As a retired North Carolina dentist-turned-lawyer, I write to urge patients and policymakers to pay closer attention to the actions of the N.C. Dental Board of Examiners. Unlike the overwhelming majority of health-related boards and agencies in this state, the Dental Board is made up of dentists elected by their peers — not appointed by the legislative and executive branches. These board members make consequential decisions that impact dental competition, access to care and costs for patients.
In 2015, the U.S. Supreme Court criticized the make-up of the Dental Board and determined it had engaged in unlawful, anticompetitive conduct that was less about public health and more about pecuniary interests of dentists who sat on the board. In short, the Dental Board went after tooth-whitening kiosks at malls delivering the service at a lower cost. The board not only lost at the Federal Trade Commission on this issue but appealed and lost at the U.S. Supreme Court. In addition to finding anticompetitive behavior, the Supreme Court admonished the board by finding it had no state action immunity (a legal defense that would shield the board from liability in its actions).
More than a decade later, those concerns have not been addressed, and the board continues to engage in anticompetitive behavior.
In 2025, the board was sued for unfair and deceptive trade practices under the 2015 Supreme Court decision for pursuing yet another tooth whitening case against a dental hygienist. Allocating about $750,000 to defend itself from those claims (presumably paid from dentist board dues), the board ultimately settled the matter without posting this resolution on its website.
Further, in 2025, the board tried to adopt a rule requiring all North Carolina dental offices to appoint a supervising dentist to oversee all other dentists within the same practice. The board admitted no other state in the country had such a rule. For practices with multiple dentists and locations, the requirement would have dramatically increased costs and staffing burdens that would have trickled down to patients.
Internal communications showed the board deliberately chose to seek this change through rulemaking rather than legislation, avoiding the scrutiny and debate that would come with action by the General Assembly. Regardless, the Rules Review Commission ultimately and unanimously rejected the proposal, correctly concluding it was an attempt to change the “landscape of dentistry” in North Carolina.
None of this occurs in a vacuum. Dentistry, like much of health care, has evolved. New dentists face substantial student debt and often seek employment in larger practices rather than incur the debt to buy or build their own practice. This allows them to focus on patient care while minimizing administrative and debt burdens. As a result, larger practices have been able to expand hours, invest in technology, and absorb compliance and administrative costs in ways that benefit patients. Those efficiencies translate into improved access and affordability. Regulatory actions that unnecessarily target those models do not protect the public. They protect incumbents.
The Dental Board’s stated mission is to regulate dentistry for the safety and benefit of patients. The Supreme Court warned years ago about the danger of allowing active market participants to police their own industry without meaningful oversight.
It is past time for the board to take that warning seriously. If it will not, lawmakers should.
Steve Petersen is a former dentist and retired lawyer who lives in Wagram.