The enforcement of regulations restricting expanded duties by dental auxiliaries: an analysis of the recent disciplinary actions of the Texas State Board of Dental Examiners.

The issue of delegation of dental procedures (expanded duties) to auxiliaries continues to be controversial. Although it has been shown that these practices are usually beneficial to the public, many states continue to maintain laws prohibiting expanded duties. In Texas, auxiliaries are not allowed to perform many simple functions, and dentists who supervise these acts are tried and sentenced by the Texas State Board of Dental Examiners. Although one might expect that more serious categories of offenses would be treated in a harsher manner, this study indicates that this is not the case in Texas. The disciplinary actions of the Texas State Board of Dental Examiners were analyzed, and the rate of conviction and severity of penalty for three types of offenses: supervising auxiliaries in the performance of unauthorized expanded duties, malpractice/negligence, and drug offenses were compared. The results revealed that dentists who were convicted for unauthorized auxiliary expanded duty use were assigned harsher penalties than those given to dentists convicted for other classes of offenses (P = .02, Fisher's exact test). This study indicates that, at least for the dentists of Texas, the punishment may not always fit the crime.