Disciplinary Actions against Michael D. Margolis, D.D.S.
Stephen Barrett, M.D.
Michael D. Margolis, D.D.S. who practices what he called "biological dentistry," has been disciplined by the Arizona Board of Dental Examiners seven times. In 1984, he was placed on one year's probation and ordered to take 21 hours of continuing education. In 1987, the board found concluded that he had failed to adequately document the reasons for several procedures that the board suspected were questionable. After concluding that he had acted unprofessionally, it fined him $200 and placed him on probation for one year. In 1989, the board censured him for installing a crown improperly and ordered him to pay restitution of $330 to the patient. In 1995, the Board censured him for failing to supervise a dental assistant whom he had authorized to polish teeth. The other three disciplinary actions—in 2004, 2012, and 2013—each concerned inappropriately diagnosing and treating a patient for "neuralgia inducing cavitational osteonecrosis" ("NICO") and unnecessarily extracting teeth based on diagnoses made with a Cavitat device. In two of these cases he had also performed invasive jawbone surgery that was unnecessary and had left the patients with persistent jaw discomfort. In he 2004 case, he was ordered to take 12 hours of board-approved continuing education. In the 2012 case he was ordered to take 24 hours of continuing education. In the 2013 case, as shown below, he was ordered to pay restitution of $11,986 to the patient.
The NICO diagnosis is used by a tiny minority of dentists who claim that most facial pains and even pains and diseases located far from the mouth are caused by cavities (cavitations) within the jaw bones that can be diagnosed with a Cavitat device and should be treated with invasive and irreversible surgeries and extractions. The The Cavitat is an ultrasound device that does not have FDA approval for diagnosing disease. In 2012, the American Association of Endodontists issued a position statement that concluded:
The American Association of Endodontists cannot condone surgical interventions intended to treat suspected NICO lesions. Even when a NICO lesion is suspected to be associated with an endodontically treated tooth, no surgical procedures should be performed until orofacial pain specialists confirm the diagnosis. . . . In addition, the practice of recommending the extraction of endodontically treated teeth for the prevention of NICO, or any other disease, is unethical and should be reported immediately to the appropriate state board of dentistry.
BEFORE THE ARIZONA STATE BOARD OF DENTAL EXAMINERS
IN THE MATTER OF:
Michael D. Margolis, D.D.S.Holder of License Number D 2957
For the Practice of Dentistry
In the State of Arizona
Case No. 201300171
In order to resolve this case quickly and judiciously, the Arizona State Board of Dental Examiners (Board") and Michael D. Margolis. D.D,S, enter into this Disciplinary Agreement and Order ("Consent Agreement) in lieu of further administrative and judicial proceedings. It is consistent with the public interest and the requirements and statutory authority of the Board, specifically, A.R.S. §§ 32-1263.01, 1263.02 and 41-1092.07(F)(5). This Consent Agreement shall resolve all issues the Board has reviewed and investigated regarding the allegations in this matter.
Therefore, in lieu of further proceedings, Michael D. Margolis, D.D.S. admits and understands that:
I. Any record prepared in this matter, all investigative materials prepared and received by the Board concerning the allegations, and all related materials and exhibits may be retained in the Board;s file pertaining to this matter.
2. Dr. Margolis waives any right to a hearing or re-hearing of this matter and any right to judicial review of the attached Findings of Fact, Conclusions of of Law, and Order.
3. Dr. Margolis has the right to consult with an attorney prior to entering into this Consent Agreement.
4. The findings contained in the Finding of Fact portion of' the Consent Agreement are conclusive evidence of the stated facts. The Board may consider this Consent Agreement when and if future disciplinary proceedings arise.
5. This Consent Agreement is subject to the Board's approval and will be effective only when the Board accepts it and it is signed on behalf of the Board. In the event that the Board, in its discretion, does not approve this Consent Agreement, it will be deemed withdrawn, will be or no evidentiary value and shall not be relied upon or introduced in any disciplinary proceeding by any party. Dr. Margolis agrees that should the Board reject this Consent Agreement and this case continues through the administrative process, he shall assert no claim that the Board was prejudiced by this review and discussion of this document or any related records.
6, Dr. Margolis further understands that this Consent Agreement, if approved and signed by the Board, constitutes a public document that may be disseminated as a formal action by the Board, including being reported to the National Practitioner Data Bank.
7. Dr. Margolis agrees to the Board approving the following Findings of Fact,
Conclusions of Law and Order.
DATED this 12 day of November 2012.
Michael D. Margolis, D.D.S.
FINDINGS OF FACT
1, Dr. Margolis holds license no. D 2957 initially issued by the Board on June 22. 1983.
2. Patient DT initially presented to Dr. Margolis on January 25, 2010. Dr. Margolis noted that DT had 3 endodontically treated teeth in the maxillary left quadrant which he identified as teeth nos, 13 14, 15 or 16. Dr. Margolis also noted that DT has, multiple health problems that correlate to her teeth. including headaches, sinus problems, low blood pressure, allergies, a history of breast reduction surgery, fatigue, and sleeping difficulties. Dr. Margolis obtained a complete set of radiographs and 3-D cone beam radiographs.
3. Dr. Margolis advised DT of NlCO (Neuralgia Inducing Cavitational Osteonecrosis). On January 20, 2010, Dr. Margolis performed Cavitat on DT;s upper 1eft quadrant.
4. Based on the results of the Cavitat, Dr. Margolis treatment planned DT for the removal of teeth numbers 13, 14 and 15. with a biopsy of tooth no. 16 area. He completed the procedures on March 1, 2010., The treatment included removal of bone with the biopsy. DT's treatment records do not indicate that any of the teeth Dr. Margolis removed were symptomatic.
5. On May 27, 2010. Dr. Margolis delivered a partial denture for DT's maxillary left quadrant. DT experienced persistent discomfort. Dr. Margolis adjusted the partial denture several times. DT alleged that the partial denture never seemed to fit. Given the removal of bone in the maxillary left quadrant, it is likely that the partial denture would not have a secure fit.
6. The consent form and documentation Dr. Margolis provided DT for the upper partial denture and surgery did not describe the removal of bone and likely difficulty with removable appliance retention. IDT was given and signed a standard consent form. This form did not describe the end result of bone removal and how this would impact further restorative procedures in this area.
7. Dr. Margolis performed a second Cavitat on DT that, according to Dr. Margolis, indicated abnormality in the mandibular right quadrant. On November 16, 2010, Dr. Margolis performed invasive surgery in the maxillary right and mandibular right quadrants involving the regions of teeth nos. 1 and 32. Following (that surgery, DT had persistent numbness of her lower lip on the right side.
8. Dr. Margolis, on six occasions, saw [DT subsequent to the November 16, 2010 surgery and provided multiple homeostasis and autodyne light therapies in an attempt to improve DT's condition of numbness. On April 28, 2011, at DT's six-month recall appointment. Dr. Margolis noted in DT's treatment records that DT had persistent numbness at that time. DT's treatment records do not contain any documentation regarding a referral to a micro-neural specialist.
9. Dr. Margolis should have referred D'T to a specialist for her numbness within the first 4 months following its onset. DT has permanent numbness or the right side of her lower lip.
10. Dr. Margolis made no notes discussing the physical status or radiographic findings associated with the maxillary left, maxillary right and mandibular right quadrants.
11. Dr. Margolis' treatment of DT was predicated on the results of a Cavitat. The Cavitat has not been found conclusive for pathology requiring invasive and destructive procedures. The surgery and removal of asymptomatic endodontically treated teeth Dr. Margolis performed was not indicated by routine, accepted methodologies of diagnosis, It is Dr. Margolis professional opinion that the Cavitat, in combination with a 3D cone beam x-ray, clinical examination and patient complaints, is sufficient to provide a diagnostic basis to support removal of bone tissue.
CONCLUSION OF LAW
The conduct and circumstances described in the above Findings of Fact constitute unprofessional conduct as defined by A.R.S. § 32-1201.21(n). Such conduct is grounds for discipline under A.R.S. § 32·1263(A)(1).
IT IS HEREBY ORDERED that, within thirty days from the effective date of this Consent Agreement and Order. RESTITUTION in the amount of $11.,986,00, payable to Complainant. Dr. Margolis shall submit the restitution in certified funds to the Board for delivery. In the event Dr. Margolis fails to timely comply with this paragraph, the Board may take further disciplinary action, after notice to Dr. Margolis and an opportunity to be beard,
2. IT IS FURTHER ORDERED that Dr. Margolis is hereby CENSURED.
DATED this 10th day of December, 2013.
ARIZONA STATE BOARD OF
A copy of the following mailed by CERTIFIED MAIL this 11th day of December to:
Michael D. Margolis, D.D.S.
2045 S. Vineyard Road
Mesa, AZ 82510
A copy by US MAIL to:
David W. Williams, Partner
Davis Miles McGuire Gardner, PLLC
80 E. Rio Salado Parkway, Suite 401
Tempe, AZ 85281