Nevada is not the only state with dental oversight problems

At least Nevada has somebody looking at dental patient complaints in the Silver State.

That is what I have been thinking as I have followed the unfolding investigation into the failings of the Nevada Board of Dental Examiners. When I was still regularly reporting on medical misdeeds back in the mid-2010s, I remember thinking that medical doctors had way more oversight than dental doctors – as bad as that medical oversight was in many cases. Some states had no dental boards at all, or oversight had been handed over to an understaffed agency with a grab bag of responsibilities for dentists, hair stylists, car mechanics, and everything in between.

These problems persist today, and one of the things you should do if you want to see if there are problems in your state similar to what the Las Vegas Review-Journal found is start by simply checking on who regulates dentists in your state. If there’s a dental board, you can then pose some of the same questions that the Review-Journal asked.

How many complaints has the board received and what did the board do about those complaints?

Arthur Kane at the Review-Journal wrote this compelling finding early in the investigative series: 

More than 900 complaints have been filed since 2013, but the number of sanctions issued by the board has plunged even as grievances have increased. 

In the cases where dentists were disciplined, what type of discipline did they receive?

Again, here’s Kane at the Review-Journal: 

All but a handful of complaints were dismissed or settled with corrective actions that allowed dentists to continue practicing while undergoing additional training and partially repaying patients.

The Review-Journal had to do quite a bit of digging to nail down its story. You will too. Whether this type of information is easy for the public to find is often part of the story.

Let’s take the example of Alabama.

Trying to figure out whether the Board of Dental Examiners of Alabama is doing its job requires some sleuthing. 

How many complaints does the Board receive? I couldn’t find that out with any ease. Often you will see an annual report or even some sort of regular update. You can ask board representatives that question, of course. And the Alabama board helpfully provides you a real person to email, Linda@dentalboard.org.

I tried to find a reference to the number of complaints or any anecdotes about complaints in the meeting minutes. The Board appears to meet at least monthly, which is a good sign. You can read through the Board’s meeting minutes, which are provided here. 

What should you be looking for? I read through a few months’ worth of minutes and found the board doing what boards do, discussing the general upkeep of the standards of the profession, denying certain licenses, allowing others to be reinstated, and approving new licenses. One dentist was denied a general anesthesia permit. Another dentist had his controlled substance permit reinstated, which raises the question, “Why was it taken away?” There are often stories behind those types of actions, but you won’t find them in the minutes. 

There also can be little tidbits like this: “Members discussed adding a question regarding adverse occurrences to the dental licensure application.” Have they been seeing too many dentists moving to Alabama after running into trouble in other states? It’s worth talking to some board members and local dentists about that.

You can download a full list of dentists who are licensed by the state without too much trouble. Look for the link that says “active roster.” It will take you to a link to download a spreadsheet of all the dentists. There are 2,574 active dentists in Alabama. A quick scan revealed a few potentially interesting topics worth exploring. The average age of these dentists is not obvious because no age information is given, but you can tell how long they have been in practice. About 350 of them will have been in practice for 40 years at the turn of the calendar. You could say, “Hooray for experience!” You could also zero in on those dentists who are approaching 60 years in the business and see if any issues have cropped up. One dentist was licensed in 1954, meaning he was practicing dentistry before Elvis released his first hit single. 

Whether any dentists in Alabama have been disciplined is not immediately clear from the list. But there is a clue. There’s a column in the spreadsheet that says “Public File.” This often means that there is a disciplinary file on record for the doctor. If my supposition is correct, that would mean 301 of these dentists — or 13% — have some sort of discipline on their record, a pretty high percentage in my experience. Think about it, would you want to know that you had a one in 10 chance of ending up in the dental chair with a dentist who had been in trouble with the state board?

But remember what I said about dentists who had been in practice since the 1970s and earlier? Well, that’s nearly the entire checkered-past crew. Of the 301 dentists who were licensed between 1954 and 1979, 268 have a “public file.” That’s 89%. Put another way, dentists who have been in business for 40 years make up 12% of the dentists in the state but about 90% of the dentists with a record. How do you like those odds?

Finding out what is inside the “public file” isn’t easy. There is no searchable database for licenses. Instead, you have to email the board and ask for a copy of the file. In a friendly gesture, the board again directs you to a specific person. It’s Linda! You can email her – as I did – at Linda@dentalboard.org. I sent her a note requesting a couple of files and received the files less than 24 hours later. That may be some kind of government agency record.

If I were a reporter in Alabama, I would find out about each of those 268 records and see if there were some patterns. If my experience with other boards is any predictor, some of those records have likely been destroyed, too. So you may have a mystery on your hands. And who doesn’t like a good mystery?

A good start for you for these types of investigations is the agency that provides oversight in your state. The American Dental Association not only recommends certain toothbrushes, it also lists the agencies that regulate dentistry  across the country here. Now, I checked and some of these links no longer work, which is another sign that you may not have a fully functioning oversight board in your area. Let me know what you find.