Board without Bite

Disgruntled patients say that getting help from the Arizona Board of Dental Examiners is like pulling teeth.

Imagine you're in a dentist chair, having a new bridge installed. From behind, you hear grinding, but only the dentist's assistant is in the room with you.

Shortly after leaving the office, you begin experiencing sharp pains in your mouth and notice the new bridge has no bite. Upon inspection, your dentist finds numerous chunks of cement under the bridge. He tries to correct the bite problem by installing a short-term solution, one for which you will be charged.

Seeking a permanent fix to the bite problem, you discuss it with the dentist--who denies his assistant ground the bridge--while refusing to pay for most of the previous work until it is corrected. Eventually, however, the dentist stops seeing you, sending a letter that reads, "You have made a lot of demands on me, my time, my staff and lab. Yet you accuse me of abandonment! I can't work with people who only see their side of the situation. I have instructed my Office Administrator to file suit to protect my interests." Your unpaid $934 bill is turned over to a collection agency.

This is what Charles Licurse says happened to him beginning almost two years ago in the dental office of Dr. Ronald Walker. But what Licurse has experienced since then has been even more painful for him.

To object about the way he was treated, and to seek relief from the unpaid bill, Licurse sent a detailed letter of complaint to the Arizona Board of Dental Examiners. This is the committee of six dentists, two dental hygienists and three lay people which uses a $750,000 annual budget generated entirely from the dental community to oversee Arizona's 2,300 licensed in-state dentists and 1,800 dental hygienists.

Licurse's allegations were summarized into seven charges, and he was seen by an independent dentist who evaluated the situation. The findings of this evaluation were then turned over to an investigative subcommittee of the board.

At a hearing before the subcommittee held one year ago, both Walker and Licurse testified. The panel recommended two of the charges against Walker be upheld and he be censured according to Arizona state law for unprofessional conduct, "which does or would constitute a danger to the health, welfare or safety of the patient or the public". The panel also suggested he be required to take 24 hours of continuing-education courses for risk management/treatment planning and that a new investigation look into his billing practices.

When the case went to the full board three months later, however, the outcome was completely different. After brief statements from both parties, board members asked Walker eight questions and one of Licurse. They then voted to issue only a "Letter of Concern," an advisory and not disciplinary action, about the failure of the dentist to take necessary x-rays prior to treatment.

In response to allegations that the assistant ground the bridge, the board concluded, "Patient states dental assistant did adjustments; Dr. Walker states dental assistant did not." To determine the truth, the board had the power to subpoena the assistant, who had been fired within one week of Licurse's bridge work, but they didn't.

While the outcome of the hearing was a shock to Licurse, it probably wasn't to Walker, who did not return the Weekly's phone calls. According to records in his file at the Arizona Board of Dental Examiners office in Phoenix, he was originally licensed in Arizona in 1977 and had only two unsuccessful complaints lodged against him over the next 17 years. But between 1995 and 2000, 10 complaints were filed against Walker, with five resulting in Letters of Concern and the others being dismissed for various reasons.

The Board of Dental Examiners has a history of not taking disciplinary action against the vast majority of the dentists it receives complaints about. The agency's most recent annual report to Governor Hull shows that during the last fiscal year, of the 471 cases heard by the board, 83 percent ended up dismissed, with a total of 63 Letters of Concern being issued.

Charles Licurse says of the board, "I feel a grave injustice was done. Dr. Walker's statements carried more weight with them than mine did. I could have been singing The Star-Spangled Banner and the board wouldn't have noticed me. It would almost seem impossible that they would favor him based on the evidence. There is certainly something wrong if 83 percent of the cases are found in favor of the dentist."

Another person who complained to the board, but requested anonymity, agrees. "I don't think the board handled my case fairly at all," the patient says. "The board went along with everything my dentist said. It seemed like it was me against the world."

Licurse also accuses board members of being unprepared to hear his case because they apparently hadn't read the submitted written material. That isn't surprising, however, since the board considers 100 cases at each of its six yearly meetings, sessions that last an average of 14 hours.

But it isn't its overall record in handling patient complaints that has the Arizona State Board of Dental Examiners in political hot water. Instead, it is the consideration of complaints against Dr. Terry Lee, who practices holistic dentistry in the Phoenix area, which has caused the board its recent headaches.

Some members of the State Legislature thought the board was picking on Lee for his unusual form of dentistry after it placed him on five years probation following serious allegations made against him. In retaliation, the Legislature provided no funding for the board in the fiscal year beginning July 1, 2002, instead requiring it to submit a report by this September 1 before it will consider further funding.

As for Charles Licurse, once his complaint was rejected by the Dental Board, he looked for help from the state's ombudsman office. Even though procedurally the board shouldn't have reconsidered his case, it did so anyway in February. But after allowing Licurse to testify again briefly, the board quickly upheld its earlier decision.

Despite that, Licurse insists he will never pay for the unsatisfactory bridge work. While he still has to deal with the collection agency, which he says has placed his account on hold until his complaint is finally resolved, at least he might have a little good news. His discount dental plan is now considering paying for a new bridge.

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