Dentist License Defense in Massachusetts

A Board of Dentistry complaint often starts with an unhappy patient, a billing dispute, an insurer audit, or an adverse event during sedation. Whatever the source, you generally have 21 days from the day you receive the Board’s request to respond in writing, and that response sets the direction of the case. Call (978) 273-8337 before you send anything.

A lawyer who understands airways, sedation and monitoring.

I’ve been a registered respiratory therapist since 2005 and a registered nurse since 2010. As a respiratory therapist I spent many years at the bedside providing hands-on respiratory care. As a nurse I’ve worked in critical care and the intensive care unit of an acute care hospital, and I’ve held management roles in that setting. Respiratory care and critical care nursing center on the airway, oxygenation, sedation and monitoring, so I can follow the clinical sequence in a sedation complaint and explain it to the Board.

— Richard Alan Gaudet, JD, RN, RRT

Who regulates dentists in Massachusetts

The Massachusetts Board of Registration in Dentistry licenses dentists, dental hygienists and dental assistants. Its authority comes from G.L. c. 112, §§ 43 through 53, and its complaint and discipline procedures are in 234 CMR 9.00. The ethical standards it enforces include the Principles of Ethics and Code of Professional Conduct in 234 CMR 5.19, and sedation and anesthesia permits are governed by 234 CMR 6.00.

Board staff and investigators handle complaints for the Board. A prosecuting counsel brings formal charges, and an administrative hearings counsel usually presides at hearings.

What leads to Board of Dentistry complaints

Under 234 CMR 9.02(1), anyone can send the Board information alleging misconduct, “in any form.” The grounds for discipline in 234 CMR 9.03 include several that apply specifically to dental practice:

Standard of care: treatment outcomes, failed restorations, extractions, implants and endodontics (9.03(1)(j))
Sedation and anesthesia: adverse events, monitoring, emergency response, and practicing beyond your permit (9.03(1)(b), (k), and 234 CMR 6.00)
Infection control: failing to keep the office in line with CDC guidelines and OSHA standards (9.03(1)(h))
Prescribing: prescribing without a medical history, an appropriate exam, or a recorded diagnosis and treatment plan (9.03(1)(cc)), or violating the controlled-substance laws (9.03(1)(a) and (g))
Billing: charging a patient or insurer for a service not performed (9.03(1)(dd)), or failing to refund a prepayment for work not done (9.03(1)(ee))
Referral payments: giving or receiving commissions or rebates for patient referrals (9.03(1)(ff))
Records: falsified, altered or missing entries (9.03(1)(bb))
Boundaries: any conduct with a patient that is or could reasonably be seen as sexual (9.03(1)(v) and (w))
Supervision: letting hygienists or assistants work beyond their scope, or aiding unlicensed practice (9.03(1)(k) and (m))
Mandated reporting: failing to file required reports, such as child-abuse reports under G.L. c. 119, § 51A (9.03(1)(gg))

Your own duty to report: 30 days

You must report certain events to the Board yourself, in writing, within 30 days, and failing to do so is a separate ground for discipline. Under 234 CMR 9.03(1):

What happened	Deadline
A criminal charge or conviction, in any state	30 calendar days
Any final action on a dental or other health care license, by any government authority	30 calendar days
Disciplinary action by any entity: a hospital, employer, dental insurer, or dental or medical society	30 days

The last item surprises many dentists: discipline by an insurer, a practice employer or a professional society can trigger a duty to report to the Board. Before you file a report, have a lawyer review it.

The 21-day deadline for your written response

If the Board asks for your response, it is due within 21 days of the day you receive the request, and you must sign it yourself (234 CMR 9.02(2)). Failing to respond without cause is itself a ground for discipline (9.03(1)(r)). The Board can treat a letter as received on the day it’s delivered to your address of record, or on the day delivery was attempted if you moved without updating it (9.06(2)).

Your response becomes part of the record. Include the treatment record, the informed-consent documents, and a clear clinical explanation, but answer what was asked and don’t speculate.

The investigation, and how a matter can end early

Staff may request records and gather information from patients, staff, insurers and other providers (9.02(1)). Before a formal complaint is opened, the Board can close the investigation (9.02(3)). After one is opened, it can still dismiss the complaint for lack of jurisdiction or insufficient evidence, or because the conduct, even if proven, doesn’t warrant action (9.04(1)). Closure or dismissal may come with an advisory letter, which is not discipline and makes no finding, but is a public record (9.06(1)).

Summary suspension

The Board, or its Chair between meetings, can suspend a license before any hearing if affidavits or documents show your continued practice is a threat to public health, safety or welfare (234 CMR 9.05):

Immediate and serious threat: the license can be suspended right away.
Serious threat: you’re ordered to file opposing evidence within three business days, and the Board decides after reviewing it.

The suspension is effective when you receive the order, and a post-suspension hearing must be held within seven business days. If you ask to postpone it, the suspension stays in place in the meantime. Call a lawyer the same day you receive the order.

A Board complaint is not a malpractice case

A patient can file a Board complaint, a malpractice claim, or both. They run separately: the Board decides whether to act on your license, while a court or insurer decides whether to pay damages. The Board’s action doesn’t limit other agencies or private lawsuits (234 CMR 9.04(8)), and what you say in one matter can surface in the other. Check whether your malpractice policy includes license-defense coverage, and make sure your Board lawyer and your insurer’s defense counsel coordinate.

Consent agreements

Most formal complaints that aren’t dismissed end in a consent agreement (9.04(4)). It can include any action the Board could order after a hearing, an agreement to stop practicing, or other terms such as continuing education, practice monitoring, a records audit, or limits on sedation. Consent agreements are public records (9.04(6)). The terms, and the description of the facts, are negotiable before you sign.

Permanent surrender

You can offer to permanently surrender your license to resolve a complaint (9.04(3)). An accepted surrender counts as discipline, and the Board may treat the allegations as true. Don’t offer one without advice.

The Order to Show Cause and the hearing

If the matter doesn’t settle, prosecuting counsel can issue an Order to Show Cause requiring you to show why the Board should not act against your license (9.04(2)(a)). From then on it is a formal adjudicatory proceeding under G.L. c. 30A and 801 CMR 1.01, with a written answer due within 21 days of receipt unless a statute or Board rule says otherwise (801 CMR 1.01(6)(d)(2)). Both sides present evidence and witnesses, often including dental experts on the standard of care, and an administrative hearings counsel usually presides.

Possible outcomes

After a hearing, if the Board finds a 9.03 ground exists, it can order (9.04(2)(b)):

Outcome	Is it discipline?	Can you practice?
Stayed probation	No	Yes, with temporary conditions
Reprimand	Yes, a formal public rebuke	Yes, with no conditions
Probation	Yes	Yes, with temporary conditions
Suspension	Yes	No, for a set period or until conditions are met
Revocation	Yes	No

An order can set conditions you must meet before asking to lift restrictions or reinstate your license (9.04(2)(c)), and the Board may impose a fine where the law allows (9.04(7)). Any action also applies to your right to renew (9.04(5)).

Appealing a Board decision

If the Board suspends or revokes your license after a hearing, you can generally petition the Supreme Judicial Court for review under G.L. c. 112, § 64. The court reviews the hearing record and doesn’t hold a new trial, so the record built at the hearing is what any appeal depends on.

What I do at each stage

Reporting: decide with you whether and how to report a charge, an insurer or employer action, or an out-of-state action within 30 days, and draft the report.
The response: review the complaint and the chart, and draft a 21-day response that explains the clinical reasoning and any corrective steps.
The investigation: handle communication with Board staff and push for closure or dismissal.
Coordination: work alongside your malpractice carrier’s defense counsel so the two matters don’t undercut each other.
Negotiation: negotiate consent agreement terms, including monitoring, education and sedation limits, and the wording of what becomes public.
Summary suspension and hearings: prepare evidence, witnesses and experts, and build the record for any appeal.

What to do when the Board’s letter arrives

Write down the date you received it, and count 21 days.
Notify your malpractice carrier if your policy requires it, and ask about license-defense coverage.
Don’t contact the patient about the complaint, and don’t offer a refund in exchange for withdrawing it.
Don’t change, add to or “complete” any chart, radiograph log or consent form.
Gather the full record: the chart, images, consents, sedation records, billing ledger and correspondence.
Tell your lawyer about any related insurer audit, employer action, lawsuit or criminal charge.

Facing a Board of Dentistry complaint?

Call or text (978) 273-8337, or send a message. I represent dentists, hygienists and dental assistants across Massachusetts, in person at my Middleton office or by video.

Frequently asked questions

How long do I have to respond to the Board of Dentistry? Generally 21 days from the day you receive the Board’s request, under 234 CMR 9.02(2). You must sign the response yourself, and failing to respond without cause is a separate ground for discipline.

Do I have to report discipline by an insurer or employer? Yes. The Board’s rules require a written report within 30 days of disciplinary action taken against you by an entity such as a health care facility, an employer, a dental insurance company, or a professional society (234 CMR 9.03(1)(hh)).

Is a Board complaint the same as a malpractice claim? No. The Board decides what happens to your license; a malpractice case decides whether damages are paid. They can run at the same time, and what you say in one can matter in the other.

Can my hygienist or dental assistant be disciplined too? Yes. The Board licenses dentists, dental hygienists and dental assistants, and a dentist can also be charged for allowing staff to work beyond their scope (234 CMR 9.03(1)(k) and (m)).

Is an advisory letter discipline? No. An advisory letter makes no finding and is not a formal Board action against your license, but it is a public record (234 CMR 9.06(1)).