Peer Review System
If you are unhappy or dissatisfied with the quality of care provided by your dentists, the California Dental Association (CDA) can help.
The Peer Review System is a patient/doctor mediation option operated by a committee of ethical member dentists who follow specific procedures and protocols to fairly review and resolve disputes.
Peer Review is a free service to you if the treatment was provided by a CDA member dentist. To initiate the Peer Review process or see if it is an option for you, contact CDA at (800) 232-7645. If your dentist is not a CDA member, please contact the Dental Board of California at (877) 729-7789.
Potential outcomes of cases resolved by the Reer Review System:
- Treatment is acceptable/appropriate. If the committee determines the treatment is acceptable and appropriate, no refund will be awarded.
- Treatment is unacceptable/inappropriate. If the committee determines the treatment is unacceptable or inappropriate, the committee will award a refund to the patient and/or insurance carrier for the amount paid toward unacceptable or inappropriate treatment.
- Corrective Treatment. If the committee determines that further harm was caused, necessitating additional treatment, the committee will award the amount estimated to correct the problem.
- Acceptable but incomplete. If the committee determines that the treatment provided is acceptable, but the treatment is incomplete, the committee will award a refund of the amount of the treatment that is incomplete.
- No determination. If there is insufficient evidence to render a decision, the committee will not make a determination about the case.
Not every complaint is appropriate for Peer Review. The following types of complaints are NOT within the scope of peer review system:
Cases which do not meet “time” criteria
Excessive passage of time alters clinical conditions. Therefore, a complaint will not be reviewed if it is received more than three years from the date that treatment was completed, or more than one year from the date the patient became aware of the problem, whichever occurs first.
Cases in litigation
The peer review system is designed to resolve patient/dentist disputes. Consequently, no inquiry will be accepted for peer review if either party has initiated litigation (including small claims court or sending a 90-day notice of intent to sue); have initiated or have gone through a formal arbitration process and/or both parties have signed an arbitration agreement concerning any aspect of the dental services which might otherwise be reviewable.
Cases petitioning for non-treatment monetary awards
Requests for reimbursement for time lost from work, pain and suffering, mileage and medical expenses cannot be accepted in the peer review system as it is not a punitive system, but rather an evaluative one.
Cases about fees
A peer review committee may not comment on a dentist’s fees. To do so may be construed as price fixing.
Cases not related to treatment
Questions concerning matters other than dental treatment (e.g., a dentist’s attitude, communications problems, etc.) are outside the purview of the peer review system.