defense attorneys can help from the investigation process all the way through to the resolution of the complaint against you. We will be your contact with TSBDE investigators and officials and can conduct our own investigation on your behalf to uncover information that may help your defense. Our attorneys can represent you in discussions or negotiations with TSBDE officials and at any hearing that may take place in the event your complaint isn't resolved through an agreement. We understand how important your license is to you, and we will use our experience, knowledge, and skills to help you protect your rights, your license, and your livelihood.
Ways the Texas State Board of Dental Examiners Can Discipline Dentists
The TSBDE has a number of disciplinary options when a complaint is filed against a licensed dentist in Texas. Depending on the situation, the Board has the power to take the following steps:
- Dismiss the complaint where the issue is “outside the TSBDE's jurisdiction” (designating it as “Non-Jurisdictional”) or where the complaint contains “insufficient information to determine jurisdiction or insufficient information about the allegation” (designating it as “Jurisdictional: Not Filed”).
- Impose a monetary fine or administrative penalty against the dentist.
- Issue a cease-and-desist order and seek an injunction against the practitioner to stop them from practicing in Texas. This can happen in cases where the dentist is practicing without a license or is performing procedures that exceed the scope of their license.
- Reprimand the dentist. This is a relatively mild form of discipline.
- Issue a warning letter against the dentist. This is the next level of discipline above a reprimand; it will typically advise the dentist that continued violations may result in probation, suspension, or revocation of their license.
- Place the dentist on probation, with conditions that the dentist must meet during the probation period. The dentist may be required to report regularly to the Board, to limit their dental practice to certain agreed types of treatments defined by the Board, or to undertake additional education as specified by the Board. In some cases, the dentist may be required to seek treatment for an alcohol or drug abuse condition.
- Suspend the dentist's license. This can happen when the dentist is initially convicted of certain crimes, including any felony and certain designated misdemeanors. It can also happen when the dentist violates certain standards set by the TSBDE for dental practice and patient treatment.
- Revoke the dentist's license. This can happen when a dentist's conviction that resulted in their license being suspended is made final, as well as for violating the TSBDE's dental practice standards.
What Standards Does Texas Expect Dentists to Uphold?
Texas has specific requirements for dentists that describe what dentists are expected to do in the course of practicing their profession. Some of these are restrictive; for example, there are specific limits on what a dentist is allowed to delegate to dental assistants and requirements for how the dentist is to supervise them. Other requirements are affirmative and cover things such as keeping proper patient treatment records and providing proper access to those records while maintaining proper levels of patient confidence; the use of certain types of drugs in the dental practice; proper use of x-ray equipment; procedures for practicing pediatric dentistry; and administration of anesthesia, among others.
That said, when it comes to the day-to-day practice of dentistry on patients, dentists in Texas are given a considerable amount of latitude and are generally expected to meet “the standard of care in the practice of dentistry.” What that standard is isn't specifically defined by the TSBDE, as it changes in the same way other healthcare professions and practices change with time.
Grounds for Dentist Discipline in Texas
The TSBDE may discipline dentists for a variety of reasons. Specifically, it can do so where the dentist:
- Is convicted of a “misdemeanor involving fraud” or a felony;
- Practices dentistry “in a manner that constitutes dishonorable conduct;”
- Fails to follow “the standard of care in the practice of dentistry” when treating patients;
- Uses false or deceptive advertising to solicit patients;
- Submits a fraudulent license application;
- Has a substance abuse problem, including with alcohol or drugs;
- Allows someone not licensed to practice dentistry to do so at the dentist's office;
- Doesn't use “proper diligence” in their dental practice, including failing to protect patients against “avoidable infections;”
- Violates any dental law or regulation;
- Isn't physically or mentally able to practice dentistry in a safe manner;
- Negligently practices dentistry in a way that injures a patient;
- Is disciplined by another state where the dentist is also licensed;
- Has been declared mentally unfit to practice;
- Knowingly provides dental care in a way that violates state or federal law.
The Lento Law Firm Professional License Defense Team understands the disciplinary standards that the TSBDE applies when investigating and disciplining dentists in Texas. We're ready to help you protect your license and defend yourself against all types of misconduct allegations, and our experience has shown us that there are two sides to every story. We're here to help you present the evidence that supports your side of the story and to use that evidence to help protect your license and your practice.
Don't Assume the Truth Will Protect You From Dental License Sanctions in Texas
It's very natural to want to defend ourselves as soon as someone accuses us of doing something wrong. You might think that if you receive a notice that a complaint has been filed against you and you're under investigation by the TSBDE or that disciplinary proceedings against you are beginning, all you need to do is go to the TSBDE and explain the situation, and everything will be fine. In a perfect world, that might work, but in reality that approach may end up doing you more harm than good.
The TSBDE investigation and disciplinary process is just that – a process. Once it begins, it will follow a path until the matter is resolved. Communicating directly with a TSBDE investigator or representative could result in you providing them with information that they may believe helps their case against you. License investigations and disciplinary proceedings are stressful for someone whose license is on the line, and it's easy to make mistakes when communicating directly with those who are investigating or disciplining you.
This is where it can be enormously helpful to be working with one of the skilled attorneys from the Lento Law Firm Professional License Defense Team, who can act as your go-between in communicating with the TSBDE, making sure that any communications are ones that are likely to benefit you. If you're interviewed by a TSBDE investigator, we can be there to help make sure that you only answer clear, understandable questions and that if you provide an answer that might be misconstrued by the investigator, you have a chance to explain it in more detail. You have a right to be treated fairly throughout the investigation and discipline process; let us help you make sure you are.
The Adjudication Process for Dentist Licensing Issues in Texas
As noted above, when a complaint is filed against a dentist, the TSBDE will review it to make sure it's about an issue that the Board has legal jurisdiction over and that the complaint includes enough information so that the Board can act on it. Assuming it does, the following steps may then take place:
- Investigation. The Board will assign one or more investigators who will look into the complaint. You may be interviewed, as well as anyone you work with who may have information about the matter. Your office's records relating to the complaint will likely be turned over to the investigator. The person who filed the complaint may also be interviewed. Depending on the situation, you may be asked to submit to a physical or mental evaluation. The goal is to determine whether there is substance to the complaint and whether a disciplinary proceeding should be brought against you.
- Decision on Disciplinary Action. If the investigation appears to uncover violations in your practice, the TSBDE Legal Division will review the evidence to determine if it is “sufficient to proceed with disciplinary action.” If the allegations against you involve the standard of care you provided to a patient, the Dental Review Panel will also evaluate the allegation and evidence. If there isn't sufficient evidence that you violated TSBDE Rules or Regulations, the matter will be dismissed. In cases where the investigation reveals “Minor non-patient care related violations,” the Board may issue an Administrative Penalty (a fine) against you. In more serious cases, the Board will vote on whether to take more formal actions against you, such as a Board order or a Remedial Plan.
- Administrative Penalty. In the case of an administrative penalty, you'll have the option to accept the penalty and pay whatever the amount of the penalty is or to request a hearing on the matter. In either case, you have 20 days after receiving the notice to make your decision. The hearing will take place before an administrative law judge, who will issue a recommendation that the TSBDE will, in almost all cases, adopt. You will then have an opportunity to pay the administrative penalty or to seek judicial review of the decision.
- Fine, Reprimand, Probation after Suspension, Suspension, or Revocation. In cases where the TSBDE intends to issue a reprimand or fine against you, or place you on probation after suspending your license, or suspend or revoke your license, you are entitled to a hearing.
- Formal Complaint. If the Board decides to issue a formal complaint against you, it will include “a statement alleging with reasonable certainty the specific act or acts” that the Board is relying on and the specific “statute, Board rule, or Board Order” that you're alleged to have violated. You will have 20 days to respond to the complaint; if you default, the Board will assume that you admit to all of the allegations in the complaint and are waiving your right to a hearing.
- Hearing. Hearings follow Texas procedural law and are conducted before an administrative law judge (ALJ). You're entitled to be represented by counsel in connection with the hearing. The judge is required to apply the same rules of evidence that apply in civil cases in Texas, with some limited exceptions. If witnesses are presented to testify at the hearing, the opposing side will have an opportunity to cross-examine them. The ALJ can order the state to produce documents in discovery in advance of the hearing and may also authorize subpoenas.
- Settlements. At any time, you and the TSBDE can come to an agreement to resolve the disciplinary proceeding by way of a written agreement following an Informal Settlement Conference. By working with an experienced attorney from the Lento Law Firm Professional License Defense Team, you have a better chance of being able to resolve disciplinary proceedings without a hearing; our attorneys have experience with these kinds of cases and understand what kinds of settlements the TSBDE is willing to accept, given the facts of any particular case.
- Decision. Within 60 days of the close of the hearing (unless there is an extension), the ALJ will issue a “proposal for decision,” in the form of “findings of fact and conclusions of law.” You may have an opportunity to file “exceptions” to the ALJ's decision or to ask for a rehearing. Your attorney can help you in cases where exceptions or a rehearing request may be appropriate; you may be required to request a rehearing before you are entitled to appeal the ALJ's decision.
- Action by the TSBDE. Once the ALJ's proposal for decision is final, the TSBDE will consider the ALJ's proposal and may accept or change the decision. If the board changes the decision, it must provide reasons for doing so. There will be an opportunity either to appear before the Board and present an oral argument or to submit a written argument to the Board concerning the ALJ's proposed decision. When the TSBDE makes its decision about your disciplinary case, it will do so in writing. You may request a rehearing of the Board's decision if you do so within 20 days of when you or your attorney was notified of the decision.
The TSBDE disciplinary procedures are complicated and require you to be aware of a number of different deadlines with filing requirements along the way. Between settlement discussions, hearings before an ALJ, and Board reviews of ALJ decisions, there are a lot of back-and-forth and procedural steps involved in a fully-contested disciplinary matter. This is why you need the help of an experienced professional license defense attorney. Our lawyers understand the disciplinary process and will work with you to help make sure your rights are protected every step along the way.
What Happens if You Are Disciplined by the Texas State Board of Dental Examiners?
Final disciplinary actions are disclosed to the public in two ways; first, the TSBDE issues periodic reports of disciplinary actions taken against dental practitioners. These disclose the name of the dentist, their license number, disciplinary case number, and type of discipline imposed. In addition, it's possible to search individual dentists online; these records will indicate the status of their license and where they've been disciplined. It will also include links to the disciplinary orders issued against the dentist.
How the Lento Law Firm Professional License Defense Team Can Help
When you're facing a misconduct investigation or disciplinary proceedings, you shouldn't have to do so alone. Working with an experienced attorney from the Lento Law Firm Professional License Defense Team can make a significant difference in the outcome. We understand the complicated disciplinary rules and procedures that apply to dentists in Texas and can help you understand the allegations against you and the potential risk you and your license face as a result. We will work with you to resolve the situation in as favorable a way as possible.
We can help at every stage of the disciplinary process. For example, our experienced attorneys can investigate allegations on your behalf, sometimes uncovering helpful information missed by the TSBDE's investigators. We can help prepare you for interviews with investigators and can be there to make sure the interview questions are clear and fair so that your answers aren't misconstrued. We'll help with settlement discussions, where appropriate, and if matters don't settle, we will represent you at your disciplinary hearing.
Whether you practice in one of Texas's large cities, such as Houston, Dallas-Fort Worth, San Antonio, or Austin, or one of its many smaller ones, such as Amarillo, Marfa, McAllen, Beaumont, or Paris, the Lento Law Firm Professional License Defense Team is ready to help you protect your license, your practice, and your reputation when misconduct allegations are made against you. Call us today at 888.535.3686 or use our contact form to schedule a confidential consultation to learn more about how we can help.