Tennessee Dentist Wrote 71 Opioid Prescriptions to a Single Patient in Just Six Months

A small-town Tennessee dentist has lost his professional license after admitting to giving about 200 opioid prescriptions to a handful of patients despite questionable justification in his medical records.

In one case, the dentist wrote a single patient 71 opioid prescriptions, averaging 10 hydrocodone pills each, in a span of only six months, according to newly released medical discipline records. Five of these prescriptions occurred in within two weeks, records state.

As a result of these findings, Michael Tittle, a 64-year-old dentist in Erwin, a small town near the North Carolina border, agreed to have his dental license revoked during a settlement agreement with the Tennessee Board of Dentistry in October. The agreement was publicly disclosed Thursday.

When reached for comment, Tittle accused state investigators of "telling lies" but did not provide any more details. He said he was too busy for a interview.

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According to state records, an investigation of Tittle’s dental clinic began after the Tennessee Department of Health received a complaint that he was inappropriately prescribing controlled substances. Further investigation revealed that Tittle’s clinic was lacking records justifying the size and frequency of prescriptions, which often consisted of dozens of opioid prescriptions over relatively short periods of time. In addition to the prescriptions described previously, investigators found that:

• Tittle gave another patient 49 prescriptions of hydrocodone and 14 prescriptions for oxycodone, totaling 630 tablets, during a year-long span from October 2016 to September 2017.

• Tittle gave another patient 41 prescriptions for oxycodone, totaling 365 tablets, over a four-month span from February to May of this year.

• After a patient underwent a root canal, Tittle continued to prescribe them controlled substances for nearly a year — amounting to 24 prescriptions totaling 210 tablets.

• In 2015, another patient was prescribed 110 tablets of opioid painkillers despite Tittle having “no documentation of the patient ever being seen in the office.”

To resolve this investigation, Tittle agreed to have his dental license revoked and to pay $13,000 in penalties.

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The revocation of Tittle’s medical license was revealed through a monthly discipline report by the Tennessee Department of Health, which maintains public records on licenses for doctors, nurses, chiropractors, massage therapists and other health care professionals throughout the state. According to the report, two Nashville dentists, Norman Cordice and Ronald Lubovich, agreed to surrender their dental licenses as a result of prescription-related investigations.

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Brett Kelman is the health care reporter for The Tennessean. He can be reached at 615-259-8287 or at brett.kelman@tennessean.com. Follow him on Twitter at @brettkelman.

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