Texas Government Inspections - Is Your Practice Next?

Seldom will a government agency walk into your dental office unannounced. The primary agency to do so is the Department of State Health Services (DSHS) Radiation Control folks.


They used to give notice before they showed up. As of 2016, x-ray inspections are unannounced. It seems they always show up at the worst possible time (short staffed, busy day, and etc.).


While you can turn these people away it is probably not in your best interest to do so (you know what they say about a woman scorned? Uncle Sam scorned can be worse! Ask me how I know!). Turn them away and they will come back with an administrative warrant (and you will certainly have an unpleasant experience).


The #1 thing Texas dental offices get busted for is being late (or not having completed) x-ray Equipment Performance Evaluations (EPEs).


Violations are classified by seriousness. EPEs are (usually) level 4 violations. If the EPEs were updated, but after their due date, the dentist/dental office usually gets a violation notice, but no fine for a first offense. If EPEs are overdue and it is not corrected prior to the unannounced inspection you will most certainly face a $4,000 fine.


Over the years, so many people have been busted for this that a very large number of dental offices today have already been warned about having late EPEs. I have seen more fines (even during the pandemic) than ever (and it’s silly, as they are so easy to avoid). 


There are processes to contest the violation/fine, but in the end that means 1). Taking time away from the office to go an administrative hearing in Austin, Texas or 2). Hiring an attorney to go to a hearing for you in Austin. How much would either option COST you? A day of dentistry?


Here are the requirements for EPEs:

  • All machines within 30 days of an installation.
  • 2D x-ray machines – every 4 years (and not a day late).
  • 3D x-ray machines – annually (and not more than 14 months from the prior EPE)


What about handheld units? When you receive the handheld in your possession that is an ‘installation’.


Group practices and DSOs get busted for moving handheld x-rays to other offices without notifying DSHS and failure to have an EPE within 30 days.


Move x-ray equipment from one operatory to another? Get an EPE!


Move your office to a new location or relocate a machine within the office? Get an EPE!


Check out my LIVE Texas Radiation Safety and Compliance Training!


I welcome your comments. Drop me an email at


About the Author

A former Law Enforcement Officer/ Dental Board investigator, Duane Tinker is the CEO of Dental Compliance Specialists. Mr. Tinker provides compliance consulting, auditing and training services for dentists and Dental Service Organizations on compliance risks including OSHA, HIPAA, Dental Board rules/ regulations, state radiology rules, DEA and state drug regulations, and Medicaid. Mr. Tinker is a frequent speaker for dental societies and study clubs. He also hosts a podcast called Talking with the Toothcop. Mr. Tinker can be reached by calling (817) 755-0035 or through his company’s website

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