Dentists Rumble Over Rules

Mary Gadbois thought she was being singled out last year when the Missouri Dental Board put her on probation for violating state rules that govern dentists’ advertising.

Rather than simply stew, the Columbia dentist filed "about 30" complaints with the dental panel about other dentists who advertise in the Yellow Pages.

But Gadbois, of Cherry Hill Dental Associates Inc., hasn’t necessarily gotten the results she wanted.

"I’ve sent in the same dentist like six times in a row," she said in an interview last week. "Nothing happens."

Gadbois’ case highlights the rumblings in Missouri’s dental industry in the wake of new advertising restrictions implemented at the end of 2002.

Advertising complaints submitted to the dental board jumped from 19 in fiscal 2004 to 101 last year. Observers say other dentists are often behind the complaints, and the dental board - made up of volunteers appointed by the governor - is trying to figure out whether the rules should be changed again.

"We deal with much more serious issues," said Rolfe McCoy, a Chillicothe dentist and member of the board. "We’re trying to clean this up so that it isn’t an issue."

The rules implemented in 2002 require dentists to attach disclaimers to ads in a variety of situations. Specialty areas such as "implant dentistry," for example, are not recognized by the American Dental Association, and an ad touting those services must say that they require no specific training.

Although implant dentistry - which uses metal anchors to allow the installation of crowns or replacement teeth - might not be officially recognized as a specialty area, some practitioners get additional training in the field. That could explain why a proposed change to the rule, circulated this year, would exempt specialists from using disclaimers if they received extra training.

Critics don’t like that idea. Guy Bates Jr., a Springfield dentist on the Missouri Dental Association’s board of trustees, said it "made no sense" that a specialist wouldn’t have to include a disclaimer. If it’s misleading for a general dentist to imply a specialty exists when it doesn’t, he said, the same should be true of specialists. He also highlighted the issue of cosmetic dentistry, saying he has lost patients who thought they were switching to a cosmetic specialist.

"There is no ADA-recognized specialty in cosmetics," he said. "Sadly, the public doesn’t realize that."

The message might be getting through to dentists, however. A glance at Columbia’s CenturyTel "Opportunity Pages" reveals several dentists who advertised cosmetic dentistry with no disclaimers last year. Those ads carried no such references or included disclaimers in this year’s edition.

In fact, at a hearing earlier this month, Gadbois displayed a copy of a St. Louis phone book with an ad on the cover. She said in an interview that the ad featured the president of the dental board but lacked the proper disclaimer.

Sharlene Rimiller, the board’s executive director, said it generally responds to complaints instead of searching through the phone book for violations. She noted that dentists usually get two strikes before facing disciplinary action.

Gadbois’ case was somewhat different because she was already on probation for an unrelated matter when the board sanctioned her for noncompliant ads.

She got the message. The Columbia dentist told board members at a hearing that she now wraps disclaimers around free toothbrushes she gives to patients.