White Smile USA, Inc. and D'Markos, L.L.C. v. Board of Dental Examiners of Alabama

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REL: 10/16/2009 N o t i c e : This o p i n i o n i s s u b j e c t t o formal r e v i s i o n before p u b l i c a t i o n i n t h e advance s h e e t s o f Southern R e p o r t e r . R e a d e r s a r e r e q u e s t e d t o n o t i f y t h e R e p o r t e r o f D e c i s i o n s , Alabama A p p e l l a t e Courts, 300 D e x t e r A v e n u e , M o n t g o m e r y , A l a b a m a 3 6 1 0 4 - 3 7 4 1 ((334) 2 2 9 - 0 6 4 9 ) , o f a n y t y p o g r a p h i c a l o r o t h e r e r r o r s , i n o r d e r t h a t c o r r e c t i o n s may be made b e f o r e t h e o p i n i o n i s p r i n t e d i n Southern R e p o r t e r . SUPREME COURT OF ALABAMA OCTOBER TERM, 2009-2010 1080780 White S m i l e USA, I n c . , and D'Markos, L.L.C. v. B o a r d o f D e n t a l E x a m i n e r s o f Alabama (Montgomery C i r c u i t Court, CV-08-153) LYONS, J u s t i c e . White L.L.C. Circuit USA, I n c . ( " W h i t e Smile"), and D'Markos, ("D'Markos"), a p p e a l from a judgment o f t h e Montgomery Court whitening as Smile defined that held that their sale i n Alabama o f t e e t h - p r o d u c t s and s e r v i c e s were t h e p r a c t i c e o f d e n t i s t r y b y § 3 4 - 9 - 6 , A l a . Code 1975. We a f f i r m . 1080780 Factual Background White Smile including Smile Alabama, markets system." offices sells It Procedural the LightWhite not trademark as a sell or f o r i n d i v i d u a l , "cosmetic LightWhite at-home use. product store. nail salon Smile or i n Montgomery and D'Markos e n t e r e d D'Markos a g r e e d to Anticipating ("the sell D'Markos, on Montgomery C i r c u i t judgment use in the Alabama dental LightWhite In Smile apply the a hair and 2007, White to which Randall's. Board dentistry without January declaring that as of w i t h i n the dentistry thus not of Dental and sued Smile s a l e of and of Examiners White Board D'Markos not that Smile in the a with in-store the practice requirements t o r e g u l a t i o n by the sought § 34-9-6, A l a . Code licensing 2 the LightWhite a t R a n d a l l ' s , was meaning s u b j e c t to the a license, 2008, White the performed 3, A l a . C o d e 1 9 7 5 , 28, Court. application, and whitening i n t o an a g r e e m e n t p u r s u a n t at White B o a r d " ) w o u l d b r i n g an a c t i o n a g a i n s t t h e m a l l e g i n g t h e y were p r a c t i c i n g and for Randall's. LightWhite that teeth D'Markos o p e r a t e s known as states, Instead, White stores that s e l l salon i n 22 "LightWhite." r e q u i r e s t h a t s a l o n s and i n the History a teeth-whitening product under does and of § 1975, 34-9¬ Board under § 34- 1080780 9-43, A l a . Code 1975. person ... any dental operation parties matter to waived the submitted Smile to the contracted or a "certified" two application the a process provided White on disputed. Smile LightWhite submitted briefs, material facts not in " When W h i t e trained the LightWhite training manual LightWhite employee trained these i n the 22 for application in the specific LightWhite instructions training manual: "2. Ask the c l i e n t i f they are t a k i n g any medication that reacts adversely with sunlight. If t h e y answer y e s , t h e n i n s t r u c t them [ t o ] seek t h e i r d o c t o r ' s advice b e f o r e going through w i t h the t e e t h whitening application. "3. Ask cleaned t h e c l i e n t when by a d e n t i s t . 3 they last at LightWhite "1. H a v e c l i e n t s i t down i n a w h i t e n i n g c h a i r . Remove A L L n e e d e d p r o d u c t s f o r p r o c e s s f r o m c a b i n e t s a n d / o r d r a w e r s a n d l a y o u t on a new towel. teeth and process. follows Smile performs instead The "Any kind disposition employees The any White D'Markos, purchases D'Markos and o r a l argument. court are application application by for D'Markos Once a c u s t o m e r Randall's, trial and process. summarizes s e r v i c e of court trial with dental formal trial deposition transcripts, as in part: s h a l l be d e e m e d t o be p r a c t i c i n g d e n t i s t r y who The the S e c t i o n 34-9-6 p r o v i d e s , had their 1080780 from "4. Explain to client this process. the the possible side "1. B l a n c h i n g o f Gums - w h i t e n i n g s o f t gum t i s s u e . effects of "a. Cause - B a c t e r i a under the gum line (regular teeth cleaning minimizes this side effect). The r e a s o n t h i s o c c u r s i s t h e Hydrogen P e r o x i d e agent i n this product searches out bacteria within t h e mouth and begins to k i l l the bacteria. This i s s a f e f o r t h e gums, b u t can cause a b u r n i n g s e n s a t i o n o r swelling resulting from blanching. I f c l i e n t experiences discomfort beyond minor burning, discontinue application. "b. Resolution The blanching of t h e gums i s a t e m p o r a r y s i d e e f f e c t a n d gums w i l l r e t u r n t o t h e i r normal pink c o l o r w i t h i n 5-15 m i n u t e s a f t e r process. Have client use a Vitamin E swab on gum f o r immediate r e l i e f . due "2. Teeth S e n s i t i v i t y to tooth pain. - discomfort "a. Cause - Some clients have s e n s i t i v e t e e t h ( g e n e t i c s ) , over-exposure to peroxide (peroxide left on teeth too l o n g ) , and/or p e r o x i d e percentage too high i n w h i t e n i n g g e l . I f a client has a cavity, cracked t e e t h , o r any o t h e r d e n t a l i s s u e s that r e s u l t i n root exposure, 4 1080780 discontinue the use of this product. The exposure to peroxide on an exposed root, though temporary, can cause severe discomfort. "b. R e s o l u t i o n - Due t o o u r unique w h i t e n i n g formula and the limited exposure period (12minutes), less than 1% o f o u r clients experience any teeth s e n s i t i v i t y what so e v e r [ s i c ] . One o f t h e m a j o r a d v a n t a g e s o f t h e LightWhite® p r o d u c t l i n e i s the l a c k of t e e t h s e n s i t i v i t y . "5. P l a c e b i b a r o u n d c l i e n t ' s with provided b i b chain c l i p . neck and attach "6. Use p r o v i d e d V i t a Pan T o o t h Scale to determine clients' pre-application teeth shade. Have c l i e n t l o o k i n m i r r o r f o r agreement o f c u r r e n t t e e t h shade. Once t h e shade i s a g r e e d u p o n , r a i s e up t h e a p p r o p r i a t e t e e t h c o l o r o n s h a d e g u i d e a n d place next to c l i e n t ' s chair f o r comparison use a f t e r whitening process i s complete. "7. G l o v e up. A s k t h e c l i e n t i f t h e y have any allergies to latex. P u t on l a t e x or non-latex gloves. "8. Remove ' B r u s h Up' f r o m p a c k a g i n g c l i e n t brush their teeth. and have "9. Remove Custom Mouthpiece (CM) from packaging. Use y o u r finger to manipulate the s i l i c o n so t h a t i t s l o p e s t o w a r d t h e upper front e d g e o f t h e CM on b o t h t o p a n d b o t t o m . "10. H a n d CM t o c l i e n t t o s e l f - a d m i n i s t e r , ensuring that mouthpiece i s inserted correctly before client bites down into soft silicon. 5 1080780 Instruct the c l i e n t the s i l i c o n bead. to bite down i n the middle on "11. H a v e c l i e n t g e n t l y r o c k j a w f r o m FRONT t o BACK to dislodge CM from teeth. Have client c a r e f u l l y r e m o v e CM f r o m m o u t h w i t h t a b p r o v i d e d . C h e c k f o r p r o p e r r e g i s t r a t i o n a n d show c l i e n t t h e results. Now y o u a r e r e a d y t o a p p l y w h i t e n i n g g e l p r o v i d e d i n t o t h e CM. "12. F i l l CM w i t h w h i t e n i n g g e l . Ensure that each t e e t h c a v i t y i s approximately ^ f u l l w i t h g e l . DO NOT O V E R F I L L TRAY. S t a r t f i l l i n g from the f r o n t t e e t h t o t h e b a c k u s i n g l e s s g e l p e r c a v i t y as you move t o w a r d s t h e b a c k t e e t h . Repeat process f o r the top and bottom t e e t h r e g i s t r a t i o n s . Once g e l i s applied, spray o n e (1) s q u i r t of provided Photo I n i t i a t o r t o t h e t o p a n d one t o t h e b o t t o m t r a y . "13. B e f o r e i n s e r t i n g CM, r e q u i r e c l i e n t t o DRY t h e i r teeth with provided paper towel. Why? Best r e s u l t s o c c u r when w h i t e n i n g g e l i s n o t d i l u t e d w i t h saliva. S a l i v a p r e s e n t on t e e t h c a n c a u s e l e s s t h a n o p t i m a l r e s u l t s - IMPORTANT. "14. Offer c l i e n t q - t i p with Vaseline to apply to l i p s as p r o t e c t i v e b a r r i e r f r o m t h e l i g h t d r y i n g out l i p s . Chap s t i c k o r l i p s t i c k w i l l w o r k j u s t as well. "15. H a n d CM w i t h g e l t o c l i e n t to selfadminister, ensuring that mouthpiece i s i n s e r t e d correctly (make s u r e t h e m o u t h p i e c e i s l i n e d up properly with e x i s t i n g r e g i s t r a t i o n ) before client b i t e s down i n t o t r a y w i t h g e l . REMOVE GLOVES! "16. Have c l i e n t g e t c o m f o r t a b l e i n c h a i r a n d p r o v i d e them w i t h t h e p r o t e c t i v e eye g l a s s e s [ s i c ] s u p p l i e d t o wear d u r i n g w h i t e n i n g process. 6 1080780 "17. Adjust whitening position (approximately 1-2 c l i e n t ' s mouth). light into proper inches away from "18. C h e c k t i m e r on w h i t e n i n g l i g h t t o t h a t i t i s s e t c o r r e c t l y on 12 o r 15 m i n u t e s . the s t a r t b u t t o n . ensure Press "19. Check w i t h c l i e n t p e r i o d i c a l l y f o r s i g n s of d i s c o m f o r t . I f issue arises, discontinue process and determine reason for discomfort. Very few c l i e n t s e v e r have any d i s c o m f o r t , b u t i t w i l l h a p p e n from time to time. M o s t l y due t o an e x p o s e d r o o t ( c a v i t y ) t h a t c l i e n t i s unaware o f . "20. W a t c h t i m e r s c a r e f u l l y as y o u n e e d t o p r e p a r e one e m p t y c u p a n d two 1.5 o u n c e w a t e r c u p s f o r c l i e n t t o r i n s e m o u t h o u t a f t e r t h e 12-15 m i n u t e process i s complete. "21. Once 15-minute process i s over, the whitening light will automatically shut off. Q u i c k l y r e m o v e l i g h t a p p a r a t u s , h a v e c l i e n t s i t up a n d i n s t r u c t t h e m t o r e m o v e CM f r o m m o u t h a n d h a n d to you. Use a paper towel to receive used mouthpiece. "22. P r o v i d e c l i e n t w i t h empty cup t o s p i t i n a n d t h e n p r o v i d e t h e m w i t h 1.5 o u n c e w a t e r c u p t o wash out mouth. Have c l i e n t r i n s e and s p i t c o n t e n t s of mouth back i n t o p r o v i d e d 3-ounce cup. Repeat t h i s p r o c e s s a g a i n w i t h 2 n d 1.5 o u n c e c u p o f w a t e r . " (Capitalization in original.) The a determine chart his to or her White transcripts help the t e e t h and Smile of customer whether and their D'Markos e m p l o y e e t h e n to have D'Markos respective 7 the current a second submitted owners, who uses shade of application. the deposition described the 1080780 a p p l i c a t i o n process submitted the in detail. deposition transcript likened LightWhite products sold because LightWhite because no mouth, the dentistry. argued was to was sale LightWhite sale the p r a c t i c e an and this ever testimony, of L i g h t W h i t e by He the not opined who that, customer the the to customers and customer's practice White Smile of d e n t i s t r y w i t h i n witness teeth-whitening touched was D'Markos a l s o expert use. self-applied employee B a s e d on of at-home D'Markos of Smile over-the-counter for individual, t h a t the not White of and D'Markos at Randall's the meaning of § 34¬ 9-6. The Board chairman and extensively adverse as sold within Board an expert regarding side process. submitted and applied deposition transcripts witness. the effects Ultimately, the of both at testified c o n t r a i n d i c a t i o n s and potential practice t h a t the of d e n t i s t r y Randall's, sale as LightWhite witnesses the meaning of § 34-9-6. argued its witnesses the Both of opined that was "dental B a s e d on of L i g h t W h i t e d e f i n e d by 8 teeth-whitening a this LightWhite, service" testimony, the a t R a n d a l l ' s was the § 34-9-6 and was subject 1080780 to the l i c e n s i n g requirements the February finding 2009, teeth performed The the trial by [D'Markos] as trial court noted the that the associated dentistry of with LightWhite review as by i t s application judgment in by concerns the constituted and their and scope [§ 34¬ regarding the g e n e r a l l y and Randall's order and LightWhite court the the found services practice D'Markos's r e q u e s t favor. White Smile of for and appealed. Standard This within same i s d e f i n e d i n policy denied White Smile's declaratory D'Markos fall an provided B a s e d on i t s c o n c l u s i o n s , t h e t r i a l sale and entered service ... s a f e t y of t e e t h - w h i t e n i n g procedures specifically. court whitening of d e n t i s t r y the p r a c t i c e 9-6]." 2, "the that activities a to r e g u l a t i o n Board. On of o f § 34-9-3 and Court has of explained Review the applicable standard follows: "The trial court's judgment was based on undisputed facts and documentary evidence. Thus, r a t h e r than a p p l y the s t a n d a r d of review g e n e r a l l y a p p l i c a b l e t o a d e c l a r a t o r y j u d g m e n t , we w i l l a p p l y a de n o v o s t a n d a r d o f r e v i e w . See A l f a M u t . I n s . Co. v . S m a l l , 829 So. 2 d 7 4 3 , 745 ( A l a . 2002) ( h o l d i n g that ' [ o ] u r review of a d e c l a r a t o r y judgment i s g e n e r a l l y g o v e r n e d by the ore tenus standard of 9 of 1080780 r e v i e w . H o w e v e r , i n c a s e s s u c h as t h i s , w h e r e t h e r e a r e no disputed f a c t s and where the judgment i s b a s e d e n t i r e l y upon d o c u m e n t a r y e v i d e n c e , no such p r e s u m p t i o n o f c o r r e c t n e s s a p p l i e s ; o u r r e v i e w i s de novo.')." R a l e y v. Main, 987 So. 2d 569, 575 (Ala. 2007). Analysis Article 34, Chapter 9, Ala. p r a c t i c e of d e n t i s t r y i n Alabama. licensing of authority to r e g u l a t e i n Alabama. dentists, Section and § Code 1975, Section 34-9-43 regulates 34-9-3 r e q u i r e s grants the the p r o f e s s i o n a l a c t i v i t i e s 34-9-6 d e f i n e s the Board of the the dentists the p r a c t i c e of d e n t i s t r y , stating: "Any p e r s o n s h a l l be d e e m e d t o be p r a c t i c i n g d e n t i s t r y who p e r f o r m s , o r a t t e m p t s o r p r o f e s s e s to p e r f o r m , any d e n t a l o p e r a t i o n o r d e n t a l s e r v i c e o f a n y k i n d , g r a t u i t o u s l y o r f o r a s a l a r y , f e e , money o r o t h e r r e m u n e r a t i o n p a i d , o r t o be p a i d , d i r e c t l y o r i n d i r e c t l y , t o h i m s e l f , o r t o any p e r s o n i n h i s b e h a l f , o r t o any a g e n c y w h i c h i s a p r o p r i e t o r o f a p l a c e where d e n t a l o p e r a t i o n s or d e n t a l s e r v i c e s are performed " (Emphasis added.) activities that Chapter sale 9. The Section constitute ultimate of L i g h t W h i t e with 34-9-6 the issue then practice in this lists of action 10 dentistry other under i s whether i n - s t o r e a p p l i c a t i o n , as p e r f o r m e d 10 the at 1080780 Randall's, § i s the they S m i l e and did meaning of before the dentistry. the sale They application customer of the in and practice application of LightWhite, LightWhite, as undertaken dentistry. The the at with enforcing activities the of v. 1115, So. 2d D'Markos a r g u e t h a t e n t i t l e d t o no regarding the on the step no Based on the the its deference. the risks sale of practice of agency interpretation of See, e.g., QCC, White Smile Both p a r t i e s a l s o argue 11 details the (Ala. 2000). numerous h y p o t h e t i c a l the step regulating Board's i n t e r p r e t a t i o n of deference. the single administrative statutes of of potential is and, practice Board argues that dentists 1119 the that on salon each Randall's, to great 757 not argue B o a r d a r g u e s t h a t as § 34-9-6 i s e n t i t l e d Hall, is and the Randall's dentistry. process with professional in detail they associated charged on LightWhite focus process, constitutes court, appeal, self- therefore, trial a r g u m e n t on that by the their proposition administered the D'Markos f o c u s i s m e r e l y an o v e r - t h e - c o u n t e r p r o d u c t t h a t i s LightWhite of the 34-9-6. White as p r a c t i c e of d e n t i s t r y w i t h i n situations. Inc. and § 34-9-6 i s extensively 1080780 Section include of 34-9-6 defines the performance Chapter regulation 9 defines the practice of a "dental the term promulgated by research has not produced defining the term. This service." "dental the of service," Board. No by to provision n o r does any Furthermore, any d e c i s i o n Court has dentistry an A l a b a m a our court stated: "'The fundamental principle of statutory construction i s t h a t w o r d s i n a s t a t u t e must be given t h e i r p l a i n meaning.' M o b i l e I n f i r m a r y Med. C t r . v . H o d g e n , 8 84 S o . 2 d 8 0 1 , 814 ( A l a . 2 0 0 3 ) . 'When a c o u r t c o n s t r u e s a s t a t u t e , " [ w ] o r d s u s e d i n [ t h e ] s t a t u t e must be g i v e n t h e i r n a t u r a l , p l a i n , o r d i n a r y , and commonly u n d e r s t o o d m e a n i n g , and where p l a i n language i s used a c o u r t i s bound t o i n t e r p r e t t h a t l a n g u a g e t o mean e x a c t l y w h a t i t s a y s . " ' E x parte Berryhill, 801 S o . 2 d 7, 10 ( A l a . 2001) ( q u o t i n g IMED C o r p . v . S y s t e m s E n g ' g A s s o c s . C o r p . , 602 S o . 2 d 3 4 4 , 346 ( A l a . 1 9 9 2 ) ) . " Trott v. B r i n k s , specifically, defined term Dep't I n c . , 972 S o . 2 d 8 1 , 85 this Court has e x p l a i n e d : i n a statute, s h o u l d be of applied." Revenue, Republic Steel 446, (1958)). 447 t h e commonly 855 Corp. 2d v. Horn, Dredging, 517 More a term i snot L.L.C. v. of the Alabama (Ala. 2003)(citing 268 A l a . 2 7 9 , 2 8 1 , 105 S o . 2 d of the term § 34-9-6. "[W]hen accepted d e f i n i t i o n 513, Accordingly, accepted d e f i n i t i o n i t s meaning under So. Bean ( A l a . 2007). we m u s t "dental look commonly s e r v i c e " to determine We m u s t c o n s i d e r 12 to the whether the sale 1080780 and a p p l i c a t i o n of LightWhite at Randall's falls within this definition. The c o m m o n l y a c c e p t e d d e f i n i t i o n o f t h e w o r d "of or r e l a t i n g to the teeth Collegiate Dictionary 333 accepted d e f i n i t i o n of serving: as not Collegiate accepted helpful a definition act or useful the D'Markos whether suggest the sale performed the labor process we Considering who do. than j u s t the product labor as i s the p r a c t i c e used LightWhite itself. 13 teeth. of Smile and presented we a each step White t o us i s a p p l i c a t i o n , as will within consider the as a w h o l e . i t i s apparent at Randall's Although commonly of d e n t i s t r y i n Randall's facts, does i s , therefore, in-store Accordingly, that The not consider The i s s u e the undisputed purchase i s "the act of 2003). service" with commonly Merriam-Webster's isolation of LightWhite process The of or r e l a t i n g to the in should o f § 34-9-6. teeth-whitening customers (11th ed. "dental i n Randall's, meaning "service" we n o t e t h a t we w i l l application 2003). commodity." 1137 of Merriam-Webster's a c t [or] bL u s e f u l tangible Dictionary Initially, (11th ed. t h e word a helpful produce or d e n t i s t r y . " "dental" i s receive the LightWhite that more teeth- 1080780 whitening process i s largely self-administered c u s t o m e r , D'Markos o f f e r s t h e c u s t o m e r a s s i s t a n c e employees are process. D'Markos proper present application presumably with with the employees of some customer instruct the product; knowledge; by i n that i t s throughout the customer they answer the i n the questions, many of the m a t e r i a l s used i n the process while wearing p r o t e c t i v e gloves. Accordingly, D'Markos s e l l s helpful and u s e f u l l a b o r the sale acts customer's Randall's i s a dental Consequently, meaning with but also the of i t s employees t h a t experience. relate to Therefore, s e r v i c e w i t h i n t h e meaning o f § 34-9-6. of dentistry within i n t e r p r e t a t i o n o f § 34-9-6; merits of evaluation these considerations of considerations the section. We a c k n o w l e d g e t h e c o n f l i c t i n g p o l i c y a r g u m e n t s the the i n - s t o r e a p p l i c a t i o n as p e r f o r m e d a t i t i s the p r a c t i c e of that handle not only the product, teeth-whitening of LightWhite and they the the i s a merits matter currently exists, services in i t s definition the p a r t i e s thoroughly. of the f o r the § 34-9-6 i n c l u d e s of 14 have regarding argued the However, competing legislature. the policy As i t the performance of dental the p r a c t i c e of d e n t i s t r y . 1080780 Because the record definition of LightWhite at service, the shows that term, Randall's trial was court constituted the p r a c t i c e 34-9-6. therefore We that, under the sale the and correctly the commonly trial of determined within accepted application performance of d e n t i s t r y affirm the a of dental that i t the meaning of § court's judgment. AFFIRMED. Cobb, C . J . , and Stuart, Bolin, 15 and Murdock, J J . , concur.

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