It is a violation of the Dental Practice Act for a dentist to self-prescribe any controlled substances as defined in Division 10 (commencing with Section 11000) of the Health and Safety Code, or any dangerous drug as defined in Article 8 (commencing with Section 4211) of Chapter 9 (B&P 1681[a]). According to Health and Safety Code 11190, prescribers of Schedule II medications must document not only the basic information concerning type, quantity, and dose but also the pathology and purpose for which the drug is being prescribed (Thomson Reuters, 2023). In California, all healthcare practitioners, including dentists, who are authorized to prescribe Schedule II through IV controlled substances are required to register to use the Controlled Substance Utilization Review and Evaluation System, CURES 2.0 (Dental Board of California, 2018), California’s prescription drug monitoring program. This program allows prescribers and dispensers to view patient reports, send peer-to-peer communications, and receive patient alerts (Dental Board of California, 2021b).
practice limitations imposed by B&P Section 1625 mean that a dentist cannot prescribe drugs for a nondental purpose, even though the dentist is allowed by statute to prescribe that drug. To write prescriptions for controlled substances, a dentist must have a Drug Enforcement Administration (DEA) number issued by the U.S. Department of Justice. Division 10 of the California Health and Safety Code governs the form and content of prescriptions (California Health & Safety, 2021). All written prescriptions for Schedule II through V controlled substances must be written on tamper-resistant prescription forms that contain a number of features designed to prevent fraud. Starting on January 1, 2021, California state law has required 15 elements to appear on California Security Prescription Forms. These forms must be produced by printers licensed by the California Department of Justice. (For details, see https:// www.dbc.ca.gov/licensees/prescription_pads_101.shtml.) Dental assistants and RDHs cannot prescribe drugs.
CITATIONS, FINES, REVOCATION, AND SUSPENSION
Concerning sexual misconduct, if a dentist or licensed staff person is convicted of such a crime, California Code of Regulations Section 1018 indicates that the Board may refuse to renew the individual’s license. California Code of Regulations section 1005 sets forth the minimum standards for infection control in the dental office. Failure to abide by these well-recognized standards is a violation of the Dental Practice Act and subjects the owner of the practice to sanctions. Therefore, failure to maintain the standards for infection control is more typically sanctioned by the Dental Board of California rather than by Cal/OSHA (California Division of Occupational Safety and Health). The most common reason for an audit of infection control performance of an office is a complaint by an employee, or less frequently, by a patient. Because infection control is a required course for every licensee, ignorance of the requirements and appropriate implementation are inexcusable in most cases. In October of 2017, Governor Brown signed Assembly Bill No. 1277, adding Section 1601.6 to the Business and Professions Code. This new law ordered the Board to amend the minimum standards of infection control to require that “water or other methods used for irrigation … be sterile or contain recognized disinfecting or antibacterial properties when performing dental procedures that expose dental pulp.” The law ordered that final regulations be adopted on or before the end of December 2018 (California Legislative Information, 2017). However, the law was repealed by the passage of Senate Bill 1491, which instead prohibited “using water, or other methods used for irrigation, that are not sterile or that do not contain recognized disinfecting or antibacterial properties when performing dental procedures on exposed dental pulp unprofessional conduct by a person licensed pursuant to the Dental Practice Act” (Birschbach, 2019). Business and Professions Code 1706 provides that: ● Every complete upper or lower denture fabricated by a licensed dentist, or fabricated pursuant to the dentist’s work order, shall be marked with the patient’s name, unless the patient objects. The patient’s initials may be shown alone, if use of the patient’s name is not practical. The markings shall be done during fabrication and shall be permanent, legible, and cosmetically acceptable. The exact location of the markings and the methods used to implant or apply them shall be determined by the dentist or dental laboratory fabricating the denture.
When exercising its licensing, regulatory, and disciplinary functions, the Board holds as its highest priority the protection of the public. To achieve this goal, the Board investigates complaints against licensees and disciplines and monitors those licensees found to be in violation of the Dental Practice Act. Any licensee may have his or her license revoked or suspended or may be reprimanded or placed on probation by the Board for unprofessional conduct, incompetence, gross negligence, or repeated acts of negligence in his or her profession (Dental Board of California, July 2023). The Board may also revoke or suspend a license, or reprimand or place a licensee on probation, for violations of the Dental Practice Act and for conviction of a crime substantially related to that licensee’s qualifications, functions, or duties. The Board has the power to impose certain terms and conditions on a licensee’s probationary status, including obtaining additional training or passing an examination, submitting to diagnostic examination, limiting a licensee’s scope or type of practice, and requiring restitution of fees or completion of community service (Dental Board of California,2023i). The term unprofessional conduct includes a long list of actions punishable by fines and/or imprisonment, such as fraud; misrepresentation; aiding or abetting the unlicensed or unlawful practice of dentistry; practicing outside the scope of practice; sexual abuse, sexual misconduct, or sexual relations with a patient (unless the licensee is married to, or in a recognized domestic relationship with, the patient [B&P 726]); fee kickbacks; false or misleading advertising (which includes guaranteeing a result or painless treatment [B&P 1680h,l]); employing or making use of solicitors (B&P 1680j); altering patient records with intent to deceive; violations of laws regulating the procurement, dispensing, or administration of dangerous drugs or controlled substances and prescribing excessive medications (typically the failure to document the pathology and purpose of a prescription of a Schedule II or Schedule III medication); and any violation of the Dental Practice Act (B&P 1680n). For a full list of the acts and omissions that constitute unprofessional conduct, see Sections 726, 1680, 1681, 1682, and 1700 through 1706 of the Dental Practice Act. As a result of amendments adopted by the California Legislature in 2012, unprofessional conduct is further defined in the CCR under Section 1018.05, and the Board is given power to require a prospective licensee to submit to a mental or physical examination under Section 1020.
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