Succor Consulting, LLC

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Harold Nemetz, D.D.S., A.M.Ed.
Call: 707-465-1453

Dr. Harold Nemetz is a dental expert witness assisting both Plaintiff and Defense attorneys with General and Prosthetic Dentistry matters.

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Category: Blog

Patient Education: Informed Consent

Patient education is often overlooked.  Just because the patient does not ask questions about the proposed treatment does not mean they understand what is going to be done and accept the treatment.

INFORMED CONSENT: includes identifying and educating the patient about the following six components.

  1. The “dentist” must present all treatment options.
  2. The “dentist” must discuss the advantages of each option.
  3. The disadvantages/limitations of each option must be talked about. 
  4. The risk of each option should be identified and adequately discussed.
  5. The cost of each option must be furnished.
  6. The outcomes of no-treatment should be discoursed.

The dentist/clinician is responsible for providing informed consent (education) to each patient and for each proposed treatment AND there are a variety of ways to do this including:

  • a well trained staff
  • visual aids
  • software and video programs,,computers, TVs/DVDs, iPads or portable tablets.

Holistic Dentristy

The Holistic Dental Network defines the field as: “an approach to Dentistry that promotes health and wellness instead of the treatment of disease. This approach to Dentistry encompasses both modern science and knowledge drawn from the worlds great traditions on natural healing. Holistic Dentistry acknowledges and deals with the mind, body, and spirit of the patient, not just his or her “Teeth”.

Holistic dentistry may also be called alternative dentistry/ unconventional dentistry, biologic dentistry/ biocompatible dentistry emphasizing approaches for which is supposed to consider the patient’s dental health in the context of their entire general physical and/or emotional and/or also spiritual health in some cases. This is part of the alternative health movement.

Although the holistic dental community is very diverse in its practices and approaches, common threads include:

  • strong opposition to the use of amalgam
  • root canal fillings and,
  • nonsurgical approaches to gum disease.

Many practices and opinions among alternative dentists are criticized by the mainstream dental community.

What is a Dental Specialist?

What is a Dental “Specialist”?
A specialty is an area of dentistry that has been formally recognized by the American Dental Association as meeting the specified Requirements for Recognition of Dental Specialties. The responsibilities of the different areas of specialization, the requirements and other information can be found below. Currently there are nine dental specialties recognized by the ADA.

  • Dental Public Health:
    Dental public health is the science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice which serves the community as a patient rather than the individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis. (Adopted May 1976)
  • Endodontics:
    Endodontics is the branch of dentistry which is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated peritadicular conditions (Adopted December 1983)
  • Oral and Maxillofacial Pathology:
    Oral pathology is the specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. (Adopted May 1991)
  • Oral and Maxillofacial Radiology:
    Oral and maxillofacial radiology is the specialty of dentistry and discipline of radiology concerned with the production and interpretation of images and data produced by all modalities of radiant energy that are used for the diagnosis and management of diseases, disorders and conditions of the oral and maxillofacial region. (Adopted April 2001)
  • Oral and Maxillofacial Surgery:
    Oral and maxillofacial surgery is the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. (Adopted October 1990)
  • Orthodontics and Dentofacial Orthopedics:
    Orthodontics and dentofacial orthopedics is the dental specialty that includes the diagnosis, prevention, interception, and correction of malocclusion, as well as neuromuscular and skeletal abnormalities of the developing or mature orofacial structures. (Adopted April 2003)
  • Pediatric Dentistry:
    Pediatric Dentistry is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. (Adopted 1995)
  • Periodontics:
    Periodontics is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. (Adopted December 1992)
  • Prosthodontics:
    Prosthodontics is the dental specialty pertaining to the diagnosis, treatment planning, rehabilitation and maintenance of the oral function, comfort, appearance and health of patients with clinical conditions associated with missing or deficient teeth and/or oral and maxillofacial tissues using biocompatible substitutes. (Adopted April 2003)

Dental specialists are Dentists who:

  • have previously undergone the prescribed Dental School/University education necessary to become general dentists (3-4 years)
  • graduated and received a diploma
  • they had been accepted for post-doctoral education in an ‘ADVANCED EDUCATION PROGRAM’ or ‘POSTDOCTORAL PROGRAM’
  • receives a ’GRADUATE DEGREE’ or ‘CERTIFICATE.’

Various programs prepare students (dentists) for careers as researchers, academics and specialists among many other possibilities so as to complete at least two additional years of training to become experts in a particular specialty of the Dental profession (usually at a Dental School in a University).

Even though they have been previously trained in the practice of general dentistry, most dental specialists practice only within their (new) specific field of expertise. Patients seen by dental specialists are generally referred by general dentists to receive care for complex oral health issues that are beyond the scope of their general dentistry practice. THE “DENTAL SPECIALIST” IS BOARD ELIGIBLE UPON COMPLETION of the post-doctoral education program AND, is CERTIFIED as a DIPLOMAT OF THE SPECIALTY BOARD if a successful examination has been complete.

You can be a licensed practicing SPECIALIST without ever passing the boards. The big pressure to take the ‘specialty board exams’ comes from insurance companies, third party payers and hospital administrators, who are more likely to pay better or promote someone who is board certified.  Until you have passed the specialty board and become a Diplomat, you are ‘board eligible.’

Dental Patients’ “BILL OF RIGHTS” [American Dental Association/California Dental Association]


PATIENTS HAVE A RIGHT to know in advance the type & expected treatment AND:–>

PATIENTS HAVE A RIGHT to expect dental team members to use appropriate infection & sterilization controls

PATIENTS HAVE A RIGHT to ask about treatment alternatives & be told in understandable language;  the advantages & disadvantages of each treatment

PATIENTS HAVE A RIGHT to ask the dentist to explain all the treatment options regardless of coverage or cost

PATIENTS HAVE A RIGHT to know the education of the dentist & the dental team

PATIENTS HAVE A RIGHT to know the professional rules, laws & ethics that apply to the dentist & the dental team

PATIENTS HAVE A RIGHT to choose their own dentist

PATIENTS HAVE A RIGHT to see the dentist every time they receive treatment

PATIENTS HAVE A RIGHT  to schedule an appointment in a timely manner

Dental Standards of Care

Unlike Standards for most non-professional skills [like driving a car-->where laws establish the rules of the road;  a lay person is deemed capable of determining when they have been violated; the law generally delegates the settling of detailed professional standards to members of various professions. 

Medical/Dental practice or malpractice standards are drawn in large part from the customs and behavior of the members of the profession.  An EXPERT WITNESS must establish a standard for medical/dental care and give an opinion on whether the defendants conduct met this standard [the standard must be general and specific to the individual plaintiffs circumstances] and ideally should be supported by uncontroverted scholarly literature.  (Ref: “LectricLawLibrary”)

NOTE: A general practitioner who provides specialty services to patients may be held to the same standards that a specialist would be held if the specialist had provided the services.

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I retained Dr. Harold Nemetz as a dental expert in _ v.USA. The case hinged on whether Mr. Unin's dentist exercised the degree of care ordinarily exercised during a tooth extraction. Dr. Nemetz took pains to educate me on the nature of teeth and gums and relevant standard of care, all of which helped immensely. And during his trial testimony, he presented as professional, knowledgeable, unbiased and forceful.
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Power & Brown, LLC

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Harold Nemetz, DDS, AMED
P.O. Box 328
Crescent City, CA 95531
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