Even when the Office of the Attorney General ruled in favor of the magazine’s appeal, the dentistry board initially responded with an extremely rare move: a legal action for “injunctive/declaratory relief” with the Oregon Court of Appeals—in short, an effort to block the attorney general’s ruling to release the case files. But days later, after hiring and consulting with its own attorney (another unusual move for a state board, which would typically consult with the Office of the Attorney General), the dentistry board reversed course. Its president, Norman Magnuson, said the board’s primary concern was not protecting Isom, but rather its ability to withhold information on investigations that don’t lead to discipline.

“We have a policy,” he said, “and regardless of what you or I might think is in the public interest, you have to do what’s in the best interest of the policy.”

Greenlick says it’s business as usual. He and his committee have spent four years questioning whether the state’s medical boards are properly balancing public interest with confidentiality protections. Their work has led to six bills over two legislative sessions, increasing transparency and bolstering the boards’ charge to protect consumers.

Appalled by the dental board’s fight to keep the files closed, Greenlick said that even more oversight is needed. “Right now, the boards have none,” he said.

The University of Pennsylvania’s Layden argues that the arbiters’ and dental board’s rulings in Isom’s case were a tremendous step backward in experts’ ongoing efforts to raise awareness about the harmful effects of pornography. Before education, research, and courts “put the genie back in the bottle,” she says, similarly relaxed attitudes once allowed smoking to become a national addiction. The protection of the perpetrator rather than the victim, she says, “is the standard response to this kind of problem.”

Three days after Webb received the Oregon Board of Dentistry’s decision to not discipline, another letter from the board arrived informing her that the Oregon Bureau of Labor and Industries “does appear to be the appropriate agency to deal with your concerns.” But after feeling legally compelled as a licensed professional to report Isom’s behavior only to be greeted with inaction—and once again fearing the impact on the other two dentists—Webb and her colleagues felt dispirited.

“When they did that, I thought, ‘That good ol’ boys club; they just protect their own, don’t they?’” she recalls. “And with my faith in the dental board? Why bother?”