State Board of Dentistry
Meeting Summary
September 6, 2013
Prosecutorial Report
 Dentist is charged with six counts of ordering one type of crown and billing for another type. The
consent agreement calls for seven hours of remedial education on ethics and for reimbursing
patients and/or the insurer.
 Consent agreement is for impaired hygienist to enter the Voluntary Recovery Program for a
minimum of three years.
Status of Regulations
 Licensure Fees:
Office of General Counsel and the Budget Office approved the draft regulations raising licensure
and permit fees for dentists and auxiliary personnel. Board counsel will deliver the draft
regulations to the House and Senate Licensure Committees and the Independent Regulatory
Review Commission for review this fall.
 Teeth Whitening:
At its July meeting, the board voted to change its policy statement on teeth whitening into a
legislative proposal that would state that the application of teeth whitening agents is the sole
practice of dentistry. Board counsel did not provide any further updates.
 Anesthesia permit holders:
Board counsel updated the regulations to denote that anesthesia permit holders should be
using the newest standards issued by professional dental organizations as to the use and
administration of anesthesia. Other changes include language that makes clear that dentists
may not administer any level of anesthesia if they do not renew their permit. The same is true if
a dentist’s license becomes inactive, suspended, etc. Board counsel also added peer review
organizations that the board had approved since the regulations were first enacted. The board
also clarified the types of anesthesia that falls under each permit.
The board discussed whether it should incorporate other changes to the existing regulations
that are based on the concerns raised by the PA Society of Oral and Maxillofacial Surgeons
Anesthesia Committee earlier this year. The Committee wanted the board to discuss the issue of
“stacking” medications and whether permits are needed to administer oral sedatives, among
other things. Board counsel advised that “now would be the time” if the board wanted to
regulate these kinds of issues. She will meet with board members to draft further revisions to
the regulations.
 Botox/Dermal fillers:
Board counsel stated that the board would need to change its draft policy statement to a
regulation if it wanted to require that dentists fulfill a certain number of training/education
hours in order to administer botox/dermal fillers. She explained that a policy statement can only
be considered a guide for the dental community as to what the board believes they should
aspire to in order to achieve minimal competency with a certain procedure or task, but that it
cannot be enforced as if it were a regulation.
The board voted on whether to change the policy statement to a regulation. The vote was tied
and Dr. Deem cast a “nay” vote in order to break the tie. She likened this issue to dentists
placing dental implants and that the board should not be micromanaging the hours of training
dentists should obtain on every single dental procedure.
The board discussed the pushback it received from the medical community, which feels that this
procedure should be limited to practitioners in the medical field. The PA Medical Society
questioned what the board meant by the provision that dentists may apply botox/dermal fillers
to “associated structures” of the teeth and jaw. The Scope of Practice Committee will draft a
definition of “associated structures” for inclusion in the policy statement. The policy statement
will also include language that the board strongly believes that dentists should get the education
and training they feel is necessary to competently administer botox/dermal fillers.
 Mobile Dentistry: Board counsel is in the process of reviewing the latest draft.
Legislative Update
Board counsel reported that the Department of State’s legal office was asked to provide an analysis of
HB 1603 (copy of bill attached), which pertains to the administration of anesthesia in hospital settings.
She pointed out some consistencies in the bill and how dentists with unrestricted anesthesia permits are
regulated by the Department of Health’s health care facilities regulations when they administer
anesthesia in hospitals, so the exemption in the bill for dentists with unrestricted permit holders is not
enforceable. The board believes HB 1603 needs to be amended to address this inaccuracy, to include
dentists in the definitions provided and to correct the implication that dentists are exempt only if they
provide the anesthesia and perform the dental work. Board counsel will convey the board’s concerns
through the appropriate channels.
Chair’s Report
Dr. Deem made note of a Congressional report on the role of corporate dentistry in Medicaid fraud and
abuse. The board is relying on a 1938 statue about corporate businesses should any cases be brought
before them, but Dr. Deem asked the board to consider supporting a law or regulations that explicitly
states that only dentists may own dental practices. Most board members agreed, but several raised
concerns about the difficulty with addressing all the nuances and variables that exist with ownership of
a dental practice. The board as a whole did not pass any motions or directives on how to proceed, other
than to take a look at bills on corporate ownership that were already introduced in the General
Assembly.
Committee Reports
 The EFDA Committee is now actively reviewing 11 applications from EFDA programs. Its next
step is to review the EFDA exam process to ascertain whether DANB should be the testing agent,
rather than PSI. Ms. Groody noted that PSI does not test for coronal polishing, fluoride
applications and teeth impressions, even though legislation allowing EFDAs to perform these
functions was enacted several years ago.
 The Licensure Committee researched whether the board should accept practice management
courses as part of licensees’ continuing education (CE) requirement. Dr. Erhard, committee
chair, stated that the board would also need to consider whether only dentists should be
allowed to take these courses for credit, and whether the board should accept all courses that
are offered. He noted that 19 states accept practice management courses as part of their CE
requirement. Some board members believed that the board should accept practice
management courses since students are graduating with significant debt and they receive little
instruction in dental school. Others noted that the original intent of CE was for dentists and
others to maintain their clinical competency. The board directed Dr. Erhard to conduct further
research on the 19 states with regulations.
 The Ownership Committee is planning to focus on the corporate dentistry issue, with emphasis
on addressing dental management organizations and dental service organizations.
NEXT MEETING: OCTOBER 25, 2013
LAST MEETING: DECEMBER 13, 2013