Evidence-Based Dentistry in Ohio State Dental Board Hearings

The dental attorneys at Nardone Limited in Columbus, Ohio defend dentists who face standard of care allegations in Ohio State Dental Board hearings by utilizing the dentists’ practice of evidence-based dentistry.  This article will address how the concept of evidence-based dentistry relates to the standard of care in dentistry, and its importance in Ohio State Dental Board hearings.

Evidence-Based Dentistry and the Standard of Care

Evidence-based dentistry is an approach to oral healthcare that requires the judicious integration of systematic assessments of the following areas:

  1. the clinically relevant scientific evidence;
  2. relating to the patient’s oral and medical condition and history;
  3. the dentist’s clinical expertise; and
  4. the patient’s treatment needs and preferences.

     ADA Policy on Evidence-Based Dentistry, American Dental Association, //www.ada.org/en/about-the-ada/ada-positions-policies-and-statements/policy-on-evidence-based-dentistry (last visited June 30, 2017).

A dentist can adhere to this patient-centered approach by providing personalized dental care for his patients that is based on current and relevant scientific knowledge. About EBD, American Dental Association, //ebd.ada.org/en/about (last visited June 30, 2017). As noted in a previous blog post, the standard of care is the accepted standards for the practice of dentistry, which functions as a minimum baseline of acceptable behavior. The definition of this standard does not change. But, the science of dentistry and the way in which dentists practice continues to evolve. A dentist can keep up with this moving target by staying up to date on the current evidence-based research, and providing treatment accordingly.

Evidence-Based Dentistry’s Role in an Ohio State Dental Board Hearing

The Ohio State Dental Board investigates and disciplines dentists when their treatment of a patient falls below the minimum standard of care.  An Ohio State Dental Board hearing is a formal public proceeding that is conducted similar to a civil trial, complete with opening and closing statements; the presentation of evidence and witnesses; and direct and cross-examination. An Assistant Attorney General (AAG) from the Ohio Attorney General’s Office will represent the State, and the dentist may be represented by an Ohio-licensed attorney or proceed pro se. The AAG will begin by presenting his case to the Board or Hearing Examiner. The AAG’s evidence may include testimony, guidelines, and other documents that support the allegation that the dentist failed to meet the standard of care, and can include materials relating to evidence-based dentistry. The dentist, with help of counsel, may cross-examine any witness who testifies, and object to the introduction of any evidence. To prove the allegation against the dentist, the AAG is required to present reliable, probative, and substantial evidence that the dentist did not meet the standard of care.

Then, the dentist, with help of counsel, may present his defense to the Board or Hearing Examiner. The dentist’s evidence may include testimony, guidelines, and other documents that refute the allegation that the dentist failed to meet the standard of care.  Here, a dentist may introduce evidence to establish the standard of care that is founded on evidence-based dentistry, or to establish that he practiced within the standard of care by his adherence to evidence-based dentistry. For example, the dentist could provide the evidence-based research literature that his treatment plan was based on, or clinical guidelines founded on evidence-based research. As another example,  an expert witness may offer the opinion that the standard of care is to treat a patient according to a certain evidence-based research, and upon review of the dental records give the opinion that the dentist did treat according to the that evidence-based research. Providing evidence that the dentist’s treatment adhered to evidence-based dentistry may help to prove that the dentist was practicing above the minimum accepted standards of the profession. The AAG has the opportunity to cross-examine any witness who testifies for the dentist, and object to the introduction of any evidence.

The Board or Hearing Examiner will weigh the credibility of the evidence presented and make findings of fact to determine the minimum standard of care that applies to the dentist’s circumstances. The Board or Hearing Examiner will then compare the dentist’s treatment against the minimum standard to determine whether a violation of the standard of care has occurred.

Conclusion

Evidence-based dentistry’s goal is to help dentists provide optimal care for their patients. Richard T. Kao, The Challenges of Transferring Evidence-Based Dentistry into Practice, 6 J. Evid. Base Dent. Pract. 125 (2006). A dentist who practices evidence-based dentistry provides his patient with personalized and scientifically current dental care that is likely to rise above the minimal accepted standards of the profession. Therefore, the dental attorneys at Nardone Limited can utilize the dentist’s practice of evidence-based dentistry to defend the dentist against standard of care allegations in an Ohio State Dental Board hearing.