The Groupon Whitening
Lena is a Kentucky dental hygienist who starts a side business called "BrightSmile Mobile." She advertises on social media: "$99 whitening - no dentist exam needed - licensed hygienist only." She offers a $50 gift card to any dentist who refers patients and pays a local dentist $40 for each patient he "clears" by text message without an exam. She posts before-and-after photos of patients without written authorization. At her main job, she notices that a coworker, a licensed dentist, smells of alcohol at 8 a.m., has slurred speech, and is about to extract a tooth. The office manager says, "He's the owner's son; don't report it." Lena asks what she can advertise, whether the referral payments are allowed, and what to do about the coworker.
1. Analyze the advertising and the "no dentist exam needed" claim.
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Lena may advertise her business, but the ad must be truthful and not misleading. "No dentist exam needed" is the main problem: tooth whitening is a dental service, and a hygienist may provide it only within the scope and supervision rules of 201 KAR Chapter 8. A blanket claim that no dentist is needed implies unsupervised practice and may violate the Dental Practice Act. She should remove that claim, state her license and the supervising dentist where required, avoid guaranteeing results, and include the required business information. The Board can discipline licensees for false or deceptive advertising. She should have the final ad reviewed by the supervising dentist and her own attorney.
2. Are the referral payments and text-message clearance permissible?
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Paying a dentist $40 per patient or giving $50 gift cards for referrals looks like fee splitting or paying for patient referrals, which Kentucky law and Board rules restrict. A text-message "clearance" without an examination, diagnosis, and written authorization is not adequate supervision and does not satisfy informed consent. The dentist must actually examine the patient, document findings, and authorize the specific treatment; the hygienist must keep the written order and the patient's records. If the arrangement is a bona fide employment or lease arrangement, it must be structured in writing and not tied to per-patient referrals. Lena should stop the payments and the text-clearance practice until she gets legal advice.
3. What should Lena do about the impaired dentist?
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Patient safety comes first. The dentist smells of alcohol, has slurred speech, and is about to extract a tooth; Lena should interrupt the procedure, notify another dentist or the office manager, and not allow him to treat. She should offer him a private, nonjudgmental path to help, but she cannot conceal impairment. If he is practicing while impaired, she should report him to the Kentucky Board of Dentistry; many states impose a duty on licensees to report impaired colleagues who pose a risk. The "owner's son" and "don't report" instructions are not a defense. Document what she observed factually and keep the report confidential to the extent required.