Board Revokes License of Air Abrasion Dentist
Stephen Barrett, M.D.
The Wisconsin Dentistry Examining Board has revoked the license of Lee R. Krahenbuhl, D.D.S., owner/operator of the Advanced Care Smile Centers in Appleton and Oshkosh. The board ordered the revocation in July 2004 after concluding that Krahenbuhl had falsely diagnosed 13 cavities in a patient and proposed to charge $1,500 for unnecessary repairs. Case records indicate that the patient became suspicious and consulted three other dentists, each of whom said he had no cavities and needed no dental work. The revocation order states:
The Board’s Order revokes Dr. Krahenbuhl’s dental license, in part, because there is nothing in the record to suggest that imposing any discipline short of revocation would have a rehabilitative effect on him. To be sure, Dr. Krahenbuhl does not believe that he has engaged in any wrongdoing in this matter. As such, it is extremely unlikely that he would respond to any efforts at remediation. By imposing such a stringent measure upon his license, other patients will be protected from treatment of this kind. Furthermore, the revocation of his license is essential in order to prevent other licensees from engaging in conduct of this nature and to ensure that the public continues to be adequately safeguarded .
The board's conclusion reflected its concern about Krahenbuhl's history of misrepresentation:
- In 1991, Krahenbuhl pleaded no contest to three misdemeanor counts of Medicaid fraud and his professional service corporation was convicted of a felony charge of the same offense. He was ordered to pay fines and costs totaling $48,260, donate 200 hours of services to the poor, and complete coursework on business ethics .
- In 1993, in response to the criminal conviction, the dental board suspended Krahenbuhl's license for 30 days.
- In 2002, Krahenbuhl was disciplined in connection with faulty root canal treatment and misrepresenting that an x-ray film was the patient's post-treatment examination. The dental board suspended his license for six months, fined him $5,000, banned him from doing more root-canal work, and required his practice to be monitored by another dentist for at least two years . He appealed to county and state courts but lost.
Krahenbuhl appealed the revocation order, which included an assessment for costs of $22,771. In April 2005, the county circuit court upheld the Board but permitted Krahenbuhl keep practicing while he appealed to the state court of appeals . In March 2006, the appeals court denied his appeal .
Various reports indicate that Krahenbuhl was combining air abrasion with the use of a disclosing dye to detect tooth decay. Air abrasion uses a fine-tipped instrument to blast air and aluminum oxide particles that rapidly abrade the tissues to which it is directed. Disclosing dyes can help dentists judge how deep to drill or scoop out decayed areas when preparing teeth for fillings, but they are not reliable for determining whether or not a repair is needed. That requires the use of a probe to detect areas of softness. Dr. Robert Baratz has warned:
Dental scams occur when . . . caries-detecting dyes are misused. Here a dentist claims that many teeth have caries in the pits and fissures through use of these dyes. The dyes are not intended for this use. The dentist then places inordinately high numbers of unnecessary fillings, having justified the work by the use of the dye. Once the tooth has been cut it is impossible to tell what was previously present .
Fortunately, the patient who complained to the Board about Krahenbuhl investigated while the alleged evidence of wrongdoing was still available. Krahenbuhl said in his defense that he could legitimately find cavities where other dentists could not, but the dental board did not regard this claim as credible.
- Final decision and order after remand. In the matter of the disciplinary proceedings against Lee R. Krahenbuhl, D.D.S., July 24, 2004.
- Lowe E. Dentist’s use of ‘microdentistry’ debated among industry experts. The Post Crescent, Appleton, Wisconsin, April 28, 2005.
- Final decision and order after remand. In the matter of the disciplinary proceedings against Lee R. Krahenbuhl, D.D.S. Dec 6, 2002.
- Lowe E. State says dentist’s diagnosis full of holes: Revocation of license upheld after 13-cavity discrepancy. The Post Crescent, Appleton, Wisconsin, April 28, 2005.
- Decision. Krahenbuhl, v. Wisconsin Dentistry Examining Board, Appeal No. 2005AP1376, Cir Ct. No. 2004CV771, March 22, 2006.
- Baratz RS. Dental air abrasions systems: Potential for injury and abuse. Dental Watch, April 29, 2005.
This article was revised on March 22, 2006.