Trooth.Com – The David Nicholls DDS Interview Part Two

Posted Posted in David Nicholls, Heath Hendrickson, Trooth.Com

Trooth Website Trooth.Com   The David Nicholls DDS Interview Part One

From the website Trooth.Com

You remember the FLAP.

A number of Utah oral and maxillofacial surgeons have begun a dentistry turf war with a fellow dentist, Heath Hendrickson, over the extraction of wisdom teeth. The surgeons have sponsored a website (Trooth.com) and a billboard on I-15 in Utah County, Utah.

The oral surgeons who are listed below have a beef with general dentist, Heath Hendrickson, who refers to himself as Dr. Wisdom Teeth.

Monday afternoon, I had the opportunity to speak with David Nicholls, D.D.S., one of the oral and maxillofacial surgeons who comprise the Board of Trooth.Com.

Part One of my interview with Dr. Nicholls is posted here.

The interview continues:

Flap: You are saying that you object to Dr. Hendrickson’s advertising. Are you saying it is false and misleading?

Nicholls:

I am not speaking to his intent. What I am saying is that his advertisement that he puts out, billboards and other advertisements, do not comply with the Utah State Dental Practice Act that clearly states that if you are a generalist, advertising specialty care you must put on your advertisement a general dentist is performing services – so the public knows. And, as to his intent, I cannot clearly speak.

But, very clearly his advertising is not in compliance with the Utah State Dental Practice Act.

If you look under the section of Unprofessional Conduct, the advertising not specifying the person is a generalist is under Unprofessional Conduct. And, it is the idea of making claims in your advertising that you are somehow better and a more competent clinician than others, while you are only trained as a generalist, if you are advertising in a specialty area, so if you pull up the section of the Dental Practice Act, it is only 14 pages long, and you read it under the section of Unprofessional Conduct, you will see very clearly that it is stated. And, just look at his billboards and his websites and it becomes clear that he is not complying.

Flap: There is the advertising portion of your complaint and there is Dr. Hendrickson’s image in the community, and that the public would be confused with his advertising. Patient care is also an issue. You are saying that he is having complications and he is not managing the complications?

Nicholls:

Well, I can speak personally from a patient I saw from the practice who was a young woman, college aged student who had her wisdom teeth out there. A month post-op, she developed a swelling, a mass, in her lower jaw. The patient was concerned about it. She went back to Wisdom Teeth Only, according to the patient. She was told that whatever the specialist is going to do and we will do that.

And, based on that interaction, she lost confidence in the practice. She went to her physician. The physician ordered a CT Scan. It showed a mass associated with a third molar site – the #32 position. And, then the patient showed up at our office for treatment.

What she had was an acute osteomyelitis with destruction of the mandible in that area and the loss of both buccal and cortical plates in the area of the wisdom tooth.

So, what it required was debridement, IV antibiotics and oral antibiotics. And, it eventually resolved.

So, that is an example of something that we see where the patient needs treatment that they will not be allowed to be provided in that practice – or what he can’t provide.

And, so, I am sure you are aware,that if you do oral surgery from time to time you see infection and complications that require hospitalization. and, oral surgeons as you know are dentally, medically trained. And, so all of the oral surgeons are able to manage those complications in the hospital and take the case to completion. Whereas, a generalist doing surgery is not able to do that because he does not have hospital privileges and operating room in order to make care of complications that arise from tooth removal.

That by default falls to the oral surgeons.

And, it somewhat akin to a family practice doctor who is exposed to tonsillectomy in his family practice residency setting up a clinic and saying well, I have done some tonsils and know how to do it, so I am going to do tonsils and that is all I am going to do. And, I am going to advertise that I am going to have people come see me for their tonsils. And, I am going to kind of underbid the ear, nose and throat surgeons so that I can ..since a lot of people need tonsils out.

And, the reason it does not happen is in the medical community is because you have to do surgery in a hospital setting. A hospital demands proper credentialing and training in order for the person to do that type of service. Because dentistry is not regulated in the office setting, the dentist can pretty much do what he wants – as long as he does not get into trouble and the patient’s sue.

There is no other way to regulate what a dentist is doing as far as a physician who says he wants to do ..and the first thing the hospital says, are you trained to do this? And, if you are trained we need to see the documentation of your training, before we let you do this.

It is kind of an interesting dynamic since it is kind of unique to dentistry and there really is nothing equivalent in medicine because the hospitalization part of it, controls it.

Flap: You are aware at least in California (where I am licensed), that as a general practitioner that you can obtain hospital privileges?

Nicholls:

We have some general dentists who are on staff here as well. They bring in mentally compromised patients, pediatric patients, bring in patients that need to be sedated and to take care of trauma – tooth trauma on an emergency basis. Dr. Hendrickson is not among that group. He does not have hospital privileges.

In Part Three of my interview with Dr. Nicholls, we will discuss the remedies that these oral surgeons have taken against Dr. Hendrickson and about the impact to their own professional reputations.

Yesterday afternoon, I did have a telephone conversation with Dr. Heath Hendrickson. He told me that he would like to respond to Dr. Nicholl’s interview and the other Board Members of Trooth.Com, after this series of interviews is posted. Also, he has legal counsel and is consulting them about his possible remedies.

Stay tuned…..

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The Trooth.Com Archive

Trooth.Com – The Billboard

Posted Posted in Heath Hendrickson, Trooth.Com

The Trooth.Com Billboard

In the photo above you see the Trooth.Com billboard that Utah oral surgeons have erected in their “public awareness” campaign or what I call a “Turf War” with Dr. Wisdom Teeth, general dentist, Heath Hendrickson, D.D.S..

I will have another installment of my interview with oral surgeon, David Nicholls, D.D.S. tomorrow. The first installment is here.

In a telephone conversation with Dr. Hendrickson this afternoon, I will have his response after Dr. Nicholl’s posts are completed.

Stay tuned…..

Trooth.Com – The David Nicholls DDS Interview Part One

Posted 2 CommentsPosted in David Nicholls, Heath Hendrickson, Trooth.Com

Trooth Website Trooth.Com Board Member Interview Tomorrow

You remember the FLAP.

Yesterday afternoon, I had the opportunity to speak with David Nicholls, D.D.S., one of the oral and maxillofacial surgeons who comprise the Board of Trooth.Com.

While I characterize this “Public Awareness Campaign” as a Turf War between Utah oral surgeons and general dentist, Heath Hendrickson, D.D.S., Dr. Nicholls takes exception with this terminology. But, more on this later.

I have now reached out and left messages (either via e-mail or web form) with most, if not all, of the oral and maxillofacial surgeons on the Trooth.Com Board. Dr. Nicholls is, so far, the only one, who has contacted me. I welcome the other Board members to contact me for an interview or to comment below, if they wish.

Yesterday, I, also, had e-mail correspondence with Heath Hendrickson, D.D.S.. He told me that he would get back to me today since he was accompanying his wife, who is pregnant with twins to her doctor. She is due this week. I, certainly understand, and wish them both well – as everyone does.

On to the interview, which I will break down into a number of parts:

Who is David W. Nicholls, D.D.S.?

The graphic below is from Dr. Nicholl’s website:

Screencap of David Nicholls DDS WebsiteFlap: Why Trooth.Com?

Nicholls:

Well, in Utah, there seems to be a growing problem with individuals who are not specialty trained taking on specialty care and they are entitled to do that under the state’s Dental Practice Act. But, the state Dental Practice Act clearly states that if a general dentist is going to provide specialty care and advertise that he is providing specialty care that his advertisements must say that the services are performed by a general dentist. And, supposedly that font of the disclaimer is supposed to be of the same size as the largest font that he uses in his advertisements.

Additionally, the state Dental Practice Act states that a general dentist, providing specialty services, cannot make claims of superiority or advanced training when he has not gone through formal training – in terms as to how he represents himself to the public. And, in this case, Dr. Hendrickson, is a general dentist who has limited his practice to the surgical removal of wisdom teeth. And, he advertises very heavily. He has several billboards up and down the state, placards all over the community and multiple websites, all of which do not comply with that regulation. Meaning that he promotes himself as one who takes out wisdom teeth, that is all he does – you don’t need to see the oral surgeon because I can do it for you for whatever he is advertising.

The problem with that is that when people go to see him (Hendrickson) they don’t realize he is not an oral surgeon. He does provide the same level of care as an oral surgeon, but he is not trained. He graduated from Creighton in about 2003, as I understand it.

He uses a nurse anesthetist as the anesthetic, which is OK. But, we, as oral surgeons in the community around him have seen patients who come from his practice who develop post-operative complications, the way of infection, that is the most common one. And, so what happens is the patient either loses confidence in his practice and come and see the oral surgeon to treat the complication or the complication is beyond his ability to treat.

So, this creates a dynamic, where people are going to his practice because of the advertisement, but they do not know, until after the fact, that he is not an oral surgeon. And, that is the part we take issue with.

Any dentist can perform, any kind of treatment within the realm of his training under the Dental Practice Act. But, if he is going to advertise himself as doing that exclusively as a specialty then he is bound by the Dental Practice Act to state that to the public, so the public knows what they are getting, when they go to see that practitioner.

And, what happened is, we as his colleagues in the community have asked him several times to make that clear because as we have researched the circumstances we realize the public doesn’t know that and many of them feel that it has been misrepresented to them. And, he has not been responsive to that.

And, the professional regulation, in Utah run by the Department of Public Licensing (DOPL) which also covers physicians and other kinds of professionals who are licensed – and, so their main concerns are drug abuse and inappropriate contact with patients and that kind of thing. So, when DOPL was advised regarding these Dental Practice Act infractions, they just haven’t acted. They have too much else to do.

So, because Dr. Hendrickson did not respond and we got no support from DOPL, we felt the only thing left to do was, in the interests of truthful rendering of specialty care in our area, was to undertake a public education campaign.

And, that is our interest. And, that is our interest only.

Later in the interview, I asked in follow up, what kind of formal contact from the Trooth.Com Board or individual oral surgeons was made to Dr. Hendrickson. Dr. Nicholls replied that the Board had sent him a letter.

I requested a copy of the letter and Dr. Nicholls said that he would have to check with their legal counsel before he could supply the document. I will try to get the letter from the Board, Dr. Nicholls or from Dr. Hendrickson.

In Part Two of the interview, I will delve more into the issues of why the Board has seemingly taken the enforcement of the Utah Dental Practice Act into their own hands and what impact Dr. Nicholls sees in their public awareness campaign.

We will also discuss why some may see this awareness campaign, simply, as a Turf War, between specialty trained dentists who want to protect their own business interests from Dr. Hendrickson.

Stay tuned….

Wisdom Teeth Turf War Erupts in Utah

Posted 14 CommentsPosted in Dentistry, Heath Hendrickson, Trooth.Com

Trooth.com Website

From Trooth.com

A number of Utah oral and maxillofacial surgeons have begun a dentistry turf war with a fellow dentist, Heath Hendrickson, over the extraction of wisdom teeth. The surgeons have sponsored a website (trooth.com) and a billboard on I-15 in Utah County, Utah (I will endeavor to get a photo of the billboard tomorrow).

The oral surgeons who are listed below have a beef with general dentist, Health Hendrickson, who refers to himself as Dr. Wisdom Teeth.

Trooth.com Board MembersBut, what is the FLAP?

Dr. Hendrickson is a licensed, undisciplined Utah dentist who extracts wisdom teeth.

There seems to be more to the story.

Here is Dr. Hendrickson’s website at DrWisdomTeeth.com:

Dr Wisdom Teeth websiteMy experience in these dental turf wars is money, money and more money.

Do the oral surgeons resent the fact that as a general dentist, Dr. Hendrickson is invading their lucrative turf of extracting wisdom teeth – and at a reduced fee to boot?

Or, is there a public safety concern?

Yet, the Utah Board that regulates dentistry has never disciplined Dr. Hendrickson.

Here are the Utah records:

Heath Hendrickson Provo Dental Licenseand

Heath Hendrickson Heber City Dental License

Even the Utah Association of Oral and Maxillofacial Surgeons has jumped into the act seemingly denigrating general dentists in order to protect their own dental turf. Here is more:

Why an Oral and Maxillofacial Surgeon Should Manage Your Wisdom Teeth

Dentists learn to remove teeth in dental school the same way physicians learn how to cast a broken bone in medical school.  However as with broken bones, the difficulty, complexity and risk of the procedure varies; often requiring specialty training in order to provide the most effective, safe, and comfortable treatment.

Oral and maxillofacial surgeons are dental specialists who receive 4 to 6 years of additional medical and surgical training beyond dental school in order to specialize in surgical procedures related to teeth, jaw, and face and to administer general anesthesia. Oral and maxillofacial surgeons focus on:

  •             Wisdom tooth removal
  •             Complicated tooth removal
  •             Dental implants
  •             Reconstructive jaw surgery
  •             Facial skeletal reconstruction
  •             Management of impacted teeth
  •             TMJ disorders
  •             Facial trauma
  •             Facial cosmetic surgery
  •             Oral and maxillofacial pathology (diseases of the mouth, face and jaws)
  •             Sleep apnea
  •             General anesthesia

Dentists may perform any treatment they believe necessary that falls within scope of the state’s dental practice act, including tooth removal. Many dentists are able to perform straightforward tooth removal without difficulty. However, occasions may arise when removal of an impacted or erupted tooth is difficult or complicated. It is in the patient’s best interest to have these procedures performed by an oral and maxillofacial surgeon with proper training, as this ensures the best outcome for the patient.

If a dentist without appropriate training performs difficult or complicated tooth removal, patients may have increased risk of infection, dry socket, nerve injury, a lengthy and unpleasant procedure, and possibly additional surgery needed to produce complete healing. (Some dental practices limit their procedures to tooth removal only and patients may not be aware that the practitioner is not a formally trained oral and maxillofacial surgeon. The Utah Association of Oral and Maxillofacial Surgeons understands  “Wisdom Teeth Only” and “Simply Wisdomteeth” to be examples of this type of practice.) If complications occur during tooth removal, the patient is often referred to an oral and maxillofacial surgeon. In such cases, the patient has often experienced considerable stress and discomfort that likely would have been avoided if a properly trained oral and maxillofacial surgeon had been consulted originally. In most cases, an oral and maxillofacial surgeon can perform complicated or difficult tooth removal in a few minutes. A properly trained oral and maxillofacial surgeon typically can provide an anesthetic and remove four impacted wisdom teeth in 30 minutes or less.

I will try to interview some of the parties involved during the next few days.

I have a feeling this turf war is going to get uglier.

Stay tuned…..