Dental Complaints & Investigations Overview

Pursuant to Iowa Administrative Code 650 Chapter 1, the purpose of the Board is to protect the public health, safety, and welfare by administering, interpreting, and enforcing the provisions of law that relate to the practice of dentistry, dental hygiene, and dental assisting.  The Iowa Dental Board provides a number of services to accomplish this.

• Find a practitioner (dentists, dental hygienists, dental assistants);
• File a complaint;
• Online Services Website 

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Complaints

The Iowa Dental Board investigates complaints filed against dentists, dental hygienists, and dental assistants. If the Board finds that the licensee has violated state law, it may take action against the individual’s license.  650 Iowa Administrative Code details the disciplinary procedures. Below is an overview of the process. 

Anyone can file a complaint, including patients, family members, insurance companies, and others.  The board identifies each of these reports as a “complaint.”

How to File a Complaint

The board office accepts complaints in writing. Refer to the contact information below.

• Online complaint form.
• Email at IDB@Iowa.gov.
• By letter to:
  Iowa Department of Inspections, Appeals, and Licensing
  Iowa Dental Board
  6200 Park Ave. Suite 100
  Des Moines, IA 50321

Complaints should include the following information:

• Your name, address and telephone number or email address.
• Information about the patient: name, date of birth, address, telephone number, and your relationship to the patient.
• The practitioner(s): name, address, telephone number.
• The approximate date(s) when the patient went to the practitioner(s) and why.
• A detailed explanation for why you are making a complaint.
• Any other information that you believe is relevant to the complaint.

What Kind of Complaints Receive Board Action?

The board prioritizes complaints that may pose a significant danger to patients, including: 

• Serious competency concerns.
• Alleged patient harm.
• Criminal conduct related to the practice of dentistry.
• Substance abuse or other impairment.
• Sexual misconduct.
• Other unprofessional conduct that impacts patient care.

Concerns which the board considers to be less serious are those that do not involve serious patient harm or that are isolated occurrences, including: 

• Billing disputes.
• A single incident of rude behavior or communication problems.
• Personality conflicts.
• Poor record keeping practices that are not repeated and do not significantly affect patient care.

While the board may close a less serious case without taking any formal disciplinary action against the licensee, the board may reopen a case if the board receives similar complaints at a later date.  When a pattern of problems begins to emerge, the board may prioritize investigation that may seem less concerning on their own.

How Are Complaints Handled?

Upon receipt of the complaint, staff assigns a case number and opens an investigative file.  Staff reviews complaints to determine the level of investigation needed, and prioritizes them accordingly.  In some cases, the board will review complaints to determine whether to investigate further.  Other cases are immediately assigned to an investigator.

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Investigations

What Happens in an Investigation?

The purpose of an investigation is to get enough information from all parties so that the board can make an informed decision as to whether there was a violation of state law.  To obtain information, the investigator may:

• Interview those involved.  (e.g. complainants, licensees, others)
• Request relevant records. (e.g. patient records, financial records, etc.)
• Examine the licensees’ prior disciplinary history, if any.
• Contact law enforcement or other regulatory agencies.

After obtaining the additional information, the investigator writes a report to the board summarizing the information. The investigator does not make conclusions or recommendations for the board. The board reviews the materials on each case and makes a decision. In some cases, the board may forward the complaint to outside experts for further review. 

The Board’s Options When It Reviews a Case

Each board member has a copy of the investigator’s report and all relevant records related to a case.  The board must determine that there is probable cause to take public disciplinary action.  Probable cause means that it is reasonable to believe that the wrongdoing occurred.

After discussing the case, the board takes one of the following actions:

• Dismisses the complaint and closes the case without action.
• Closes the case and issues a confidential Letter of Education or Letter of Warning to the licensee.
• Investigate the case further, which may include:
  • Referring the case back to the investigator for further investigation;
  • Referring the case to peer reviewers for expert opinion; or
  • Ordering the licensee to submit to a confidential evaluation.
• Take public action, including Notices of Hearing and Statement of Charges, and Settlement Agreements.
• Issues an Emergency Adjudicative Order that suspends some or all of the licensee’s privileges to practice.  In these cases, the board orders a hearing within 30-45 days.  In some instances, the board may issue an emergency suspension in the most serious cases when continued public harm is likely.

What Makes an Investigation Take So Long?

A case remains under investigation until the board decides to close the file or order a hearing.  The investigative process can take several months, or longer, for some of these following reasons:

• The investigator receives and may work on many cases at the same time.
• A licensee/registrant may not be prompt in supplying records or a report.
• A licensee/registrant may have to get a confidential evaluation that takes several weeks or months to schedule.
• Competency cases may require peer review before the Board can rule.
• The board typically only reviews cases at its quarterly meetings.

What Is Public Information and What Is Not?

An investigation is confidential and the board cannot share with the public.  The public may know only when the board files public charges against a licensee.  In those cases, the board can share the investigative file with the licensee who was charged.  The investigative file is never open for review by the complainant or the public.  The board complies with Iowa law about sharing information.

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Prosecutions

Statement of Charges

The board may file charges if it finds probable cause that a licensee violated Iowa law or other regulations.  The Statement of Charges notifies the public that the board has initiated legal action against the licensee.  The board provides the licensee with several legal documents that include charges and an order for a hearing.  This begins the contested case process, which allows the licensee to defend himself or herself before the board.  Following a decision by the board, the licensee also has the option to appeal that decision in district court. 

Once the board files charges, the Assistant Attorney General represents the State during the proceedings.  Licensees may hire a private attorney to assist them through this legal process and to assure their interests are protected.

Settlement or Hearing?

The board office schedules a hearing to allow both sides to present evidence.  State law encourages the board to enter into informal settlement negotiations before the start of a hearing.  In most circumstances the State makes a settlement offer.  If a settlement is not reached, the case proceeds to hearing.  The members of the board hear the case. 

Whether a Hearing Is Open or Closed to the Public

The board office notifies the public when a hearing is scheduled.  Iowa law allows the licensee to choose whether to hold the hearing in open or closed session. Members of the public may attend open session hearings. Most licensees choose to hold the hearing in closed session.  The decision to close the hearing to the public is often made at the beginning of the hearing.

Administrative Law Judge

An administrative law judge (ALJ) presides over Board hearings.  The ALJ rules on matters of law and assists the Board in preparing the written decisions made by the board. 

Disposition of Cases

Iowa law provides the board a range of actions following a hearing, or as part of a settlement.  The Board may impose any combination of the following which it finds appropriate:

• Dismiss the charges and close the case without formal action;
• Dismiss the case and close it without action;
• Issue the licensee/registrant a formal Citation and Warning;
• Place a licensee/registrant on probation subject to monitoring or conditions;
• Restrict a license/registration;
• Suspend or revoke a license/registration to practice;
• Accept a voluntary surrender of a license/registration; and/or
• Issue a civil penalty not to exceed $10,000.

Appeals

Board actions are public documents. The board makes the documents available on the board’s website.  Board actions are also reported to the National Practitioner Data Bank.

Iowa law allows all parties to a case to appeal a decision of the board within the timeframe allowed by law. When an appeal with the board has finished, the interested parties may appeal the board’s decision to district court.  While the decision of an appeal is pending, the sanctions imposed by the board remain in place.

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Confidentiality

All board investigative materials are confidential.  They are not subject to discovery, subpoena, or other means of legal compulsion for their release except to the licensee and the board.  The board may only release investigative materials to a licensee in cases where the board has publicly charged the licensee.

The board may release investigative information to the applicable licensing authority in another state in which the licensee received a license. Additionally, if the board’s investigative materials suggest that a crime has been committed, the board may share the information may with the appropriate law enforcement agency. 

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Civil Immunities

Iowa law protects members of the board, its staff and peer review committee members from civil liability.  Board members and staff are immune from a suit for their role in any act, omission, or decision of the board, as long as they act in good faith.  A person who files a report or a complaint is also immune from civil liability if the reporter acts without malice.

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Mandatory Reporting of Peers

Iowa law requires licensees to report a peer who may have violated the law or other regulations by omission or wrongdoing.  A person licensed by the Iowa Dental Board is required to report someone else licensed by the Iowa Dental Board, but not other health practitioners.  Any licensee who fails to comply with mandatory reporting may be subject to board discipline.

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