Here’s why a Miami Beach area dentist got fined $10,000 and ordered to refund payment

After an unusually long time from complaints to conclusion, the Florida Board of Dentistry approved punishment of a Bay Harbor Islands dentist that demands unusual amounts of money and time.

Dr. Anatoly Ripa got hit with a $10,000 fine plus $5,000 in reimbursing the Florida Department of Health’s case costs. Most doctors get assigned two or three continuing medical education courses, even after a death. Ripa got assigned five — ethics, risk management, record keeping, prosthodontics and diagnosis and treatment (the board added that one to the proposed settlement agreement).

Plus, Ripa has to refund one patient’s $385 out-of-pocket costs and pass a Laws and Rules of Florida dentistry examination before Dec. 22, 2024.

Ripa signed the board’s version of the settlement agreement, though he officially neither admits nor denies what he’s accused of in the administrative complaints.

These are the first Florida punitive actions against Ripa, who has been licensed in the state since Dec. 30, 2003. The Board’s final order was adopted Dec. 22, but concerns what happened and what didn’t happen with patients in 2012 and 2013.

READ MORE: Consequences for an untrained Broward anesthesiologist in a mother’s butt-lift death

Billing for things that might not have happened

An administrative complaint says “A.K.” showed up at 1048 Kane Concourse in Bay Harbor Islands on May 21, 2013 for a “limited examination of tooth No. 31,” the second molar from the back lower right of the mouth.

Ripa recommended a root canal for No. 31 and extraction of all four of A.K.’s wisdom teeth. The complaint says he did the root canal that day. Ripa also billed for a gingival flap procedure, which the International Congress of Oral Implantologists says is a “procedure where gum tissue is separated from surrounding teeth and deflected back to allow a dental surgeon access to the jawbone and the root of the tooth.”

Nothing in Ripa’s clinical record, the complaint says, justified the flap procedure for which Ripa billed nor did anything indicate it was actually done.

A.K. came back a week later, May 28, 2013, for the pulling of the four wisdom teeth. Ripa performed and billed for a full mouth debridement, which the complaint explains is “the gross removal of plaque and calculus that interfere with the ability of the dentist to perform a comprehensive oral evaluation.”

But, the complaint says, Ripa’s clinical record “did not indicate a diagnosis to support or necessitate” the full mouth debridement.

Ripa’s clinical record said he pulled each wisdom tooth, and used a billing code that indicated an “unusually difficult or complicated” extraction. But, again, the complaint said Ripa’s clinical record didn’t note anything that should’ve made it a hard extraction.

The complaint also says when Ripa pulled one of the wisdom teeth, No. 17, his clinical record said he “recovered all roots intact.” Not only were the roots not intact, “a fragment of tooth No. 17 remained in the extraction site.” Another dentist took care of the fragment and found the roots not intact.

When Ripa did the crown for another wisdom tooth, the complaint said, his clinical record said he did a “clinical crown lengthening — hard tissue.” Again, the complaint said, the clinical record lacked a diagnosis giving a good reason for the crown lengthening.

Ripa was ordered to refund $385 to A.K.

Crowns near Kendall

Ripa was working out of the professional center next to HCA Florida Kendall Hospital aka Kendall Regional when “I.D.P.” showed up on Nov. 26, 2012 with pain in the lower right quadrant of his mouth. Ripa’s clinical record said I.D.P came to have tooth No. 31 pulled, which he did.

“[Ripa] did not record a diagnosis or justification for the surgical extraction of tooth No. 31,” the complaint said. Also, Ripa “proceeded with performing the extraction of I.D.P.’s tooth No. 31 without having obtained a pre-operative” x-ray.

I.D.P. came back on Dec. 10, 2012 to prepare teeth Nos. 3 through 14 for crown preparation. The complaint says Ripa didn’t provide a reason for the crowns, the crowns he wanted to put on four other teeth on Jan. 21, 2013, nor the root canal that I.D.P. showed up for on Dec. 17, 2012. It also says Ripa didn’t take an x-ray before that root canal nor the root canal on Jan. 28, 2013.

Later, Ripa’s clinical record “indicates” that permanent cement was used on new crowns but later clinical notes make it appear as if temporary cement was used.