It was September of 1994 when a patient named Steven Johnson showed up for a dental appointment that would loom large in the life of Rapid City dentist Larry Lytle.
Johnson wanted a checkup, a cleaning, X-rays and teeth whitening. But when he mentioned that he was covered by Medicaid, the government health insurance program for the poor, Lytle stopped to explain an office policy: Johnson would have to pay $44 out of his own pocket in addition to whatever Medicaid would pay later. Lytle said the double payment was necessary because Medicaid payments were not sufficient to cover his costs.
The policy may have sounded reasonable to some patients who heard it, but double-billing for services covered by Medicaid is fraud.
And Lytle was about to be exposed. Steven Johnson was actually Chad Evans, an agent of the state Division of Criminal Investigation, and he was wearing a hidden tape recorder during his visit to Lytle's office.
The Evans tape would eventually become evidence in proceedings to strip Lytle of his dental license, but that professional embarrassment would not stop Lytle. It would only cause him to change course and pour his energy into low-power laser medical devices.
In the meantime, though, additional problems with Lytle's dental practice were under scrutiny, including accusations in a lawsuit that challenged his basic competence as a dentist.
One of the earliest public glimpses of Lytle's descent into accusations of dental malpractice came during a 1996 trial in a lawsuit filed by Diane Geary, of Piedmont. Geary had become a patient of Lytle's in 1992, when she asked him to correct a misaligned bite and improve the appearance of her teeth.
Unbeknownst to Geary, Lytle had become infatuated with the work of a relatively obscure World War II facial surgeon named Al Fonder. According to Lytle's understanding of Fonder's work - and also, Lytle wrote, according to "the early Chinese understanding of meridian energy" - adjusting the height of a patient's back teeth could alleviate problems throughout a patient's body, including headaches, backaches and bad posture.
According to court documents, Lytle's solution for Geary was something that Lytle called a Fonder's splint. Over a series of appointments, Lytle built up a surface of hardened resin or bonding material on Geary's back teeth, causing her jaw to realign as the height of her teeth changed.
He also capped her teeth with ceramoresin, a material that was described by him as better and safer than traditional crowns, but was later described in sworn testimony by two independent experts as "garbage."
Geary said the ceramoresin was rough and uncomfortable, she suffered headaches that she attributed to the Fonder's splint, and all of the dental work made talking and eating difficult. She had paid Lytle $12,000 and was unhappy with the results, but he admitted no wrongdoing by anyone in his office - least of all himself.
"All of us think your case is one of our finest," Lytle wrote to Geary in 1993, after she complained.
Geary's lawsuit against Lytle went to trial for two days in April 1996. The jury deliberated for about two hours and then awarded Geary $110,000, which Lytle paid, according to a source who was involved in the case.
Six months after the trial, the state Board of Dentistry notified Lytle that it was calling a hearing to examine allegations against him by Geary and numerous other former patients and former employees.
The hearing began on Dec. 1, 1997, with a surprising development: Larry Lytle did not show up.
Lytle had tried to avoid the Board of Dentistry hearing by demanding a new investigator and by voluntarily mailing his dental license to a board member a week before the hearing, according to the written findings and decision later filed by the board.
But the mailing of his license was a token gesture, because there was no agreement in place regarding the terms of his license surrender. So, the hearing - which had been scheduled for more than a year - commenced as planned.
Lytle skipped the entire first day, and the hearing went on without him. On the second day, he showed up without an attorney and claimed he was unaware that a hearing was occurring until he read about it in that morning's newspaper. Then, he withdrew the surrender of his dental license and proceeded to act as his own attorney.
Over the three total days of proceedings, a wide, deep and damning array of evidence and testimony emerged from former patients, former employees and investigators.
Besides the undercover recording of Lytle double-billing a DCI agent for services covered by Medicaid, there was other evidence of Lytle defrauding Medicaid and private insurance companies, both by double-billing and by requesting payments for services that he had not actually performed, and for materials he had not actually used.
There was evidence of Lytle using substandard materials such as ceramoresin on patients other than Geary. One local dentist testified that he had inherited 40 to 50 of Lytle's former patients who had problems with the ceramoresin that Lytle used on their teeth. And, Board of Dentistry documents show, there was evidence of Lytle botching a number of dental procedures, including testimony from one former patient who said Lytle's attempts to treat her with a Fonder's splint disfigured her jaw and made her look like a "Neanderthal."
Lytle, according to the board, also entrusted some work to employees who lacked necessary licenses and certifications. He allowed those unlicensed employees to perform X-rays, clean teeth, place sealants, take impressions and do other kinds of patient care.
Two months after the hearing, the state Board of Dentistry issued 23 pages of written findings and a 41-page written decision, the latter of which said that Lytle "demonstrated no remorse for the harm he caused individual patients and has instead alleged that all of the witnesses were either lying or improperly motivated. ? He minimized the mistakes he made and he attempted to blame others."
"Revocation, while extreme," the decision continued, "appears to be the only means by which to protect the public."
Lytle gets litigious
Lytle's dental license was formally revoked on Feb. 24, 1998. Eight days later, former patient Mary Bernt filed a lawsuit in state court alleging that Lytle and his daughter, Kelly Lytle, who was in practice with him, had duped Bernt into believing that her amalgam fillings were hazardous to her health because of their mercury content. Bernt allowed the Lytles to replace her fillings with composite fillings, and she alleged that the Lytles botched the procedure and damaged her teeth.
The lawsuit was scheduled for trial, but on Feb. 22, 2000, lawyers for both sides filed notice of an undisclosed out-of-court settlement.
Larry Lytle had meanwhile countersued Bernt in federal court and filed additional federal lawsuits against everyone with any connection to the revocation of his dental license. He sought millions of dollars in damages for alleged violations of his rights, all while representing himself without an attorney.
Lytle's lawsuits were eventually dismissed, and they were deemed so frivolous that a judge ordered Lytle to pay a total of $18,000 to some of the defendants as punishment for wasting their time and resources.
The judge who issued the decision, Jerome Eckrich, of the South Dakota Fourth Circuit, did not believe Lytle's excuse that his lawsuits had been thrown out because he was a layman who was ignorant of proper court procedure.
"If anything," Judge Eckrich wrote in his 2001 decision, "Lytle, a highly educated man who suffers from no apparent cognitive limitations, chose to remain ignorant. This choice, this utter disregard for proper procedure, is further evidence of Lytle's initial intent - that is to punish those who he perceived participated in the South Dakota Board of Dentistry proceedings."
Public records show that Lytle has never paid the $18,000 judgment. Nor has he admitted any responsibility for the loss of his dental license. In recent email correspondence with the Journal, Lytle said his license was unjustly revoked "for being a pioneer in bonded splints" who has been proved correct by the passage of time.
"I practiced dentistry for 35 years and helped thousands of grateful people," he added in the email to the Journal.
Yet the state Board of Dentistry has no record that Lytle ever tried to regain his dental license. Instead, he turned his full attention to what he called the "energy medicine of the future." Lasers.
New passion for 'healing light'
According to books that Lytle wrote (he self-published at least four from 2008 to 2012), his first significant exposure to lasers came during the 1990s when he began using them to contour gum tissue in his dental practice.
Those were high-powered lasers. In his book "Healing Light," he recalled being invited in 1994 to speak at the World Congress on Lasers in Dentistry in Singapore, where he was exposed to low-power lasers.
Laser technology had emerged in the 1960s while Lytle was entering dentistry. The word "laser" originated as an acronym for "light amplification by stimulated emission of radiation."
One of the simplest explanations of the technology comes from laser manufacturer Northrop Grumman, which says a laser is "a very intense, highly directional beam of light."
Unlike natural light, which is produced by different wavelengths or colors that spread in all directions, laser light consists of one wavelength or color that is focused in one direction.
"A laser," Northrop Grumman explains, "is to a common light bulb what a marching band is to a random group of people."
Among lasers used in health care, there are high-powered or hot lasers, which can cut bodily tissues in applications such as surgery, and there are low-powered, low-level or cold lasers, which are believed by some to transmit energy into the body without harming it.
Mark Crislip, an infectious disease specialist in Oregon and an editor for the website Science-Based Medicine, has written an article explaining that low-power lasers are supposed to work by the nonuniversally accepted "photochemical theory." The theory suggests that absorbed laser light interacts with organic molecules, which in turn modulate cellular activity. The result, hopefully, is healthier cells.
But Crislip noted a scientific study showing that the intensity of low-level laser radiation is diminished when it passes through human tissue, leading Crislip to opine that "hardly any" laser light penetrates the skin. He said low-power lasers may impart minor benefits such as improved wound healing, but he advised consumers to be cautious.
"If I were a potential consumer of medical products advertised in my local paper, I think I would pass on laser therapy," Crislip wrote. "Don't go into the light."
Another source - BerkleyWellness.com, a collaboration between the School of Public Health at the University of California, Berkeley, and a national team of writers and editors - has reported that although it is "not clear how cold laser therapy might work," cold lasers "may have anti-inflammatory effects, help repair connective and other tissues, and release pain-relieving endorphins." Yet the same report noted that the coverage policies of medical insurers Cigna and Aetna say there is "little or no conclusive evidence that cold laser therapy is effective for anything."
Lytle himself noted the problems with low-level lasers while recalling his early exposure to them.
"When I researched this type of laser I found many inconsistencies," Lytle wrote in one of his books. "I could not understand how one study showed quite good results while another study of the same type of lasers showed poor results."
Fortunately for Lytle, he was not restricted by the bonds of scientific inquiry. He was liberated by his amorphous allegiance to "universal energy" - the stuff that he said had powered his father's "witching" stick during the elder Lytle's Dust Bowl-era searches for groundwater on the parched plains near Wasta.
Lasers, Lytle wrote, were a form of that same universal energy, waiting to be properly harnessed.
"I set out to learn why the world's low level lasers were so inconsistent. My studies, combined with my basic knowledge of energy, propelled me into a new project - to design a low level laser system that worked consistently."
But Lytle would not be satisfied with inventing a consistently functioning device. Despite his dental career being in shambles, his marriage ending (he and his wife separated in 1998 and, court records show, continued to live apart until they divorced in 2011), and at least two malpractice lawsuits weighing down his finances, he did not shrink away but instead grew bolder.
Soon, the disgraced former dentist would be hawking low-level lasers that he said could help "almost everyone who is sick or injured." And those claims would repeatedly provoke the ire of federal regulators who would clash with Lytle in the years to come.
- Coming Tuesday: The third and final part of this 3-day series.