Protecting Your Dental License in Texas

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This podcast is for educational purposes only, does not constitute legal advice, and does not create an attorney-client relationship. If you need legal assistance about a legal problem, contact an attorney. If you’re a dental professional in Texas, whether you’re a dentist, dental assistant, dental hygienist, your license is one of the most valuable things that you possess professionally.

It represents your years of hard work, education, training, and the trust that’s placed in you by the public. But something that many licensed professionals don’t fully realize until they’ve encountered some trouble with their regulatory agency is that when you are practicing with a license, this also means you’re practicing inside of a regulatory framework. There are rules, there are standards, and there are oversight bodies that exist to enforce these standards. Now, in dentistry in Texas, that oversight comes from the Texas State Board of Dental Examiners.

This is Know Your Regulator. I’m Simone Murfrey, your host. And today I want to talk about something that every dental professional should be thinking about in their career, not just when something goes wrong. And that’s how dental professionals can avoid disciplinary action before it even begins. Because when people hear the frayed board investigation or disciplinary action, they often think that something dramatic has to occur, like major malpractice, patient harm, intentional misconduct. Someone knows that they’re going in and violating a rule. But many licensing issues start so much more quietly than that. They start with a documentation problem, a communication breakdown.

Something that seems really small in the moment that becomes so much bigger once regulators are involved. So I’m going to walk you through some of the most common areas where dental professionals run into trouble. And more importantly, we’re going to talk about the habits that can help prevent these situations from occurring in the first place. First, it helps to understand what the board is actually responsible for, right? What is the board’s mission? What are they tasked with doing? The Texas State Board of Dental Examiners, often called TSBDE, regulates dental professionals in the state. So that includes licensing, rulemaking, enforcing those professional standards that we just talked about. And their focus is to ensure that these professionals who are practicing in Texas are qualified, competent, and not going to bring harm to the public.

When the board receives a complaint, their job is not to decide whether someone had a bad day at work. Their job is to evaluate whether a license holder violated the Dental Practice Act or the board’s administrative rules. So that means they’re looking at things like whether the professional met the accepted standard of care, whether proper documentation was maintained, whether the provider stayed within their scope of care, the scope of their license, and whether patients were properly informed about their treatment.

So from the board’s perspective, it’s not just whether, you know, the treatment outcome was perfect, that everything went smooth and the patients happy. It’s about whether the license holder practiced in a way that met their professional and regulatory expectations. And that’s a very important distinction to make because even situations that don’t involve serious patient harm can still raise regulatory concerns if compliance requirements were not followed. And so let’s talk about that for just a moment. One of the most important concepts in any healthcare profession is the standard of care. And that refers to the level of care that a reasonably competent dentist would provide in similar circumstances. So it’s not about perfection, it’s not about being the best, but it’s about whether that care provided aligns with accepted professional practices.

So for dental professionals, this could include things like proper diagnosis and treatment planning, clinical protocols, maintaining sterile environments and patient safety practices, and practicing within your training and your scope of practice. If a complaint is filed, an investigator will often look at whether the care that was provided met that standard. So they’re going to be reviewing things like patient records, treatment notes, and they could even get expert opinions from other dental professionals. One of the most effective ways to protect yourself in this area is simply to stay current. Finish your continuing education, your professional development, and stay informed about best practices.

That all plays a role in you maintaining your standard of care and being prepared to answer some of these questions or give over some of these records that investigators may want to comb through if you have issues with your regulatory board. And going off of that documentation, if you talk to licensed defense attorneys or even your regulator, one of the most common things that you’ll hear is good documentation protects professionals. When a complaint is filed, that patient chart becomes incredibly important.

I mentioned just a moment ago that investigators want to see what happened during treatment. They want to know what decisions were made. They want to know what information was communicated to the patient. And if that information is not documented clearly, it can create problems, even if the care itself was appropriate. I mentioned just a moment ago that harm doesn’t have to come to the patient. The patient doesn’t have to be dissatisfied for there to be trouble with your regulator.

So strong dental records should typically include things like treatment notes, clinical observations, we’re talking diagnostic information, informed consent documentation. That is huge. Any medications prescribed, any patient communications, and any follow-up instructions. In many, many cases, that chart becomes the primary evidence of your professional judgment that was exercised. And when documentation is incomplete or it’s inconsistent, it can raise some questions that might not have otherwise existed. So one of the simplest but most important risk management habits is this: make sure that your documentation tells the full story of the patient encounter.

So I’ve been talking a lot about how the patient doesn’t have to experience harm or a major dissatisfaction for you to have trouble with your regulator. However, that is an area where you can still experience trouble with your regulator that stems from patient dissatisfaction or patient harm, right? Sometimes patients feel confused about treatment options, sometimes they feel like their concerns weren’t addressed, sometimes they’re frustrated about the outcomes, maybe they feel like it wasn’t communicated clearly.

Maybe you felt like you did it to the best of your ability, but the patient feels differently. When that frustration builds, where do you think the patient goes to look for answers or vent their frustrations? They go to the licensing board. And I always say that the fastest prevention tool is an early conversation. So this means explaining things early like treatment options, risks, documenting any informed consent, answering patient questions thoughtfully, maybe more than once, and addressing concerns before they escalate and get out of hand.

If a patient is coming to you and they’re frustrated, they’re upset, take the time to address the situation with them early on. Good communication does two things, right? First, it improves patient care. And second, it can significantly reduce the likelihood that a misunderstanding turns into a formal complaint with the board. Communication is key here, and having that conversation earlier rather than later can make all the difference. Another important thing for professionals to recognize is that complaints don’t just come from nowhere, right?

They don’t come from thin air. As we just mentioned, some of the root causes. For example, repeated patient dissatisfaction, communication breakdown in the office, documentation shortcuts during busy schedules. Maybe your staff is confused about regulatory requirements. What are they allowed to do and not allowed to do? These kinds of patterns can create huge vulnerabilities if they’re not addressed. And sometimes I know that pace of clinical work can make it very easy to overlook things.

Professionals are often extremely busy, but stepping back periodically to review office practices, anything from documentation to patient communication can help identify areas that may need improvement before you have gotten yourself into a very costly, time-consuming, very stressful regulatory issue. Now, finally, there is an unfortunate side of things, and that’s even when professionals do everything right, complaints can still happen. A patient can still file a complaint for a number of reasons. And I want to be clear, not every complaint filed results in disciplinary action.

But if a complaint does reach the board, there’s something very, very important to remember, and that’s take it seriously from the beginning. The board has the authority to investigate these complaints and determine whether disciplinary action is warranted. Remember, they need to ensure that the dentists that they are licensing are competent to practice. They follow those governing rules and they’re not bringing harm to the public. That process may include reviewing records, requesting responses from a license holder, and evaluating whether any rules or statutes may have been violated. So even if a complaint seems minor or unfounded, responding carefully and professionally is critical.

Ignoring it or responding with a rushed casual response without any thought can actually go and make the situation worse. At the end of the day, protecting your professional license is not about practicing in fear. It’s about practicing with awareness. And engaging with your regulatory agency and understanding the rules and regulations that surround and govern your profession. We talk a lot on the show about how most disciplinary cases do not start with catastrophic events.

They’re much more quiet. They start with these small compliance gaps that build over time. And if you don’t address them, they become much bigger issues with your regulator. It’s about maintaining good documentation habits, communicating clearly with patients, and staying informed about the standards that guide your fields. However, the good news is that many of these risks are preventable with the right habits and imperatives, like I just said. As a professional, it is on you though to make sure that you stay in the mill in your industry.

We do try and make it easy for you, so make sure you subscribe to Made Regulator for more conversations about how groups and regulations impact the license professionals across taxes. And follow us on social media so you never miss an updates. Until next week, stay subscribed and regulatory.