State Board of Dentistry
Meeting Summary
July 19, 2013
Report of the Prosecutorial Division
Consent agreements:
 Consent agreement for dentist with an infection control violation: $1,000 fine and an
indefinite suspension. The licensee will need continuing education before his/her license
can be reinstated.
 Consent agreement for dentist with DUI: the licensee agreed to a permanent voluntary
surrender of his/her license.
 Consent agreement for dentist who failed to maintain proper records and for
prescribing medication for eye injury that fell outside the scope of practicing dentistry
(reciprocity case): $1,000 fine and two year suspension of his/her license. Reciprocity in
New Jersey resulted in a $10,000 fine.
 Consent agreement for dentist who is 15 hours short of continuing education credits:
dentist would like to voluntarily surrender license due to a disability.
 Consent agreement for dentist with substance abuse problem and three DUIs: dentist is
currently in treatment program but agreed to enter into the state’s Voluntary Recovery
Program.
 Consent agreement for dentist who failed to report an associate allowing an Expanded
Function Dental Assistant working outside her scope of practice: dentist agreed to
$4,000 fine and six months probation.
 Consent agreement for dentist who provided substandard care and restrained child
without parental consent (reciprocity case): Dentist agreed to a $1,000 penalty and does
not intend to ever practice in Pennsylvania. She has already complied with Colorado’s
reprimand.
 Consent agreement for hygienist signing the dentist’s name to prescribe medication for
herself: the hygienist was terminated from her job and has agreed to pay for the cost of
the investigation, 10 hours of continuing education and an indefinite suspension of her
license. She may apply for a reinstatement after six months and will then be on
probation for a year and a half.
Presentation:
The board scheduled time with two employees of the Prosecutorial Division to discuss why the
cost of investigation is hardly ever included in the consent agreement for licensees. The division
raised the following issues:
 The Department of State has no statutory authority to collect on the cost of
investigation.
 If licensee refused to pay civil penalty, the case would go to trial or a new consent
agreement must be reached. Prosecutors sometimes have to weigh whether to go
through a lengthy and costly trial to maybe have the licensee pay the penalty and
investigative costs, or settling the case with a consent agreement in order to get an
unsafe practitioner to stop practicing. In these cases where a consent agreement is
ultimately accepted, prosecutors cannot charge the cost of investigation. But the state’s
focus is ensuring the public’s safety.
 Prosecutors usually try to negotiate settlements that the board and licensee will accept
without going to trial.
 Prosecutors are not considered investigators and their time is billed separately. They
cannot “charge” for the investigator’s time but they can use the information that
investigators give to them in order to prosecute the case.
The board also questioned why prosecutors are rarely presenting consent agreements with
more significant fines, now that they have the statutory authority to fine up to $10,000 per
count. The division’s answer:
 Prosecutors may be presented a lower fine because the licensee’s attorney negotiated a
lower fine than originally presented and it would “close the case.” The board always has
the ability to reject a consent agreement and go to trial.
The division noted that it generally takes six months to two years from the date of the initial
complaint for it to come before the board for review, so patient safety is always the priority.
Status of Regulations
Licensure fees: Draft regulations to increase licensure, certification and permit fees were
published as proposed rulemaking in April 2013. The board did not receive any comments from
stakeholders, but the House Professional Licensure Committee and Independent Regulatory
Review Commission (IRRC) requested more information about the board’s cost of operation.
Counsel submitted a financial report to the committee and IRRC illustrating that the board will
start incurring deficits in 2013/14 if it does not raise fees.
Updates to existing regulations: Counsel reviewed the following draft changes made to existing
regulations:
 The definition of fictitious name was updated to include corporate names, regardless if
whether the corporation is registered with another state agency.
 The continuing education section was updated to accept webinars as a regular course,
not as individual study.
 Re-licensure requirements were changed so that the board would have the option of
requiring applicants to retake a licensure exam if they have not actively practiced the
preceding five years. Some board members expressed reservation about how to define
“active practice” because some applicants may be academicians or researchers, for
example. Counsel will continue to tweak this section and noted that the regulations
could allow the board several options for reinstating licenses depending on the
applicant’s career choices. The board could also provide a definition of “clinical
competency.”
 Advertising regulations now recognize all ADA-approved specialties.
 Draft regulations now exist to better enforce the denture and dental appliance patient
identification law.
 Draft regulations now exist for the formation and registration of corporations.
 Draft regulations would allow the board to revoke a radiology certificate with cause.
 Anesthesia regulations will now require permit holders to use the most recent
guidelines from the ADA, AAOMS and the AAPD.
 Draft regulations would allow the board to still discipline licensees on inactive status.
 Regulations for public health dental hygienists were updated to reflect statutory
requirements that allows for employer malpractice coverage.
The board will continue reviewing all of Counsel’s proposed regulatory changes.
Teeth whitening policy statement: Counsel stated that the board could consider pursing
legislation declaring teeth whitening the practice of dentistry as the most “clear” path to
regulating this practice. The board could still opt to pass its policy statement or to prosecute
cases if and when they come. The board directed Counsel to draft a legislative proposal.
Mobile dentistry regulations: The Practice Ownership Committee used a Massachusetts law to
revise the draft regulations for mobile dental units. Dr. DeFinnis mentioned that the committee
increased the permit application fee, incorporated the public health dental hygienist into more
provisions, changed the mileage restriction for mobile units’ proximity to “bricks and mortar”
dental offices, and changed the ownership requirements so that anyone could be an owner so
long as there was a dental director employed with the unit. The committee is questioning the
requirement that the dental van operator or owner be accessible 24 hours a day, seven days a
week.
Varying offices within the Department of State will need to review this draft before it is
published in the Pennsylvania Bulletin as proposed rulemaking. It is difficult to ascertain when
this might be.
Board response to PSOMS Anesthesia Committee
In response to concerns raised by the PSOMS Anesthesia Committee at a meeting earlier this
year, the board agreed to the following:
 Only unrestricted permit holders can use the medicines Propofol and Ketamine.
 A permit level II is needed to administer oral sedatives.
 CRNAs can only use the level of anesthesia that the permit holder in whose office
he/she is administering the anesthesia is allowed to use.
 The board interpreted its regulations to mean that permit holders must not “borrow”
equipment from colleagues before an office inspection and clinical evaluation takes
place. Their equipment must remain fixed in the office itself. Only itinerant anesthesia
providers may bring and take equipment.
The board authorizes the PSOMS inspectors to enforce the above provisions.
Next meeting date: September 6, 2013