Principles of Ethics, Code ofProfessional Conduct and Advisory
Opinions of the American Associationof Orthodontists

Adopted April 2017
Amended May 2018
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Principles of Ethics, Code ofProfessional Conduct and Advisory Opinionsof the American Association of Orthodontists
The professional conduct of members of this Association shall be governed by these
Principles of Ethics, Code of Professional Conduct and Advisory Opinions. Every
member of this Association shall adhere to these requirements.
The primary purpose and goal of the AAO's Principles of Ethics, Code of Professional
Conduct and Advisory Opinions is to protect the public.

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PREAMBLE

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The Advisory Opinions are interpretations that apply the Code of Professional
Conduct relative to specific fact situations. They are adopted by the AAO’s Council on
Membership, Ethics and Judicial Affairs to provide guidance to the membership on how
the Council might interpret the Code of Professional Conduct in a disciplinary
proceeding.

Membership in the American Association of Orthodontists (AAO) is voluntary. By
accepting membership, all members assume an obligation to self-discipline above andbeyond the requirements of laws and regulations, in accordance with these Principles of
Ethics, their associated Code of Professional Conduct and relevant Advisory Opinions(hereafter referred to as the “Principles, Code and Opinions”).
The Principles of Ethics define the pillars of personal character members of theAmerican Association of Orthodontists voluntarily agree to pursue in order to fulfil the
position entrusted to the profession by society. Principles provide guidance, offer
direction and defend reasoning for the Code of Professional Conduct and theAdvisory Opinions. The central core of the AAO’s Principles, Code and Opinions isfixed in these five Principles: patient self-governance, do no harm, treat all people fairly,
do good, truthfulness. Principles may support multiple features of the Code ofProfessional Conduct and Advisory Opinions found within this document.
The Code of Professional Conduct illustrates specific obligatory conduct related to the
Principles voluntarily agreed to through membership in the AAO. The Code ofProfessional Conduct promulgated by the AAO through its House of Delegates andassociated legislative processes, is the result of an on-going dialogue between theprofession of orthodontics and society and, therefore, is subject to continuous review.
Violations may result in disciplinary action as the Code of Professional Conduct isbinding on all members of the AAO.

The term “ethical,” as used in the Principles, Code and Opinions, means the highest
principles and practices, customs and usages of the orthodontic specialty. It may, but

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does not necessarily, involve issues of morality in the practice of orthodontics. The term
“unethical” means conduct which fails to conform to such standards, customs andusages or policies, and thereby violates these Principles, Code and Advisory Opinions.
These Principles, Code and their associated Advisory Opinions may exceed, but arenever less than nor contrary to, legal requirements. Under no circumstances should
these Principles, Code and Opinions be construed to encourage conduct that violates alaw. Violation of law may subject the member to civil or criminal liability. Unethicalconduct in violation of any of the Principles, Code and Opinions may result in
disciplinary action by the Association, such as reprimand, suspension or expulsion frommembership, as provided in the Association’s Bylaws. Relevant Bylaws provisions
appear at the end of these Principles.
Expulsion from membership is the maximum penalty that may be imposed by the
Association on a member who violates these Principles, Code and Opinions. However,the Association may also have an obligation to report to the appropriate governmental
agency, state board of dental examiners or provincial regulatory body certain violationsof these Principles, Code and Opinions.
Acquittal or exoneration of a member charged with illegal conduct in civil or criminal
action does not foreclose the Association’s right to initiate a disciplinary proceeding
against a member with reference to the conduct that was the subject of such action.
However, such acquittal or exoneration may be considered in relation to whether aviolation of these Principles of Ethics, Code of Professional Conduct and Advisory
Opinions has occurred and/or any subsequent penalty to be imposed.

PRINCIPLES of ETHICS, CODE OF PROFESSIONALCONDUCT AND ADVISORY OPINIONSPRINCIPLE 1: PATIENT SELF-GOVERNANCE (“Autonomy”) Members have a duty torespect the patients’ rights to self-determination and confidentiality.
CODE OF PROFESSIONAL CONDUCT
1.A. PATIENT INVOLVEMENT.
Members have the duty to respect patients’ rights to self-determination andconfidentiality.
1.B. PATIENT RECORDS
Members have the duty to safeguard patient records and their confidentiality.
Advisory Opinions:1.A. (i) Members should inform their patients of any proposed treatment
and any reasonable alternatives in a manner and context that enables
patients to understand treatment alternatives and their decisions.
1.A (ii) Members should avoid interpersonal relationships with theirpatients that could impair the provider’s professional judgment or risk the

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possibility of exploiting the patient’s confidence placed in the orthodontic
provider by the patient.
1.A (iii) Members shall make treatment decisions and render all related
opinions and recommendations based on the expressed interests anddesires of the patient.
1.A (iv) It is ethical to provide a second opinion to a patient as long as it isqualified as to whether or not it is based on a review of the treating
practitioner's records and treatment history.
1.A (v) A second opinion should include a diagnosis and treatment plan
recommended to the patient. It is unethical to propound a specifictechnique, philosophy, training or ability as superior without
acknowledging that each orthodontist uses different techniques based on
training and experience, and that the second opinion is based on an
orthodontist's individual perspective.
1.A (vi) Patients should be informed of their oral health status without
defamatory statements that are both untrue and damaging comments
about the patient's prior treatment.
1.A. (vii) All opinions and treatment related recommendations, regardlessif provided during initial examination, second opinions or at other times,
must disclose any aspect of the opinion or recommendation which might
be construed as a benefit to the member in any tangible or intangible way
regarding a direct or indirect financial or other beneficial interest in a
product or service, or is motivated by a relationship with the manufacturer
or supplier of such product or service. Any second opinion must further
disclose any perceived or real conflict of interest related to any
recommendation that unnecessarily alters technique, adversely alters
treatment time, expense, anticipated outcome or any other aspect ofpatient care.
1.B. (i) Members shall maintain the confidentiality of patient records.
Upon request of a patient or another practitioner acting on behalf of thepatient, and regardless of whether the patient owes an outstandingbalance, members shall provide any information (including copies ofappropriate records) that may be beneficial to the future treatment of thatpatient. Reasonable costs for duplicating and providing such records may
be charged to the patient.
1.B. (ii) Members should retain patient records (including chart, x-rays,
models, etc.) for at least as long as the applicable statute of limitations
period in their state or province for bringing a malpractice claim (which
may not begin to run in the case of a minor until the age of majority).
PRINCIPLE 2: DO NO HARM (“Nonmaleficence”) Members have a duty to refrain fromharming the patient.
CODE OF PROFESSIONAL CONDUCT

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2.A. Members shall be dedicated to providing the highest quality orthodontic anddental care to their patients within the bounds of the clinical aspects of thepatient’s condition, and with due consideration being given to the needs andexpressed interests of the patient.
2.B. Members should devote sufficient efforts to maintain expertise in providing
evidence based orthodontic care through clinical practice and continuing
education focusing on the specialty of orthodontics as well as other interrelated
aspects of dentistry.
2.C. Members shall make every reasonable effort to enable continuing
orthodontic care for patients of record and shall not abandon their patients.
ADVISORY OPINIONS:
2.A. (i) Members must prescribe and directly supervise the work of all
auxiliary personnel through (a) being present in the orthodontic officewhen care is rendered, (b) prescribing procedures to be performed andpersonally evaluating the treatment status of the patient, and (c) except for
imaging processes and emergency removal of irritating or broken
appliances, approving all procedures performed by auxiliary personnel
before dismissing the patient.
2.A (ii) Members shall make reasonable arrangements for emergency
care for their patients and should, when consulted for emergency care bya patient not of record, make reasonable arrangements for emergency
care and advise that the patient should subsequently return to his/her
original provider unless the patient has a different preference.
2.A (iii) Members shall make treatment decisions and render all related
opinions and recommendations based on the best interest and within thedesires of the patient without regard to a member's direct or indirect
financial or beneficial interest in a product or service, or direct or indirect
relationship with the manufacturer or supplier of such product or service.
2.A. (iv) A second opinion should include a diagnosis and treatment plan
recommended to the patient. It must be honest and focus on the facts
presented. It is unethical to propound a specific technique, philosophy,
training or ability as superior without acknowledging that each orthodontist
uses different techniques based on training and experience, and that thesecond opinion is based on an orthodontist's individual perspective.
2.A. (v) All opinions and treatment related recommendations, regardless ifprovided during initial examination, second opinions or at other times,
must disclose any aspect of the opinion or recommendation which might
be construed as a benefit to the member in any tangible or intangible way
regarding a direct or indirect financial or other beneficial interest in a
product or service, or is motivated by a relationship with the manufacturer
or supplier of such product or service. Any second opinion must further
disclose any perceived or real conflict of interest related to any
recommendation that unnecessarily alters technique, adversely alters
treatment time, expense, anticipated outcome or any other aspect ofpatient care.

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2.A. (vi) Members shall not practice while abusing controlled substances,alcohol or other chemical agents which impair their ability to practice.
2.A (vii) It is ethical to provide a second opinion to a patient as long as it isqualified as to whether or not it is based on a review of the treating
practitioner's records and treatment history.
2.A (viii) Patients should be informed of their oral health status without
defamatory comments about the patient's prior treatment.
2.A (ix) It is unethical to engage, or aid and abet, in treatment which isdangerous and/or has no scientific basis.
2.C. (i) Members should seek to enter into Mutual Assistance Agreements
or other similarly intended arrangements with like-minded orthodontists toguard against patient abandonment in the event of unforeseen events
such as temporary disability or death.
PRINCIPLE 3: MEMBERS HAVE THE DUTY TO TREAT PEOPLE FAIRLY (Justice)
CODE OF PROFESSIONAL CONDUCT:
3.A. Members shall be dedicated to generating public confidence in theorthodontic specialty by improving the quality and availability of orthodontic anddental care to the public.
3.B. Members shall recognize and abide by the laws that apply to the practice ofdentistry and orthodontics in their jurisdiction.
3.C. Members shall provide a workplace environment devoid of harassment or
inappropriate behavior and a workplace that upholds respectful and cooperative
relationships for all employees and patients.
ADVISORY OPINIONS:
3.A. (i) Members may exercise discretion in selecting a patient into theirpractice, provided that they shall not refuse to accept a patient because of
the patient's race, creed, color, sex, national origin, disability, HIVseropositive status, or other legally recognized protected class.
3.A. (ii) Members should pursue changes in laws, requirements, rules
and/or regulations within their jurisdiction that are contrary to the bestinterests of patients.
3.A. (iii) It is ethical to accept for treatment or complete treatment for apatient who has an outstanding balance with a previous practitioner.
3.A. (iv) It is ethical to remove appliances from, or to continue treatment
for, a patient not of record upon request by that patient; provided, that allreasonable effort should be made to determine the reason for the requestfrom the patient. It is advisable to consult with the patient's practitioner, if
possible, prior to such removal or continuation of treatment.
3.A. (v) It is ethical to withdraw from treating a patient of record, provided
that advance written notice to the patient or responsible party is given inaccordance with state/provincial laws so as to allow for another provider tobe secured.

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3.A. (vi) It is ethical for members to provide dental care other thanorthodontics unless announcing a practice that “is limited to” orthodontics.
3.B. (i) It is ethical to decline accepting a patient not formerly of record forcontinuation of routine orthodontic care after being seen for emergency
treatment.
3.B. (ii) Members may assign to an auxiliary or other employee only thoseduties for which they have been appropriately trained and that can belegally performed by such individual in the member's jurisdiction.
3.B. (iii) Members with first-hand knowledge that a colleague is practicing
while chemically impaired shall urge such colleagues to seek treatment
and have an ethical responsibility to report such evidence to theappropriate state or provincial regulatory body or dental board as requiredby law.
3.B. (iv) Members should become familiar with signs of abuse and neglect
and must report suspected cases to the appropriate authorities in themanner prescribed by state or provincial laws.
3.C. (i) Members shall refrain from inappropriate interpersonal
relationships or behavior within the orthodontic workplace and shallpromote mutual respect, professional communication and cooperative
efforts of all team members to enhance excellence in orthodontic care andassure safe and professional relationships with and between employees
and patients.
PRINCIPLE 4: DO GOOD (Beneficence) Members have the duty to promote thepatient’s welfare.
CODE OF PROFESSIONAL CONDUCT:
4.A. Members shall be dedicated to providing the highest quality, evidence based
orthodontic care for their patients within the bounds of the clinical aspects of thepatient's condition, and with due consideration being given to the expressedinterest and desires of the patient.
4.B. Members shall seek to serve the public-at-large.
ADVISORY OPINIONS:
4.A. (i) Members must prescribe and directly supervise the work of all
auxiliary personnel in accordance with state/provincial regulations through(a) being present in the orthodontic office when care is rendered, (b)prescribing procedures to be performed and personally evaluating thetreatment status of the patient, and (c) except for imaging processes andemergency removal of irritating or broken appliances, approving allprocedures performed by auxiliary personnel before dismissing thepatient.
4.A. (ii) Members shall make reasonable arrangements for emergency
care for their patients and should, when consulted for emergency care bya patient not of record, make reasonable arrangements for emergency

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care and advise that the patient should subsequently return to the original
provider unless the patient has a different preference.
4.B. (i) Members should, whenever practicable, offer orthodontic services
to charitable or educational institutions and other deserving individuals.
4.B. (ii) Members should, where practicable, participate in activities that
contribute to an improved community.

PRINCIPLE 5: TRUTHFULNESS (Veracity) Members have the duty to assure that
communications in all forms are expressed truthfully.
CODE OF PROFESSIONAL CONDUCT
5.A. Members shall be honest with patients, colleagues and third parties.
ADVISORY OPINIONS:
5.A. (i) Members shall not falsely represent the following: their credentials
or certifications, any non-educationally qualified person to be an
orthodontist, or non-member to be a member of this Association. The
burden of responsibility is upon every member to ensure that no person
associated with them as an employee or an associate, who is not aqualified orthodontic specialist, is falsely announced or represented assuch. Members and those they employ shall represent their credentials,
certifications and licenses accurately. It shall be unethical to announce,advertise or represent credentials or certifications as similar orcomparable to other non-comparable credentials or certifications. For
example, it is unethical to directly or indirectly represent or imply Board
certification (1) by, or as comparable to, the American Board of
Orthodontics when the certifying board is not the American Board of
Orthodontics or recognized by the American Dental Association; and/or (2)in an area of dental practice that is not one of the recognized dental
specialties, unless Advisory Opinion 5.H.2 of the American Dental
Association's Principles of Ethics and Code of Professional Conduct,
incorporated herein by reference, has been satisfied.
5.A. (ii) Members may not announce certification in orthodontics anddentofacial orthopedics from certifying boards not recognized by theAmerican Dental Association unless such announcement (1) complies
with all applicable laws, and (2) includes the following language: “[name ofcertifying board] is not recognized as a certifying board for orthodontics
and dentofacial orthopedics by the American Dental Association.”
5.A. (iii) Members shall neither give nor receive "rebates" or "split fees" inrelation to the referral or acceptance of patients. The terms "rebates"
and/or "split fees" refers to any substantial remuneration paid or received,or the division of fees paid or received, in exchange for referring or
accepting a patient for orthodontic or other health care services; provided
that, to the extent permitted by applicable law and ethical rules, theseterms are not intended to include revenue sharing arrangements between

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or among members and/or other dentists or allied healthcare practitioners
in an employer/employee, partnership, corporation or other similar legallyrecognized relationship where compensation is based on revenue
received.
5.A. (iv) Members shall not misrepresent the care being rendered to apatient.
5.A. (v) Members who present educational or scientific information in anarticle, seminar or other program must disclose to the readers or
participants, in the promotional material and the presentation, anymonetary or other beneficial interest the member may have in the
products promoted or endorsed in the presentation.
5.A. (vi) Members must properly disclose any enhancement, modificationor alteration of any photographs, computer images, radiographic images
or other visual images that are used in any presentation or publication topatients, orthodontists, dentists or the public.
5.A. (vii) In addition to other rules, in any public statements,
announcements of services, and promotional activities, all claims made orutilized by members must be supported by scientifically reliable evidence.
5.A. (viii) In all promotional activities and public announcements,
members may use and indicate only the following immediately after or
adjacent to their names:(1) The title Doctor or Orthodontist, abbreviated dental degree(s)and any other earned and/or attained advanced academic degrees(e.g. PhD, JD, MS),
(2) Board certification, as long as such use and indication is inaccordance with this Principles of Ethics and Code of Professional
Conduct,(3) Entity designations required by applicable law (e.g. LLC, Inc.),and(4) Orthodontic Specialist, Specialist in Orthodontics, or any similar
legally allowable variations thereof.
Members may list the names of fellowships, honorary degrees, certificatesof training or certifications in fields other than health-related disciplines
provided that:(1) They are listed in their entirety,(2) The listings are spelled out in their entirety in each and every
place used or referenced,(3) The word “Honorary” will follow all honorary degrees listed, and(4) They comply with all other provisions of this Principles of Ethics
and Code of Professional Conduct.
For purposes of this Advisory Opinion, “earned and attained advanced
academic degrees or honorary degrees” mean degrees awarded by an

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educational institution accredited by a generally recognized accrediting
body after completion of all requirements for such degree.
5.A. (ix) Members must assure that their public statements with respect
to their practice or the specialty are true. Statements should be avoided
that contain a representation or implication regarding the quality oforthodontic or other health care services, which (a) suggest superiority
relative to other practitioners, unless it is acknowledged that eachorthodontist uses different techniques based on training and experience,and that such claim is the orthodontist's individual perspective, and/or (b)are not susceptible to reasonable verification, by the public, and/or are
intended or likely to create an unjustified expectation about results thatcan be achieved.
5.A. (x) Members whose practice is devoted exclusively to orthodontics
may announce that their practice “is limited to” that specialty.
5.A. (xi) Members may announce as a specialist to the public in any andall areas of dentistry for which specialty recognition has been granted
under the standards required or recognized in the practitioner’s
jurisdiction, provided the member meets the educational requirements
required for recognition as a specialist adopted by the American Dental
Association or accepted in the jurisdiction in which they practice.
5.A. (xii) Members announcing specialization should use “specialist in”
and shall devote a sufficient portion of their practice to orthodontics orother announced specialties to maintain expertise in orthodontics and any
additional announced specialties.

DISCIPLINARY PROCEEDINGSDISCIPLINARY AND MEMBERSHIP PROCEEDINGSA.

GROUNDS FOR ACTION:

This Association, on its own volition or upon receipt of a written complaint from anyother person, reserves the right to discipline any of its members (except honorary) for
cause. Non-disciplinary action may include a non-reportable Letter of Concern sent to amember in the event that actions of the member demonstrate behavior of concern to theCouncil on Membership, Ethics and Judicial Concerns COMEJC but which fail todemonstrate clear and undeniable evidence of violation of these Principles of Ethics orCode of Professional Conduct. Disciplinary action may include a letter of concern,
reprimand, suspension or expulsion from membership in the AAO. Violation of the
AAO’s Bylaws or Principles, Code and Opinions, or any state or provincial lawful rule ofpractice or any other conduct prejudicial to the interests of this Association, shallconstitute sufficient cause for disciplinary action hereunder. This Association, on its own
volition or upon appeal from an applicant for membership who has been denied

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membership by this Association, further reserves the right to terminate the membershipof any member and affirm the denial of membership to such applicant.
Each Member and each Applicant hereby expressly waives the right to hold thisAssociation, its delegates, trustees, officers, members and employees, or any of its
constituent or component organizations responsible for any damage, pecuniary orotherwise, as a result of disciplinary or membership proceedings against or involving
any member and or applicant.
This Association may, at its discretion, require complainants to provide a waiver of
medical privacy rights they may have under any and all applicable laws and regulations,
including, but not limited to, the Health Insurance Portability and Accountability Act of1996 (“HIPAA”)
B.

DISCIPLINARY PROCEEDINGS:
1. Jurisdiction: This Association has jurisdiction to bring disciplinary proceedings
against, and to conduct membership proceeding as to, a member, which shall be
conducted by the Council on Membership, Ethics and Judicial Concerns(“COMEJC”).
2. The AAO administrative staff will receive and review formally submitted
complaints signed by an AAO member or non-member individual or individuals
relating to alleged violations of parameters set forth in these Principles of Ethics,
Code of Professional Conduct and Advisory Opinions. Such complaints should
encompass all pertinent and available information related to the facts of theasserted violation including, but not necessarily limited to, a description of facts
related to events or activities, copies of pertinent documents, communications,and when applicable, patient records (e.g., photographs, radiographs, etc.) if
available. Such materials shall become the property of the AAO and held in
confidence (with exceptions identified below) by the AAO and those designatedby the AAO including the COMEJC to examine and process for potential
evaluation and subsequent non-disciplinary or disciplinary proceedings or action.
a. Preliminary Rejection: Upon receipt and examination of complaints, theAssociation’s executive staff following consultation with the Chair of the
COMEJC may reject complaints that it deems to be clearly without merit,patently retaliatory, or fail to include evidence sufficient for a valid
complaint.
3. Investigation: For those complaints which are not preliminarily rejected, theinvestigation of disciplinary or membership complaints and/or appeals ofmembership denials shall occur as follows:a. The Chair of COMEJC shall select three of its members to comprise an“Investigating Committee” to investigate any disciplinary or membershipcomplaints and/or appeals of membership denials. Committee members

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selected must be unbiased and without conflicts. At a minimum, they must
not represent the Association’s constituent organization, nor shall they befrom the same general geographic area, as the member they are charged
with investigating.
b. The Investigating Committee may conclude, in its sole discretion andbased upon a preliminary review of any complaint or record ofmembership decision, that the complaint or record contains insufficient
information on which to base an investigation, or is patently frivolous orinconsequential. In such case, the matter may be disposed of by written
notice to the complainant and his or her respective constituency
organization (in the case of active and retired members), as the case may
be.
c. If the Investigating Committee concludes that a complaint or record
constitutes a valid and actionable inquiry, the Investigating Committee
shall conduct a confidential investigation in order to determine whether
disciplinary or membership action is warranted. Such an investigation in
the case of disciplinary proceedings shall include contacting the accused
member and providing a copy of the complaint to the member as well as
the complainant, if necessary to gather all relevant facts. The investigationof whether any non-disciplinary or disciplinary response, including
membership in this Association is warranted shall include contacting theapplicant or existing member as the case may be, as well as themember’s constituent organization (in the case of active and retired
members), and obtaining all relevant facts. Any “whistle blower”
complaint, however, submitted by a party who could potentially be subject
to retaliation may be considered for further investigation while holding thecomplainant’s identity in confidence by means of redaction of said nameand any other identifying materials from the complaint only if preliminary
evaluation by the Investigating Committee determines that a nonreportable letter of concern is, or may be likely as the appropriate
disposition of said complaint. Should the Investigating Committee, as it
moves through its disciplinary process, later determine that a reportabledisciplinary action is instead likely, the subject member of the complaint
shall be entitled to know the identity of the complainant to enable theaccused member to respond specifically with knowledge of the origin of
the complaint. AAO staff, in communication with the complainant, would
determine if a willingness to reveal the whistle blower’s identity is
acceptable to permit any disciplinary process to proceed in such cases. If
not, the complaint would be rejected. If the accused member refuses tocooperate or provide information, the Investigating Committee may notallow such refusal to influence its judgment concerning the merits of thecomplaint. Members of the Investigating Committee shall not, at any time,
have any personal or “off the record” communications with the accused
member, or anyone advocating for the accused. All communications withthe accused member concerning the investigation shall be in writing, and

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shall only be transmitted through AAO executive staff and shall, whenpossible, be transmitted in such a way as to prove the sufficiency of thecommunication (e.g., receipted delivery). The Investigating Committee
may, at its discretion, suspend its proceedings if it becomes aware that theaccused member is involved in litigation or other official proceedings, suchas a state dental board or provincial regulatory body investigation, on thesame or substantially similar complaint.
d. Subject to Disciplinary Proceedings B.3.f, below, the Investigating
Committee shall file its report and non-binding recommendations as to a
proposed penalty with the Chairman of COMEJC within a reasonable timeafter notification of the complaint or membership issue.
e. If the Investigating Committee determines that no disciplinary action is
warranted or that membership should be maintained or granted, it shallnotify the member, as the case may be, the member’s constituent
organization (in the case of active and retired members), the chairman of
COMEJC, and Secretary-Treasurer of this Association. The notice to suchmember shall be in writing and sent via certified mail-return receipt
requested.
f. Public Statement Assurance: In the case of the first disciplinary
complaint against a member involving public statements, announcementsof services and promotional activities where the Investigating Committee
has determined that the complaint constitutes a valid and actionableinquiry, the Investigating Committee may, in its sole and absolute
discretion, elect to advise the member of its finding and obtain a writtenagreement from the member to cease the unethical activity and to waive
any further right of appeal from, or challenge to, such finding andagreement. If the member enters into and complies with such an
agreement, the Investigating Committee shall file its report as to suchmatter with the Chairman of COMEJC, and no disciplinary action shall bewarranted in relation to the Public Statement, announcement of services
or promotional activity that is the subject of such agreement.
Notwithstanding the foregoing, in the event of a subsequent complaint
against the same member involving any Public Statements,
announcements of services and promotional activities where theInvestigating Committee determines that the complaint constitutes a valid
and actionable inquiry, this section (Disciplinary Proceedings B.3.f) shallbe inapplicable, and the provisions Disciplinary Proceedings B.2.d and allother related provision of these Disciplinary Proceedings shall apply.
4. If the Investigating Committee determines that disciplinary action is warranted orthat membership should be terminated or denied, COMEJC shall follow theprocedures set forth below:

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a. Notice: The member shall be notified in writing of the charges including
a statement containing all of the actions about which have been
complained, including corresponding provisions of this Code that are
alleged to have been violated, and his/her right to a hearing before threemembers of the COMEJC selected by the chairman thereof who shall not
be members of the Investigating Committee (the “Hearing Committee”)
and who have no bias or conflicts in the matter as previously defined. The
accused member shall be given the names, states/provinces of membersof the Hearing Committee, and shall have the right to challenge any
member on the basis of bias or conflicts. In the event of such a challenge,
the Chair of COMEJC, in consultation with AAO executive staff, may
determine if a conflict does, in fact, exist. Such notification shall be sent bycertified mail, with receipted delivery, to the member’s address of record.
In the event that a conflict or that a COMEJC member is ineligible to serveon the Investigating or Hearing Committees, the Chair shall appoint analternative COMEJC representative to serve in his/her place. In the event
two alternate Council appointees are ineligible to serve, The Chair shallserve on the designated Committee. If the Chair is unable to serve, theAAO President shall appoint the Trustee Liaison to COMEJC or another
AAO Trustee to serve on the Investigating Committee or Hearing
Committee if the Trustee Liaison is ineligible. Such notification shall besent by certified mail, with return receipt requested, to the member’s
address of record. The member shall be notified that he/she may request
a hearing before the Hearing Committee in order to appear and may
present evidence, and that he/she may be represented by legal counsel, if
desired, at his or her expense.
The Hearing Committee may, at its discretion, suspend its proceedings if it
becomes aware that the accused member is involved in litigation or otherofficial proceedings, such as a state dental board or provincial governing
body investigation, on the same or substantially similar complaint.
b. Hearing: Upon timely written request from the member, which must be
given within thirty (30) days of the notice to the member of the right to ahearing, the member or applicant shall be entitled to a private hearing
before the Hearing Committee at which time he/she shall be given theopportunity to present his/her response. The hearing shall be conducted inaccordance with the procedures adopted by this Association at a place
and time selected by the Hearing Committee in its sole discretion, and themember shall be given reasonable advance notice of the date, time andplace of the hearing. The members of the Hearing Committee shall electfrom their number a Hearing Officer, who shall preside at the hearing andissue any appropriate procedural or evidentiary rulings, and summarize
the results of the investigation and non-binding penalty recommendation
at the hearing for the other members. Formal rules of evidence or civil

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procedure shall not be required. The Hearing Committee may consider
any relevant material.
At the Association’s discretion, hearings may be offered to be held via
videoconference or teleconference.
Hearings should be limited to the facts in dispute, which have beenentered into the “record” of the case by the accused and complainant.
c. In the event no timely written request for a hearing is received from themember, or if a hearing is requested but the respondent does not appear,and no extenuating circumstances have influenced such delay, theHearing Committee shall render its decision without regard to said failure
to appear influencing its judgment concerning the merits of the complaint.
d. Decision: Every disciplinary and membership decision of the Hearing
Committee shall be in writing. Each decision shall specify the charges
made against the member, the facts which substantiate any or all of thecharges and if the member has been deemed exonerated or found in
violation. If in violation, the decision shall also include the facts which
substantiate any or all of the charges, the decision rendered by the
Hearing Committee, any penalty imposed in the case of disciplinary
proceedings, and in the event of penalty, the specific sections of the
Principles of Ethics, Code of Professional Conduct and Advisory Opinions
found to be in violation, the fact that the member has a right of appeal andthe time for filing a notice of appeal. The Hearing Committee may, in its
sole and absolute discretion, give consideration as to whether the caseinvolves a second complaint against the same member concerning publicstatements, announcements of services and promotional activities if suchmember entered into a written agreement with the Association pursuant to
B.3.f. Disciplinary Proceedings Section 3.f above, in relation to thepenalty assessed. Within ten (10) days of the date on which the decision
is rendered, a copy thereof shall be sent by certified mail, with return
receipt requested, to the Association’s last known address of each of thefollowing parties: the member or applicant, the secretary of the constituent
organization of which he/she is a member (in the case of active and retired
members), the chair of the Council on Membership, Ethics and Judicial
Concerns of this Association and the Secretary-Treasurer of thisAssociation.
C.

APPEALS:

The decision of the Hearing Committee as to applicants for AAO membership shall befinal with no right of appeal. An existing AAO member receiving an adverse decisionfrom the Hearing Committee shall have the right to appeal from such a decision by filinga notice of appeal with the Secretary-Treasurer of this Association.

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The notice of appeal must be in writing and filed with the Secretary-Treasurer of thisAssociation within thirty (30) days of receipt of the notice of the adverse decision.
Each party to an appeal shall be entitled to submit a brief in support of his/her or its
position. The member and the Hearing Committee shall submit his/her or its brief to theSecretary-Treasurer of this Association via certified mail, return receipt requested,
within ninety (90) days of filing an appeal.
No decision shall become final while an appeal therefrom is pending or until the thirty(30) day-period for filing notice of appeal has elapsed. Within thirty (30) days of thereceipt of a notice of appeal, the President of this Association will name and determine
their willingness to serve, three members to an Ad Hoc Appeals Panel and threealternates, no one of whom shall have been a member of the COMEJC from the timesince the original complaint was received and disciplinary proceedings begun. The
members of the Ad Hoc Appeals Panel shall be without bias or conflict, and theirnames, cities and states/provinces shall be made available to the accused member,
who may challenge members of the panel on the basis of bias or conflict. In the eventof such a challenge, the President of the Association, in consultation with the
Association’s executive staff, must determine if a conflict or bias exists. The SecretaryTreasurer of this Association will notify the member of the names of the three principals
via certified mail, return receipt requested. If the member shows good cause why any
named principal is unacceptable, an alternate(s) will be selected by the President of the
Association. This selection shall be final. The Panel shall notify the COMEJC and themember of the time and place of the hearing, such notice to be sent by certified mail,with return receipt requested, to the last known address of the parties to the appeal andmailed not less than thirty (30) days prior to the date set for the hearing.
The Panel shall meet, either in person or via telephone conference, within a reasonable
time from the date the appeal was filed. The member may have one representative
appear, at his or her expense, before the Panel to make oral or written presentations
and to respond to questions from the Panel. The Hearing Officer shall designate a
representative to appear before the Panel to support the decision of the Hearing
Committee and to respond to questions of the Panel. Either party may be represented
by counsel; however, the proceedings shall be conducted on an informal basis.
The Panel shall be required to review the decision on appeal and determine whether the
charges involving the member support the decision and/or warrant the penalty imposedand shall be based on any evidence about which the Hearing Committee grossly erredwith regard to the facts of the case or the law. This Appeal Process shall not be “fromscratch” or de novo. The Panel shall not be required to consider additional evidence
unless there is a clear and convincing showing that either party to the appeal will be
unreasonably harmed by failure to consider the additional evidence.
Every decision on appeal shall be reduced to writing and shall clearly state theconclusion of the Panel and reasons for reaching the conclusion. The Panel shall havethe discretion to:

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1. Uphold the decision of the Hearing Committee;
2. Reverse all or any part of the decision of the Hearing Committee and thereby
exonerate the member;
3. Deny an appeal because it fails to satisfy the requirements of these Bylaws.
Principles of Ethic, Code of Professional Conduct, Advisory Opinions andassociated disciplinary procedures;
4. Refer the case back to the Hearing Committee for a new proceeding, if therights of the member under all applicable Bylaws were not accorded him/her; or
5. Accept the findings of the Hearing Committee, but impose a different penalty
or decision.
Within a reasonable time from the date a decision on an appeal is rendered, a copy
thereof shall be sent by certified mail, with return receipt requested, to the Association’s
last known address of each of the following parties: the member, the secretary of theconstituent organization of which he/she is a member (in the case of active and retired
members), the Chair of the COMEJC of this Association and the Secretary-Treasurer ofthis Association.
D.

RESIGNATION:

If a member who is the subject of a complaint or other disciplinary or membership action
by this Association resigns at any time during the proceeding, the matter shall bedismissed and the member may not thereafter reapply for any class of membership.
E.

REPORTING REQUIREMENT:This Association shall report any information to such agency or agencies as may berequired or permitted by the Health Care Quality Improvement Act of 1986, in suchform, manner and frequency as may from time to time be required or permitted by theAct.