Minnesota dentists, dental hygienists, and licensed dental assistants are regulated by the Minnesota Board of Dentistry. Below are the forms you may use to file your complaint against these dental providers. Fill out the applicable forms and return them to:
Minnesota Board of Dentistry
2829 University Avenue SE, Suite 450
Minneapolis, Minnesota 55414
The information you provide will be evaluated to determine whether the matter is a violation of the Dental Practice Act, which requires the Board to obtain additional information and, if indicated, take appropriate action against the provider.
Provide Your Identity Information
The Minnesota Board of Dentistry does not accept anonymous complaints. When completing the forms, the Board asks that you provide your identity information. You have a choice about whether to allow us to release a copy of your actual complaint (see description below relating to the form titled, Authorization to Release Complaint).
Your identity will be kept confidential under Minnesota Statute 13.41, subd. 2. Once a complaint matter is resolved (through closure, taking corrective action or taking disciplinary action), the classification of the complaint and investigation information changes from confidential to private. You may call to speak with a Board Complaint Unit staff member if you would like to learn more about the classification of data maintained by the Board
There are rare instances when the Boards proposed resolution for a complaint matter is contested by the dental provider and your identity could be disclosed.
Please be aware that failing to provide the Board with identity information may result in the Board not being able to adequately investigate alleged violations. It also prohibits Board staff from providing you with updates regarding the Boards review and resolution of your complaint.
Before completing these forms, please understand that the Board of Dentistry does not assist individuals in obtaining monetary refunds related to dental treatment. The Board of Dentistrys authority is limited to taking disciplinary or corrective action against a dental care provider when warranted in order to protect the public at large. If you are seeking monetary reimbursement, please call the Board office (612-548-2124) for information about where you may seek such assistance.
1. COMPLAINT REGISTRATION FORM:
While we do not wish to unduly complicate the filing of complaints, we ask that you submit your complaint in writing so that it can be properly evaluated. Please provide as much detail as you can regarding all facts which relate to the complaint, including records which you may have or know about, and any attempts you may have already made to resolve your complaint with the provider. If you are unable to submit your complaint in writing, please call our office.
2. AUTHORIZATION TO OBTAIN RECORDS:
If your complaint alleges that the dental care provider improperly treated you in some way, it will probably be necessary for the Board to obtain your dental records so that your complaint can be properly evaluated. For this reason, we have included an Authorization to Obtain Records form for your signature. It is not legally necessary for you to sign this form; your complaint will be evaluated regardless of whether you sign. However, it may be easier for the Board to evaluate and resolve your complaint if you sign this authorization.
If your complaint is for a minor or dependent, please complete and send us the Records Waiver Authorization for Dependent Form.
3. AUTHORIZATION TO RELEASE COMPLAINT:
When we analyze your complaint, we will likely seek a response from the provider. When requesting the providers response, it could be helpful to share your complaint with the provider. For this reason, we have included an Authorization to Release Complaint form for your signature. This form would authorize us to mail a copy of your complaint to the provider when we request a response. It is not legally necessary for you to sign this form; your complaint will be evaluated regardless of whether you sign it. However, it may be easier for the Board to evaluate and resolve your complaint if you do sign it. If you choose not to sign the Authorization to Release Complaint form, and the complaint becomes part of an active investigation, the complaint is classified as confidential data in accordance with the Minnesota Data Practice Act.
RIGHTS UNDER DATA PRACTICES ACT
In accordance with the Minnesota Data Practice Act, information supplied to the Board as part of an active investigation is classified as confidential data. However, the complaint may be disclosed to the Board members assigned to this case, Board staff, consultants retained by the Board, the Attorney Generals Office, other licensing officials and, when necessary, the courts. In addition, even if you do not sign the Authorization to Release Complaint form, the substance of the complaint may be disclosed to the provider. Disciplinary actions taken by the Board are public, but they do NOT include specific patient names.
Finally, may we again remind you to sign and date the Complaint Registration form. Please return it and the authorizations, if appropriate, to the address noted above.
The entire complaint resolution process can be very lengthy, but you will be notified in writing about the Boards decision regarding the resolution of your complaint.
Thank you in advance for taking the time to file your complaint.
For more information regarding the complaint process: