Dentists Control Clinical Activities

dentist directing clinical activity, here going over x-ray with patient

The advent of dental support organizations (DSOs) has sparked concern over whether outside organizations could somehow affect clinical care.

However, it’s important to realize that dental practices are, first and foremost, centers for dental care – and when it comes to clinical decisions, licensed dentists have, by law, the first and last word.

A Clear Distinction

For every dental practice, there needs to be a clear distinction between the clinical side of things and the business side of things.

The clinical side of every practice is all about the patient and ensuring that every patient gets high-quality dental care. In this, dentists have complete control.

On the business side, processes open up to a host of other individuals, from accountants to human resources professionals to marketing experts.

To ensure that the clinical side of the business remains focused solely on patient care, every state has legislation in place that determines which duties that anyone can perform and which duties that only licensed dentists can perform.

Almost every state requires that a dentist own a dental practice (i.e., instead of an outside entity like a corporation). Only a handful of states lack this requirement, but even they have legislation in place to ensure that only dentists can make clinical decisions.

What every state strives for is a clear delineation between what constitutes a clinical activity and what constitutes a non-clinical activity – to make sure that everyone is on the same page when it comes to decisions and tasks associated with patient care. Again, a dental practice’s core purpose is to provide dental care – and legislators know and support this.

Legal Clinical Activities

Clinical activities are the tasks that – by law – only licensed dentists can perform. These are concerned with the core function of the practice – patient care. Here’s a rundown…

  • Evaluations and diagnoses of patients.
    • When patients come to a practice, a licensed dentist is the one who evaluates them and diagnoses the state of their oral health.
  • Deciding on a treatment.
    • Choosing a treatment plan is complicated and requires all the knowledge and experience that dental professionals bring to the table. We want a highly qualified person choosing a treatment plan, and so do the patients.
  • Treatment itself.
    • Trained and licensed professionals have to perform the actual dental work. This makes sense and no doubt puts patients at ease to know the most qualified person in the room is poking around in their mouth.
  • Establishing and enforcing clinical protocols.
    • The protocols that dental practices use go a long way toward determining the quality of care given at the practice. Dentists need to set the protocols and also determine when and where the clinic fails to follow those protocols.
  • Control of patient records.
    • Patient records provide a vital guide for dentists when treating any patient. A patient’s history is a great roadmap for determining what might come down the road and how best to treat them.
  • Training and supervising dentists and hygienists.
    • Ideally, every practice should have a well-defined set of processes and procedures, but training and supervision is still vital. Obviously, there’s no one more qualified to train and supervise a dentist or hygienist than another dentist – preferably the most qualified dentist in the practice.

Dentists Make the Clinical Decisions

The concern over whether dentists will lose control over patient-care decisions may be warranted.

Even though every state has legislation on the books to ensure that only dentists are making clinical decisions, we as the professionals must not let outside organizations influence the decisions we make in our practices. If we did, we would violate the promise we’ve made to provide the best care we can.


By Quinn Dufurrena, DDS