CO Code § 12-220-201 (2021)
2021 Colorado Code|Title 12 - Professions and Occupations|Article 220 - Dentists and Dental Hygienists|Part 2 - Discipline|§ 12-220-201. Grounds for Disciplinary Action - Definition

  The board may take disciplinary action against an applicant or licensee in accordance with sections 12-20-404 and 12-220-202 for any of the following causes:   Engaging in fraud, misrepresentation, or deception in applying for, securing, renewing, or seeking reinstatement of a license to practice dentistry or dental hygiene in this state, in applying for professional liability coverage required pursuant to section 12-220-307, or in taking the examinations provided for in this article 220;    Conviction of a felony or any crime that constitutes a violation of this article 220. For purposes of this subsection (1)(b), “conviction” includes the entry of a plea of guilty or nolo contendere or a deferred sentence.    Administering, dispensing, or prescribing a habit-forming drug or controlled substance, as defined in section 18-18-102 (5), to a person, including the applicant or licensee, other than in the course of legitimate professional practice;    Conviction of a violation of a federal or state law regulating the possession, distribution, or use of a controlled substance, as defined in section 18-18-102 (5), and, in determining if a license should be denied, revoked, or suspended or if the licensee should be placed on probation, the board is governed by sections 12-20-202 (5) and 24-5-101;    Habitually abusing or excessively using alcohol, a habit-forming drug, or a controlled substance, as defined in section 18-18-102 (5);    Misusing a drug or controlled substance, as defined in section 18-18-102 (5);    Aiding or abetting, in the practice of dentistry or dental hygiene, a person who is not licensed to practice dentistry or dental hygiene under this article 220 or whose license to practice dentistry or dental hygiene is suspended;    Except as otherwise provided in sections 12-220-304, 12-220-503 (4), and 25-3-103.7, practicing dentistry or dental hygiene as a partner, agent, or employee of or in joint venture with any person who does not hold a license to practice dentistry or dental hygiene within this state or practicing dentistry or dental hygiene as an employee of or in joint venture with any partnership, association, or corporation. A licensee holding a license to practice dentistry or dental hygiene in this state may accept employment from any person, partnership, association, or corporation to examine, prescribe, and treat the employees of the person, partnership, association, or corporation.    Violating or attempting to violate, directly or indirectly, assisting in or abetting the violation of, or conspiring to violate any provision or term of this article 220, an applicable provision of article 20 or 30 of this title 12, or any lawful rule or order of the board;      Failing to notify the board, as required by section 12-30-108 (1), of a physical illness, physical condition, or behavioral health, mental health, or substance use disorder that renders the licensee unable, or limits the licensee's ability, to perform dental or dental hygiene services with reasonable skill and with safety to the patient; (j) (I) Failing to notify the board, as required by section 12-30-108 (1), of a physical illness, physical condition, or behavioral health, mental health, or substance use disorder that renders the licensee unable, or limits the licensee's ability, to perform dental or dental hygiene services with reasonable skill and with safety to the patient;    Failing to act within the limitations created by a physical illness, physical condition, or behavioral health, mental health, or substance use disorder that renders the licensee unable to practice dental or dental hygiene services with reasonable skill and safety or that may endanger the health or safety of persons under his or her care; or    Failing to comply with the limitations agreed to under a confidential agreement entered pursuant to sections 12-30-108 and 12-220-207;       Committing an act or omission that constitutes grossly negligent dental or dental hygiene practice or that fails to meet generally accepted standards of dental or dental hygiene practice;    Advertising in a manner that is misleading, deceptive, or false;    Engaging in a sexual act with a patient during the course of patient care or within six months immediately following the termination of the licensee's professional relationship with the patient. “Sexual act”, as used in this subsection (1)(m), means sexual contact, sexual intrusion, or sexual penetration as defined in section 18-3-401.    Refusing to make patient records available to a patient pursuant to a written authorization-request under section 25-1-802;    False billing in the delivery of dental or dental hygiene services, including, but not limited to, performing one service and billing for another, billing for any service not rendered, or committing a fraudulent insurance act, as defined in section 10-1-128;    Committing abuse of health insurance in violation of section 18-13-119;    Failing to notify the board, in writing and within ninety days after a judgment is entered, of a final judgment by a court of competent jurisdiction in favor of any party and against the licensee involving negligent malpractice of dentistry or dental hygiene, which notice must contain the name of the court, the case number, and the names of all parties to the action;    Failing to report a dental or dental hygiene malpractice judgment or malpractice settlement to the board by the licensee within ninety days;    Failing to furnish unlicensed persons with laboratory work orders pursuant to section 12-220-502;    Employing a solicitor or other agent to obtain patronage, except as provided in section 12-220-309;    Willfully deceiving or attempting to deceive the board or its agents with reference to any matter relating to this article 220;    Sharing any professional fees with anyone except those with whom the dentist or dental hygienist is lawfully associated in the practice of dentistry or dental hygiene; except that:   A licensed dentist or dental hygienist may pay an independent advertising or marketing agent compensation for advertising or marketing services rendered by the agent for the benefit of the licensed dentist or dental hygienist, including compensation that is based on the results or performance of the services on a per-patient basis; and    Nothing in this section prohibits a dentist or dental hygienist practice owned or operated by a proprietor authorized under section 12-220-303 from contracting with any person or entity for business management services or paying a royalty in accordance with a franchise agreement if the terms of the contract or franchise agreement do not affect the exercise of the independent professional judgment of the dentist or dental hygienist.       Failing to provide reasonably necessary referral of a patient to other licensed dentists or licensed health-care professionals for consultation or treatment when the failure to provide referral does not meet generally accepted standards of dental care;    Failure of a dental hygienist to recommend that a patient be examined by a dentist or to refer a patient to a dentist when the dental hygienist detects a condition that requires care beyond the scope of practicing supervised or unsupervised dental hygiene;    Engaging in any of the following activities and practices:   Willfully and repeatedly ordering or performing, without clinical justification, demonstrably unnecessary laboratory tests or studies;    Administering, without clinical justification, treatment that is demonstrably unnecessary;    In addition to the provisions of subsection (1)(x) of this section, failing to obtain consultations or perform referrals when failing to do so is not consistent with the standard of care for the profession;    Ordering or performing, without clinical justification, any service, X ray, or treatment that is contrary to recognized standards of the practice of dentistry or dental hygiene as interpreted by the board;       Falsifying or repeatedly making incorrect essential entries or repeatedly failing to make essential entries on patient records;    Violating section 8-42-101 (3.6);    Violating section 12-220-602 or any rule of the board adopted pursuant to that section;    Administering local anesthesia, minimal sedation, moderate sedation, or deep sedation/general anesthesia without obtaining a permit from the board in accordance with section 12-220-411;    Failing to report to the board, within ninety days after final disposition, the surrender of a license to, or adverse action taken against a license by, a licensing agency in another state, territory, or country, a governmental agency, a law enforcement agency, or a court for an act or conduct that would constitute grounds for discipline pursuant to this article 220;    Failing to provide adequate or proper supervision when employing unlicensed persons in a dental or dental hygiene practice;    Engaging in any conduct that constitutes a crime as defined in title 18, which conduct relates to the licensee's practice as a dentist or dental hygienist;    Practicing outside the scope of dental or dental hygiene practice;    Failing to establish and continuously maintain financial responsibility or professional liability insurance as required by section 12-220-307;    Advertising or otherwise holding oneself out to the public as practicing a dental specialty in which the dentist has not successfully completed the education specified for the dental specialty as defined by the American Dental Association;    Failing to respond in an honest, materially responsive, and timely manner to a complaint filed against the licensee pursuant to this article 220;    Committing an act or omission that fails to meet generally accepted standards for infection control;    Administering moderate sedation or deep sedation/general anesthesia without a licensed dentist or other licensed health-care professional qualified to administer the relevant level of sedation or anesthesia present in the operatory;    Failing to complete and maintain records of completing continuing education as required by section 12-220-308;    [ ] Failing to comply with section 12-220-505 regarding the placement of interim therapeutic restorations; or    [ ] Failing to comply with sections 12-220-501 (1)(a)(II)(C) and 12-220-503 (1)(g) and rules adopted pursuant to those sections regarding the application of silver diamine fluoride.    [ ] Failing to accurately complete and submit the questionnaire required by section 12-220-408 (2).        Editor's note: This version of subsection (1)(nn) is effective until July 1, 2023. Editor's note: This version of subsection (1)(nn) is effective July 1, 2023. Editor's note: This version of subsection (1)(oo) is effective until July 1, 2023. Editor's note: This version of subsection (1)(oo) is effective July 1, 2023. Editor's note: Subsection (1)(pp) is effective July 1, 2023.  History. Source: L. 2020: Entire article amended with relocations,(HB 20-1056), ch. 64, p. 225, § 1, effective September 14. L. 2021: (1)(oo) amended,(SB 21-102), ch. 31, p. 127, §§ 3, 4, effective September 1.    Editor's note:    This section is similar to former § 12-220-130 as it existed prior to 2020.    Prior to their relocation in 2020, subsections (1)(nn) and (1)(oo) were amended and (1)(pp) was added by SB 19-079, effective July 1, 2023.     ANNOTATION   Annotator's note. The following annotations include cases decided under former provisions similar to this section.   Unprofessional conduct means that which is by general opinion considered to be grossly unprofessional because immoral or dishonorable, as distinguished from a mere violation of a code of professional ethics prescribed by a board of health. State Bd. of Dental Exam'rs v. Savelle, 90 Colo. 177 , 8 P.2d 693, appeal dismissed, 287 U.S. 562, 53 S. Ct. 5, 77 L. Ed. 496 (1932).   Evidence insufficient to support finding of “unprofessional conduct” by reason of abandonment. Lee v. State Bd. of Dental Exam'rs, 654 P.2d 839 (Colo. 1982).   “Gross incompetence” construed. The term “gross incompetence”, in the context of dentistry, connotes such an extreme deficiency on the part of a dentist in the basic knowledge and skill necessary to dental diagnosis and treatment that one may reasonably question the dentist's ability to practice dentistry at the threshold level of professional competence. Lee v. State Bd. of Dental Exam'rs, 654 P.2d 839 (Colo. 1982).   Evidence insufficient to support finding of “gross incompetence”. Lee v. State Bd. of Dental Exam'rs, 654 P.2d 839 (Colo. 1982).   Evidence sufficient to support finding of “gross incompetence”. Bassett v. State Bd. of Dental Exam'rs, 727 P.2d 864 (Colo. App. 1986) (decided under law in effect prior to 1986 repeal and reenactment of subsection (1)).   “Negligent malpractice” construed. In the case of dentistry, the phrase “negligent malpractice” means the failure of a dentist to exercise that degree of knowledge, skill and care used by other dentists engaging in the same type of practice in the same or a similar community. Lee v. State Bd. of Dental Exam'rs, 654 P.2d 839 (Colo. 1982).   Evidence sufficient to support finding of “negligent malpractice”. Lee v. State Bd. of Dental Exam'rs, 654 P.2d 839 (Colo. 1982).   “Abandonment” construed. In the context of former subsection (2)(s) (now subsection (1)(w)), “abandonment” connotes an unjustified renunciation by the dentist of his or her professional relationship with the patient and a repudiation of his or her responsibility for the patient's condition. This type of conduct generally involves a higher degree of culpability than the failure to use reasonable care associated with substandard treatment. Lee v. State Bd. of Dental Exam'rs, 654 P.2d 839 (Colo. 1982).   Dentists, although licensed, who engage in the practice of their profession as employees of a dental corporation that has been ousted from practice in the state, held guilty of gross violation of their professional duties. State Bd. of Dental Exam'rs v. Savelle, 90 Colo. 177 , 8 P.2d 693, appeal dismissed, 287 U.S. 562, 53 S. Ct. 5, 77 L. Ed. 496 (1932).   It was held that a complaint to revoke a dentist's license, alleging generally gross violation of professional duty, might destroy itself by specifying a particular act in support of the charge which appears on its face to be innocent, because in such a case the general allegation might have yielded to the specific, and the complaint would have been demurrable on jurisdictional grounds. State Bd. of Dental Exam'rs v. Savelle, 90 Colo. 177 , 8 P.2d 693, appeal dismissed, 287 U.S. 562, 53 S. Ct. 5, 77 L. Ed. 496 (1932).   A pattern of record-keeping in which the dentist licensee repeatedly makes incorrect critical entries or regularly omits essential entries concerning patients may constitute a basis for disciplinary action under this section. State Bd. of Dental Exam'rs v. Micheli, 928 P.2d 839 (Colo. App. 1996).   Record-keeping that is significant in terms of a patient's care and treatment but not characterized by falsity or repetitiveness may be addressed under former subsection (1)(j) (now subsection (1)(k)), while record-keeping that is characterized by falsity or by repetitiveness can be properly addressed under former subsection (1)(y) (now subsection (1)(z)). State Bd. of Dental Exam'rs v. Micheli, 928 P.2d 839 (Colo. App. 1996).   Public interest prohibiting fee splitting, as expressed in subsection (1)(v), outweighs any private interests in enforcing the payment terms of agreement in which fees payable to defendants were a direct percentage of fees paid for dental services. Although voiding the contract works some degree of inequity upon defendants, they are not unreasonably prejudiced, as the law likely permits them to recover the reasonable value of the services they have provided. Mason v. Orthodontic Ctrs. of Colo., 516 F. Supp. 2d 1205 (D. Colo. 2007 ).