Q: For those who might not be familiar with your story or case, could you provide some background as to why you?re working to provide affordable dental care to individuals in Arkansas and the roadblocks you?ve faced in the process?
A: More than 60% of Arkansas residents don?t see the dentist regularly. I have struggled for as long as I?ve been in practice to get people, patients and non-patients, to go to the dentist every 6 months for a cleaning. Going more regularly when they are in braces and have hygiene issues is generally out of the question. Why? Money?plain and simple. The average household income in northeastern Arkansas where I started the hygiene program hovers around $30k, so a family of 4 seeing the dentist twice a year approaches 8% of the annual, pretax household income!
We decided to hire licensed hygienists and offer cleanings, exams and X-rays for $99 for adults and $69 dollars for kids. Within a week, I got a letter from the dental board saying that I was practicing outside my specialty because several primary care dentists complained about what I was doing. Arkansas has a specialty restriction law, which 7 other states have, that says specialists cannot practice outside our area of specialty. For one, I don?t stipulate that I was outside my specialty since I am responsible for DXing caries, reading radiographs and oral hygiene instruction on new patients whether or not they get braces from me?and there are consequences if I fail to do so. The second issue is that I have a dental license and all the training that goes along with that. Combine that with the fact that PCDs can do any specialty work they want with no formal training and you can see why this restriction and this issue is just plain silly.
I was hauled before the state board and grilled for over an hour about why I wanted to do this, why I called the press to be there and generally chastised for hiring licensed hygienists to provide the same services that occur in PCD offices for less money. Not only did they threaten to take my specialty license, they said they would take my dental license unless I signed a consent order. Talk about duress! Of course I signed it and we went to work on taking the state to court. The Institute For Justice saw the merit in our case and has agreed to take on the state of Arkansas in federal court on our behalf, which is awesome considering it was just us verse the entire state government. IJ is very selective on the cases they take and they have an awesome track record. We filed last Tuesday in federal court and will see what happens from here.
Q: What were your thoughts after the Arkansas State Board of Dental Examiners told you that you had to suspend the cleaning services or you would lose your licenses?
A: I wondered if it would have been as big an issue if I?d charged the $200-$300 dollars that is normal. I also thought that the board doesn?t know what kind of PR nightmare they were opening themselves up to by opposing access to care and lower prices for working people from Arkansas. No one, other than primary care dentists and their friends, opposes access to care. The board was clearly showing that it looks out for the pocketbooks of PCDs, not the wellbeing of Arkansans.
Q: What made you want to fight back against the decision, knowing that there might be potential backlash against you by the board, instead of just continuing with your regular practice?
A: You?re not wrong about backlash. From PCDs threatening me, saying they won?t refer me to patients, and worse, to being slow rolled by state agencies, it?s now the norm. But this fight is bigger then me and we won?t let petty issues stop us from fighting for what is right for the public. This is a patient?s rights issue at its heart and we won?t forget that or lose focus.
Access to care has been my passion for years. I created Smile for a Lifetime Foundation in 2008 and we now give away more than $6 million in free treatment every year in the US and Canada. I give away 5 orthodontic scholarships every month in my practices in Arkansas and have given away well over a million dollars in free treatment in Arkansas.
With the hygiene program, I saw another opportunity to give back and increase access to care. Offering low cost cleanings from licensed hygienists, x-rays and an exam from a licensed dentist didn?t cost me a ton of money because of how my orthodontic offices are set up, so I can offer this service for less. Offering great healthcare, conveniently and affordably with great customer service is good for patients, the community and for my business. Plus, study after study has shown that systemic diseases like diabetes and heart disease are linked to poor oral care and the state of Arkansas spends millions each year on dental emergency room visits. The savings in lives, health and money for Arkansans and the state of Arkansas are immense if we can only work to make access to quality dental care affordable.
Q: You?re now working alongside Dr. Elizabeth Gohl and the Institute for Justice to have the decision reversed. At the end of the day, regardless of the outcome, what do you hope is the future of low-cost cleaning services, not only in Arkansas, but also across the United States?
A: We filed in federal court in hopes that a win will impact other state dental boards. The goal is for all state dental boards to look out for the public good instead of protecting the interests of primary care dentists. This sounds simple and its crazy that state boards don?t look after the public good but it is a fact of life.
Q: How long do you anticipate the ruling will take to find out if the decision to provide low-cost teeth cleaning can be overturned?
A: I am no legal expert but I?ve been told to expect a couple years for this to play out.
To find out more information about Dr. Burris and his case, visit his story at the Institute for Justice.