From the 2026 Spring Journal of the Colorado Dental Association: Cut to the Chase, By
Dr. David Geck
David Geck, D.D.S., M.S.
We often ask someone to “Cut to the Chase,” a phrase that has its origins in the early film industry, where the “chase” was considered the most exciting part of the movie. In this article, the “chase” refers to the issues we most commonly see at The Trust that result in a matter that escalates between you and your patient or you and the Colorado Dental Board.
Documentation: Missing, inaccurate, incomplete or lacking detail. Your clinical notes should tell a clear, complete and detailed story of the care you provided. Strong documentation protects you and promotes continuity of care.
Informed Consent: Missing or incomplete consent. True informed consent is essential, especially for complex or higher‑risk treatment. It’s more than having your patient sign a document. It’s also a conversation outlining the risks, benefits and alternatives of treatment. It protects the patient, clarifies expectations and is one of your strongest risk‑management tools.
Communication: Lack of communication as it relates to financial policy, treatment plans, insurance and general treatment expectations. Good communication is paramount in establishing expectations and building confidence and trust with your patients. Doctors should play an active role in this process, especially when complications arise. Choose your words carefully and remember to be clear is to be kind.
Infection: Post-operative infections lead to some of our biggest claims. Consider indications for pre-operative antibiotics. Prescribe appropriate antibiotics when indicated. Recognize infections early and make timely referrals. Doctors should be available and communicate directly with the patient, preferably not through texting. Always provide written and verbal post‑operative instructions.
Surgical Complications: Paresthesia, dysesthesia and nerve injuries. Continuously review your surgical protocols and evaluate your instruments. Choose your cases wisely. Make a timely referral to an oral surgeon when complications arise.
Surgical Implant Placement: Infections, improper placement and restorative complications. Review your surgical protocols and routinely evaluate your instruments. Know when to refer complicated cases. Continue your education to expand your skill and knowledge and develop strong mentorship relationships.
OSHA: Improper training, lack of spore testing, lack of water testing, improper sterilization techniques and lack of documentation. Annual, live OSHA training is required for you and your team. Implementation of proper protocols greatly reduces the risk of a complaint by patients or current/former employees.
Dental License: Failure to renew license. You alone are responsible for renewing your license — don’t delegate this to a team member. Dental licenses renew at the end of February in even numbered years, the next one being February 29, 2028.
Continuing Education: Failure to complete and document CE. Thirty hours of certified CE is required every two years and runs in cycle with your dental license. Maintain your records — the Colorado Dental Board may audit you at any time.
Swallowed/Inhaled Objects: One of the most frequent incidents we see at the Trust. Have protocols in place to protect the patient’s airway (throat pack) and/or ligation of instruments. Confirm burs are secure in your handpiece by spinning them before entering the patient’s mouth. Always double-check the retention of your implant driver.
Billing: Incomplete financial arrangements. Have patients sign a Financial Policy. Treatment plans should be clear and complete, indicating the patient’s financial responsibility. Understand and work with the patient’s insurance company so both you and your patient understand what role the insurance company will play in paying for the treatment. Bottom line — patients don’t like to be surprised about finances, and when they are, they often file a Colorado Dental Board complaint.
Scope of Practice: Team members performing procedures outside their scope of practice. Understand what your team members are allowed to do under Colorado law, including what is permissible under direct versus indirect supervision.
Governing Documents: Colorado Dental Practice Act, Code of Colorado Regulations and Colorado Dental Board Policies: A surprising number of clinicians are unfamiliar with the content of these documents. I would encourage you to read them. They are available on the DORA/Colorado Dental Board website. Please note there are significant changes coming in the weeks and months ahead, so continue to look for guidance from CDA as the new rules are implemented.
Dr. David Geck is the executive director of the Dentists Professional Liability Trust of Colorado. Contact him at dgeck@berkleyrisk.com.
