CA Dental Law & Ethics common mistakes
CA Dental Law & Ethics · Understand the traps and how to avoid them.
Classifies a delegated procedure by who usually performs it rather than by the supervision level the statute attaches to it - e.g., telling an RDA that radiographs or coronal polishing are fine 'as long as the dentist is somewhere in the building' without checking whether the function requires direct or general supervision.
Candidates memorize duty lists in isolation and never link each function to its defined supervision category; the categories (direct, general, personal) also sound interchangeable in ordinary English.
What to do instead
Build a one-page grid of commonly delegated functions (radiography, coronal polishing, sealants, nitrous oxide, expanded RDA/RDAEF functions) cross-listed with auxiliary type and required supervision level. Memorize the statutory definitions: direct supervision requires the dentist to be physically present in the office at the time of treatment; general supervision requires prior authorization but not the dentist's presence.
Treats a signed generic consent form as conclusive proof that informed consent was obtained, even when the chart contains no note that risks, alternatives, and the option of no treatment were actually discussed.
Consent is studied as a paperwork exercise, so candidates equate a signature with the legal doctrine and never describe the conversation that the signature is supposed to memorialize.
What to do instead
Answer in terms of the discussion, not the document: the record must show the diagnosis, the nature and material risks of the proposed treatment, reasonable alternatives including no treatment, and the patient's questions and acceptance, documented in a progress note. The form supports the discussion but does not replace it - and check that a minor's consent came from a parent or legal guardian.
Applies a blanket 'HIPAA preempts state law' rule - releasing records on a broad authorization, or using patient information for marketing or fundraising, because federal rules would allow it.
Federal privacy training dominates most study material, so candidates never learn that California's Confidentiality of Medical Information Act is stricter and therefore survives preemption.
What to do instead
Apply the stricter-law rule: HIPAA sets a floor, and California's CMIA (Civil Code section 56 et seq.) controls where it is more protective - it demands specific written authorization for disclosure, imposes special handling for HIV, mental health, and substance-use information, and restricts marketing uses. State the state statute alongside the federal one.
Applies a single seven-year destruction schedule to every chart, including charts for patients who were minors at treatment and patients with an open Board complaint, lawsuit, or billing dispute.
Seven years is the one retention number people remember, so it gets applied mechanically without asking whose record it is or what is pending.
What to do instead
Retain records at least seven years from the date of last service, and longer where the patient was a minor at the time of treatment or where litigation, a Board complaint, or an insurance dispute is open. Pair this with the patient-access deadlines: allow inspection within five working days and supply copies within fifteen.
Treats CDC recommendations as the complete infection-control standard and never mentions a written Exposure Control Plan, the sharps injury log, or annual retraining when asked what California requires.
CDC guidance is the most widely circulated material, so it crowds out the enforceable Cal-OSHA regulation that actually carries citations and penalties.
What to do instead
State explicitly that Cal-OSHA's Bloodborne Pathogens standard (8 CCR 5193) is the legally enforceable floor in California: written Exposure Control Plan reviewed annually, hepatitis B vaccination offered, PPE and engineering controls, post-exposure evaluation, sharps injury log, and training at hire and yearly. Present CDC guidance as best practice layered on top.
Says CURES must be checked only for Schedule II opioids, or only when the dentist already suspects drug-seeking, and treats self-prescribing or prescribing for a family member as an ordinary courtesy.
The database is mentally filed under 'opioid crisis' rather than as a routine prescribing step tied to a defined range of drug schedules.
What to do instead
Consult CURES before prescribing a Schedule II, III, or IV controlled substance for the first time and at least once every six months thereafter while the patient continues to receive them. Maintain CURES and DEA registration, document the review, and do not prescribe controlled substances for yourself or immediate family absent a documented emergency.
Approves an advertisement calling the dentist a 'specialist' or 'board certified' on the strength of a weekend continuing-education certificate, or one promising 'painless' or 'guaranteed' results.
Advertising items get answered with marketing common sense instead of the statutory standard for false, misleading, or deceptive statements.
What to do instead
Apply Business and Professions Code section 651 and ask three questions: is every claim factually true, is any credential implied that is not held, and is a reserved term used? 'Specialist' is limited to dentists who completed an ADA-recognized advanced specialty program and limit practice to that specialty; guarantees, superlatives, and titles implying unearned credentials are prohibited, and patient images or testimonials require written authorization.
Waits for proof of abuse, or reports only to a practice owner, colleague, or the patient's family, before filing a mandated report - or assumes someone else in the office will handle it.
Candidates import a criminal-law standard of proof and fear being wrong, and they treat reporting as an office task rather than a personal statutory duty.
What to do instead
Report on reasonable suspicion, not proof, and make the report yourself - the duty is personal and non-delegable. For child abuse, phone immediately and follow with the written report within 36 hours under CANRA; for elder or dependent adult abuse, phone immediately or as soon as practicably possible and file the written report within two working days with the appropriate local agency and law enforcement. Failure to report is a misdemeanor.
Approves an arrangement in which the practice pays a marketing company or a referring dentist a percentage of collections from patients sent or treated, reasoning that the patient is informed or the fee is disclosed.
It looks like an ordinary business commission, and disclosure feels ethically sufficient, so the statutory prohibition never gets triggered in the candidate's mind.
What to do instead
Apply Business and Professions Code section 650: paying or receiving consideration for the referral of patients, or splitting a fee for services not rendered, is prohibited regardless of disclosure and can be criminal. Only fair-market-value payments for actual goods, services, or leased space that are not tied to patient volume, or bona fide employment compensation, are defensible.
Assumes peer review files are fair game in later malpractice litigation, or that the peer review body must hand the dentist under review the complaining patient's identity and the raw file.
General discovery instincts outweigh the specific confidentiality and reporting statutes, which are rarely taught together.
What to do instead
Cite Evidence Code section 1157 (peer review proceedings and records are confidential and not discoverable) and Business and Professions Code section 805 (a peer review body must report certain adverse actions and privilege restrictions to the relevant board within the statutory timeframe). The dentist under review receives the substance of the allegations and a meaningful opportunity to respond, not the complainant's identity or the entire file.