An orthodontist summoned before the Arkansas State Board of Examiners last week is defending his offering of prophylaxes at one of his practices, saying it is within the realm of his specialty and not a violation of the state's Dental Practice Act.
During an hour-long session with the dental board on September 13, Ben Burris, DDS, MDS, said the service, which is performed by staff hygienists, is helping to address access-to-care issues in areas where it is lacking.
"This is just a cleaning by a state-licensed hygienist," Matt Wilkins, CEO of Dr. Burris' five Braces by Burris orthodontic practices, told DrBicuspid.com. "Dentists with an orthodontic specialty examine them, but the idea is we're seeing kids who don't have a dental home. Now we can refer them out for restorative care if necessary."
Dr. Burris was advised by his attorney to decline interview requests.
"We wanted to make sure he wasn't practicing general dentistry," the board's attorney, Kevin O'Dwyer, said in an interview with DrBicuspid.com. That is why the board called Dr. Burris in for what O'Dwyer described as an informal, information-gathering meeting.
"We received information from various sources that he was employing dental hygienists to work in his orthodontic clinic, and we had sent him a letter requesting that he appear [to] explain his practice setting, what was going on with it," O'Dwyer said.
Arkansas regulations stipulate that general dentists with a specialty license must work within their specialty. "It's one or the other," O'Dwyer explained. "You cannot have a specialty license and practice general dentistry."
During the meeting with the dental board, O'Dwyer asked Dr. Burris directly if he understood that he was practicing general dentistry, according to an article in Arkansas Business.
"We take the position that providing low-cost access in an area that needs it is not outside of his specialty," Wilkins said. "Orthodontists are held responsible for the oral hygiene of those who come through their office."
Aiding access to care
The service goes hand in hand with Dr. Burris's mission to improve access to oral care services in Arkansas and across the U.S. The founder of the Smile for a Lifetime Foundation has donated $2 million in treatment since 2008, Wilkins said, while the foundation itself has donated $25 million in treatment and scholarships.
"As part of doing that work, he then started to see a range of people, of demographics, lacking access to care in northern Arkansas," Wilkins said. "The Arkansas Delta region is a lower-income demographic, so we started to employ hygienists in the last few months to provide access to low-cost cleaning."
The cleaning service is only performed at the Braces by Burris office in northeast Arkansas. "We're not doing this in other areas where access is a nonissue, and we have no plans to introduce it at those locations," Wilkins said.
The cleaning is $68 for children, $98 for adults, and "our hygienists have the potential to make half of what they collect," Wilkins explained. Bitewings and panoramic radiographs are done for free.
It is in the practice's interest to get all patients into the care of a general dentist, Wilkins noted. "We tell all of our patients that if they have a dental home, they are referred to it. We talk to them about where they live and refer them to dentists there. We look bad if these kids have caries when we put them in braces."
Over nine years and working with thousands of patients, Dr. Burris has never had a formal or informal patient complaint brought to the board, he added.
The board has yet to make a formal decision in this case and is still in discussions with Dr. Burris about different avenues, according to O'Dwyer.
"If the board voted that charges should be brought based on a violation of the practice act and that he was practicing general dentistry, he would have to be served with the charging document and a hearing would be held at some date in the future," he said.
