8 min read • By Dr. Kevin Baharvand, DMD, MS • Updated August 2026
The short answer
A dental office runs on a much longer list of rules than patients ever see: licensing and continuing education, sterilization standards with weekly biological testing, radiation rules for every x-ray machine, record retention requirements, and privacy law. Most of it is invisible when it is being done right, which is exactly the problem. Here is what is supposed to be happening behind the scenes, and the handful of things you can actually check yourself.
Nobody chooses a dentist based on instrument sterilization protocols. You choose based on the lobby, the reviews, and whether the person seemed decent.
That is reasonable, and it is also why the parts that matter most are the parts nobody looks at. An office can look immaculate and cut corners in the back, and you would never know.
So this is the version of the tour you do not get.
On this page
Licensing is not a one time thing
Every dentist in Texas holds a license issued by the Texas State Board of Dental Examiners, and it has to be renewed with continuing education hours behind it. Hygienists and assistants are separately licensed or registered, with their own requirements.
That board also publishes a free public license search, which shows whether a license is current and whether there is any disciplinary history attached to it. It takes a minute and almost nobody uses it.
This is the single easiest thing you can verify about any dental office, and it is worth doing before a first appointment anywhere.
What is supposed to happen to the instruments
This is the one I would want a patient to understand, because the standard is high and the shortcuts are invisible.
Anything that touches you either gets thrown away or goes through a full cycle: cleaned, packaged in a pouch that has a chemical indicator on it, run through an autoclave under pressurized steam, and stored sealed until it is opened in front of you. That pouch getting opened at the chair is not theater. It is how you know that set has not been sitting out.
The autoclave itself gets tested, and not just with a color changing strip. A proper protocol includes regular biological monitoring, meaning a test containing actual bacterial spores is run through the machine and cultured to confirm the cycle killed them. A strip that changes color only tells you the machine got hot. A spore test tells you it worked.
Beyond that, surfaces get barriers or disinfectant between patients, waterlines in the units get treated and tested, and sharps and biohazard waste go out through a licensed handler.
It is completely reasonable to ask an office how often they run biological spore testing on their sterilizers. A practice doing it properly will be glad you asked. That question tells you more than any online review.
X-rays have their own set of rules
Dental imaging equipment is regulated separately, with requirements for registration, shielding, and periodic inspection. There are rules about who may operate the machine and what training they need.
The clinical side has standards too. Imaging is supposed to be justified rather than routine, meaning there is a reason for each set based on your history and risk, not simply that it has been six months.
This is also why a new office may want current images even if you had some recently. It is not always upselling. If the previous images did not capture what needs to be seen, or are too old to reflect what is happening now, working from them is guessing. What you should expect is somebody explaining why, and being willing to use your old images if they are usable.
| What you can ask | What a good answer sounds like | Why it matters |
|---|---|---|
| Is your license current, and can I look it up? | Of course, here is the name to search | Free, public, and takes a minute |
| How often do you spore test the sterilizers? | A specific interval, without hesitation | The difference between a machine that gets hot and a machine that works |
| Why do I need these x-rays? | A reason tied to your history or symptoms | Imaging should be justified, not automatic |
| Can I have a copy of my records? | Yes, we will send them wherever you want | They are legally yours |
| Who owns this practice? | A name, usually a dentist who works there | Ownership drives incentives |
| Can I get the estimate in writing first? | Yes, we do that for everyone | Prevents the argument nobody wants later |
Your records, and who can see them
Dental records are protected health information under federal privacy law. That means the office cannot hand them to anyone without your authorization, and it also means you are entitled to copies of your own.
Offices are also required to retain records for a set period rather than discarding them when you leave, which is why a practice you have not visited in six years can usually still send your history to a new dentist.
Practically speaking: you never have to justify a records request, and you never have to collect them in person. Give the old office the new office name and email. We covered how that works when switching dentists.
Things a dental office is not allowed to do
A few that come up.
Nobody can perform procedures outside their license. An assistant can do certain things and not others, and the line varies by state and by certification. If something feels like it is being done by the wrong person, asking is fair.
Advertising has rules. A dentist cannot call themselves a specialist without the training that supports it. That word means something specific: an orthodontist, an oral surgeon, a periodontist and so on completed an accredited residency after dental school. General dentists can legally do many of those procedures, and plenty do them well, but they cannot use the title.
Board certification is separate again, and voluntary. In my case, Diplomate of the American Board of Orthodontics means I went through the board examination process after residency. It is not required to practice, which is exactly why it is worth asking about.
And no office can hold your records hostage over a balance. Money owed is a billing matter. Records are a patient right.
A specialist title, a license, and a board certification are three different things. Any office should be able to tell you which of them apply to the person treating you.
Which of this actually changes your decision
Honestly, most of it is table stakes. The overwhelming majority of dental offices follow the rules, and the ones that do not are rare enough to make the news when it happens.
What is worth using is the short list of things you can verify yourself: the license lookup, the spore testing question, the ownership question, and the written estimate. Four questions, all reasonable, all answerable in under a minute by a practice that has nothing to hide.
Everything else on the checklist for choosing an office is in the longer guide.
Common questions
How do I check if my dentist is licensed in Texas?
The Texas State Board of Dental Examiners publishes a free public license search showing whether a license is active and any disciplinary history.
Are dental instruments really sterilized between patients?
They are supposed to be. Anything reusable is cleaned, pouched, and run through an autoclave, then stored sealed until it is opened at your chair. Sterilizers should also be tested regularly with biological spore tests, not just heat indicator strips.
Can I refuse x-rays at the dentist?
You can decline, though the dentist may be unable to diagnose or treat safely without them. What you should expect either way is an explanation of why a particular set is needed rather than a routine default.
Can a dental office refuse to give me my records if I owe money?
No. Records are a patient right and are separate from a billing dispute. You are entitled to copies of your own records.
What is the difference between a specialist and a board-certified dentist?
A specialist completed an accredited residency after dental school, such as orthodontics or oral surgery, and only they may use the title. Board certification is a separate voluntary examination process on top of that training.
How long do dental offices keep records?
They are required to retain them for a set period rather than discarding them when a patient leaves, which is why an office you have not visited in years can usually still forward your history.
Ask us any of these questions
The license, the sterilization protocol, who owns the place, what it costs in writing. None of it is a rude question and all of it is answerable in a minute.
You may also be interested in these
- How to choose the best dentist in Frisco, TX
- Do you know who owns your orthodontist?
- New to Frisco? How to switch dentists without starting over
About Tribute Family Dentistry
200+ five-star Google reviews • Family owned and independent • D Magazine Best Dentist 2026 • Living Magazine Readers' Choice 2026 • Se habla espanol
Tribute is a family owned, independent practice on FM 423 in Frisco. I own it with my wife, Dr. Julia Kang, DMD, MS. We both trained at Boston University and we are both members of the Omicron Kappa Upsilon national honor society. I am a Diplomate of the American Board of Orthodontics. Day to day, most patients and their kids see Dr. Christina Pham, DMD, our general and family dentist, and oral surgery is handled by Dr. David Roberts, DDS, who has been doing it for more than 35 years. D Magazine named me a Best Dentist for 2026, and Living Magazine readers voted us Best Family Dentist in Frisco and Plano the same year.
We handle the whole family in one place: cleanings and preventive care, fillings, crowns, bridges, implants, root canals, extractions and wisdom teeth, whitening, night guards, and emergency visits. We are open Monday through Friday, 8:00 AM to 5:00 PM, we speak Spanish, we work with most major insurance plans, and we run an in house savings plan for families without dental benefits.
If you need braces or clear aligners, that is the other side of what we do. Elate Orthodontics, our sister practice, treats kids, teens, and adults out of three offices in Frisco and The Colony.
Tribute Family Dentistry
5605 FM 423, Suite 600-B, Frisco, TX 75036
Book an appointment: (469) 598-1021
About the author: Dr. Kevin Baharvand, DMD, MS is a Diplomate of the American Board of Orthodontics and a national speaker on clear aligner treatment. His clinical work was selected for the cover of the American Journal of Orthodontics and Dentofacial Orthopedics. He and his wife, Dr. Julia Kang, own Tribute Family Dentistry and Elate Orthodontics in Frisco, Texas.
