8.1 Grounds for Professional Misconduct (RSA 317-A:17, II & Den 407.01)
Key Takeaways
- After notice and an opportunity to be heard, the New Hampshire Board of Dental Examiners may refuse to issue or renew a license, or may sanction a licensee, for professional misconduct (RSA 317-A:17, II).
- Advertising that deceives the public, claims professional superiority, or promises painless service is professional misconduct under RSA 317-A:17, II(h).
- Employing or permitting an unlicensed person to practice in the office is professional misconduct under RSA 317-A:17, II(i).
- Den 407.01(s) makes yelling, swearing, throwing items toward any person, verbal threats, and grabbing, pulling, or pushing any person unprofessional conduct by a dentist or hygienist.
- For misconduct purposes, Den 101.02 defines addiction as a chronic neurobiologic disease and excludes the physical dependence and tolerance that normally follow extended opioid therapy for pain.
Grounds for Professional Misconduct
RSA 317-A:17, II lets the Board, after notice and the opportunity to be heard, refuse to issue or renew a license, or impose sanctions, when there is evidence that the licensee or applicant engaged in professional misconduct. Den 407.01 restates the grounds and adds more.
The grounds, grouped
| Group | Ground | Citation |
|---|---|---|
| Personal fitness | Addiction to mind-altering drugs or intoxicants | 317-A:17, II(a); Den 407.01(a) |
| Any felony or misdemeanor involving dishonesty, untrustworthiness, or unprofessional conduct | II(b)(1); 407.01(b) | |
| Any administrative or criminal conviction involving moral turpitude | II(b)(2); 407.01(c) | |
| Fraud or untruthfulness in obtaining credentials, exam scores, or licensure in any jurisdiction | II(b)(3); 407.01(d) | |
| A physical or mental impairment or disease that is dangerous to the public or prevents practice at ordinary proficiency | II(c); 407.01(e) | |
| Competence | Ignorance, incompetence, or a pattern of behavior inconsistent with basic knowledge and skills | II(d); 407.01(f) |
| Gross or repeated negligence | II(e); 407.01(g) | |
| Intentionally injuring a patient, or other unprofessional or dishonest conduct in practice | II(f); 407.01(h) | |
| Incorporated standards | Failing to follow ADA radiographic guidelines or CDC infection control recommendations | II(g); 407.01(i) |
| Advertising | Ads that deceive about services, techniques, qualifications, or prices; claim superiority or painless service; or announce a drug of unknown formula or an unnamed, misnamed, or unused anesthetic or system | II(h); 407.01(j) |
| Staffing | Employing or permitting an unlicensed person to practice in the office | II(i); 407.01(k) |
| Law and ethics | Knowingly or willfully violating RSA 317-A, any Board rule or order, any controlled drug law, or other laws on practice, including the ADA Code (dentists) or the ADHA Code (hygienists) as approved by the Board | II(j); 407.01(l) |
| Sedation safety | More than one sedated outpatient at a time without 1:1 monitoring | II(k); 407.01(m) |
| Inadequate recovery monitoring (same room, ratio no more than 3:1) | II(l); 407.01(n) | |
| No continuous pulse oximetry during sedation and recovery | II(m); 407.01(o) | |
| No adequate history and physical, or no written informed consent (a parent or guardian for a minor), before sedation | II(n); 407.01(p) | |
| Reporting | Failing to report an adverse event or implement a corrective action plan under RSA 317-A:20-a | II(o); 407.01(q) |
| Catch-all (rule only) | Violating any provision of RSA 317-A, any Board rule, or any state or federal law reasonably related to authority or ability to practice safely | 407.01(r) |
| Workplace behavior (rule only) | Yelling, swearing, or profanity; throwing items at or toward any person; verbal threats; grabbing, pulling, or pushing any person | 407.01(s) |
Key definitions
- Addiction (Den 101.02): a primary, chronic, neurobiologic disease marked by impaired control over drug use, craving, compulsive use, or continued use despite harm. It does not include physical dependence and tolerance, which are normal consequences of extended opioid therapy for pain.
- Moral turpitude (Den 101.24): baseness, vileness, or dishonesty to a high degree.
- Disruptive behavior (RSA 317-A:16-a, II): abusive conduct, including harassment and other verbal or non-verbal conduct that harms or intimidates others enough to compromise quality of care or patient safety. It is a trigger for the professionals' health program (section 8.2).
Misconduct triggers elsewhere in the rules
Several other rules label specific failures as misconduct or discipline grounds:
| Failure | Rule |
|---|---|
| Not registering with the PDMP within 90 days of initial licensure while holding a DEA number | Den 301.02(k) |
| Prescribing Schedule II–IV drugs without PDMP registration, or misusing PDMP data | Den 502.01(b) |
| Failing to schedule or pass the sedation facility inspection and simulated emergency evaluation by the permit expiration date | Den 402.01(f) |
| Submitting untruthful information to the Board or OPLC | Den 501.01(o) |
| Violating any Den 501 ethical duty, such as records, closure notice, or emergency availability | Den 407.01(r) |
Advertising misconduct in practice
RSA 317-A:17, II(h) is narrower and more concrete than general "false advertising":
- "Painless dentistry" or "pain-free extractions" claims that the licensee performs a service in a painless manner, so it is misconduct even if patients report little discomfort.
- "The best implant dentist in the Seacoast" claims professional superiority over other licensees.
- Advertising a secret-formula whitening compound, or a sedation "system" that is not actually used, fits paragraph (h)(3).
Section 8.3 covers the affirmative rules for ads, such as naming the dentist and stating general dentist or specialist.
Worked scenario
During a busy afternoon, Dr. Byrne throws a cassette of instruments toward his assistant and swears at her in front of a patient. No one is injured. Under Den 407.01(s), throwing items at or toward any person, and swearing, are expressly unprofessional conduct in the licensee's role as a dentist. No injury is required. The Board may also consider RSA 317-A:17, II(f) (unprofessional conduct in practice) and ADA Code 3.F (professional demeanor in the workplace). Section 8.2 explains how the Board would choose a sanction.
A practice's billboard reads "Painless Dentistry — Guaranteed." Under RSA 317-A:17, II(h), how is this advertising classified?
A hygienist grabs a coworker's arm and pulls her out of an operatory during an argument. No one is hurt. Which provision most directly makes this unprofessional conduct?
A dentist has taken prescribed opioids for chronic back pain for two years and shows expected physiological tolerance, but no craving, compulsive use, or use despite harm. How does Den 101.02 treat this for the misconduct ground of addiction?