Dental school accused of letting hygienists do too much

Sep 22, 2010

The Indiana University (IU) School of Dentistry has launched an internal review of its dental hygiene clinic after a visiting professor raised concerns about hygienists at the clinic allegedly diagnosing patients and doing treatment planning, according to a story by WRTV6 in Indianapolis.

Students in the clinic work under licensed hygienists, and the work of both the student and the hygienist must be approved by a licensed dentist.

“Faculty hygienists were checking students' work instead of dentists.”
— Peter Paris, D.D.S.

But Peter Paris, D.D.S., told DrBicuspid.com that while he was supervising the clinic from August 2009 through March 2010 he observed several cases of staff violating the state law that governs what hygienists are allowed to do.

The violations included hygienists diagnosing patients and approving "inappropriate" and "potentially harmful" treatments for patients, he said, even though the hygienists do not have dental licenses.

"In order to diagnose and do treatment plans, you have to be a dentist," he said. "They were doing prophylaxis, scaling, and planing. You could have a patient with severe periodontal disease, which runs the gamut from gingivitis to advanced periodontal disease. Faculty hygienists were checking students' work instead of dentists, as required by law. It's illegal."

Licensed dentists were not ensuring that the cleanings were done according to standards of care, Dr. Paris noted.

Allegations 'incorrect'

IU School of Dentistry Dean John Williams, D.M.D., has launched an internal review of the clinic's policies, according to spokeswoman Diane Brown.

"We believe the allegations are incorrect," Brown told DrBicuspid.com. "We are in compliance with the Indiana Board of Dentistry regarding the supervision of our dental hygiene clinic."

Dr. Paris said he reported his concerns about the clinic to the school's Director of Dental Hygiene Nancy Young, R.D.H., who told him that the university had a special exemption because it is a teaching school.

But no such exemption exists, according to Cindy Vaught, director of the Indiana State Board of Dentistry. State dental board rules require that hygienists must be under the direct or prescriptive supervision at all times of a licensed dentist, she told DrBicuspid.com.

Dr. Paris said he that after he reported his concerns to his supervisor, Vanchit John, D.D.S., M.S.D., in March, he was reassigned to work in a different area. He also discussed the issue with Dr. Williams, he said.

"He said he'd get back to me," Dr. Paris recalled. "I'm still waiting."

In April, Dr. Paris was told that his contract, which expired June 30, would not be renewed. He asserts that his work reassignment and nonrenewal of his contract were done in retaliation for his complaints.

Brown said visiting professors are reassigned according to need and performance.

The facility sees 100,000 patients a year, including about 7,000 at the dental hygiene clinic, Brown said.