Small Smiles FORBA Abuses 188,000 Children Each Year

If FORBA Dental Management treats 750,000+ children across the nation in various clinics under various names like it says it does. (that was in 2006)

And according to reports from former dentist and dental assistants, 25% of the time they use papoose boards and other various torturing methods, do you realize that is

188,000
children abused, tortured and traumatized
every year
by this company alone!

Dan DeRose and His Connection To Small Smiles/FORBA

Cagey looking character isn't he? That's is Dan DeRose (left).

Besides having his name all over many of the Corporate documents associated with Small Smiles FORBA, a "Confidential Document" on the Internet for all to see, (here) (copy at bottom of post) clearly shows that DD Marketing is representing themselves as FORBA, LLC.. (Small Smiles, Smile High...DeRose Dental Dynasty, whatever you want to call them today...)

See Todd Cruse's email address in document as well as the physical address.

So why is his dad, Ed (Edward) and his brother, Mike (Michael) taking all the heat for the years of abuse of children in their various dental clinics?

I was sent an email by Mr. Cruse and invited to tour one of their facilities just the other day, so Mr. Cruse must still work for who....? FORBA or DD Marketing? I bet if you ask him it would depend on what day or letter head was in his printer and to what "hat" he was wearing on any given day.

Anyway, Mr. Cruse gave me a wonderful idea. After talking it over with my mate we've decided to use our summer time off to travel a bit. We are going to visit as many Small Smiles and Kool Smiles in the East and South East as we can. I'm going to take my personal Papoose Board, go to the clinics, ask parents there if their child was strapped down in one of them, do some serious interviews, filming etc. I think this is just a wonderful idea!

Thanks a bunch Todd!

CONFIDENTIAL DOCUMENT SUBMITTED TO THE DEPARTMENT OF HUMAN SERVICES, IOWA MEDICAID ENTERPRISE

March 2, 2006

Response to:

RFI: MED-06-025

Vendor Information:

FORBA, LLC

415 North Grand Avenue

Pueblo, CO 81003

719 546 3333

Vendor Business Background:

FORBA, headquartered in Pueblo, CO, identifies, develops and manages clinics that provide dental care to children who are enrolled in Medicaid and the State Child Health Insurance Program (“SCHIP”). The Company’s history began with a solo dental practice in Pueblo, CO in 1928. Over the past 40 years, the Company has focused on children’s dentistry, including serving children eligible for Medicaid. The Clinic in southern Colorado was the first practice in the state to see Medicaid children when dental became a Medicaid benefit for children in 1967. In 1995, the Company expanded beyond Pueblo and opened a Medicaid-only children’s dental clinic in Colorado Springs. The Company’s early expansion was in support of the State of Colorado’s effort to improve access to dental care for the State’s Medicaid-eligible children. Due to the successes of reaching the underserved population from the Colorado clinics, FORBA was formed to develop children’s Medicaid/SCHIP dental clinics throughout the United States. The Company successfully manages dental clinics in fifteen states. The Company currently manages 41 clinics, which in aggregate have approximately 750,000 patient visits per year.

Identification of Services

Expected Outcome: “Medicaid eligible children 12 years of age and under to receive age appropriate dental care by having an established dental home for each child.”

We believe a successful Vendor or provider should provide at a minimum all preventive services contained in the definition of the federal EPSDT standard. In addition to providing the screenings and diagnostics required by EPSDT, a successful Vendor of dental services should have the capacity and experience required to perform restorative services necessary to improve a child’s oral health.

Realizing the geographical challenges within the state of Iowa that a Vendor may encounter when trying to establish a dental home for all children under the age of 12, a Vendor should establish regional general dental clinics and then either establish a mobile dental strategy to reach out to outlying rural areas or establish partnerships with single operating dentists in such rural areas.

KEEP IN MIND, OUR DEFINITION OF A VENDOR IS A PROVIDER AND NOT A MANAGED CARE ORGANIZATION (MCO) OR THIRD PARTY ADMINISTRATOR (TPA) who have to contract with organizations such as ourselves and/or individual dentists to fill out a network.

Local Partnerships

A successful provider of dental services should establish partnerships with local health clinics, school districts, Head Start programs, Title V contractors and other third parties identified as part of the local public health system. The partnerships would require local public health establishments to help the vendor communicate available services by providing mailing lists and prospective patient information to the vendor, in the spirit of access to care, in an electronic format. The Vendor agrees to not share any prospective patient information to ensure confidentiality. The partnership should also encourage members identified as part of the local health system to apply for grants and public funds that would be able to assist with public outreach and awareness of the new services provided by the Vendor.

In addition to any public grant monies made available, the Vendor would be responsible for outreach to the underserved population through direct mailings, social caseworker coordination and on-site periodic screenings in the public school system. Direct mail pieces that would be used to inform the eligible population about the services available would also help to educate parents and children through written oral hygiene information and reminders as to the importance of regular visits to their dental home.

Once a child attends an appointment with the vendor, sufficient time must be invested for an exam, x-rays, prophylaxis, fluoride treatment, preventative education and consultation with parent or guardian regarding further treatment needed. Appointments for restorative work and six month recalls will be made and it will be the Vendor’s responsibility to confirm these appointments and get them rescheduled if the appointments are broken by the patient.

How Service Shows Fulfillment/Progress

The dental services articulated above will fulfill the expected outcome of receiving appropriate dental care by definition of providing preventive, diagnostic and restorative work on the child’s teeth.

The regional dental clinics of approximately 8000 square feet will provide the dental home contemplated by the RFI itself and settle the issue of geographical challenges mentioned above. We know Iowa is divided up into quadrants and it is possible we could put 1 clinic in each quadrant in a population center and then work our regional rural strategy out of the main clinics in each quadrant [the mobile van and partnerships with single dentists in rural areas]. This provides a physical dental home for each child under the age of 12 throughout the state of Iowa.

How Vendor Shows Fulfillment/Progress

In order to measure the progress of a program that includes a network of regional dental facilities and local public health system partnerships, a study of the number of children receiving patient visits prior to the “roll out” of a successful Vendor’s program would need to be conducted by the state of Iowa. Using that report as the benchmark starting point it would then need to be compared on a semi annual basis to data provided by the Vendor of those patients who actually experienced a dental visit once the program had commenced. The study should include information based on age band and regional residence of the patient population, in addition to general oral health conditions. This reporting will prove out the dental home statistics needed by the State of Iowa for compliance purposes. We understand the state of Iowa attached data in this regard to this RFI and we would request this data to be updated as often as possible over the ensuing months and years as it will be necessary to measure progress on achieving the expected outcome outlined in the RFI.

The actual construction of the dental clinics will show progress toward the expected outcome. Once financing of the dental clinics is put in place and the location is decided upon, ground breaking to opening can happen in less than 120 days. The full scope including the front end work can be done in 6 months, beginning to end. There would be obvious overlap if the clinics were not built all at the same time. If one contractor was used, all four clinics could be built within 12 months.

We realize that we represent a different business model than a MCO or TPA and that any proposal from us ultimately would be different from such MCO or TPA.

Vendor Contact Information

Todd R. Cruse FORBA, LLC 415 N Grand Ave. Pueblo, CO 81003 Chief Development Officer 719-546-3333 work 719-546-3334 fax tcruse@ddmktg.com

Kevin G. Reilly FORBA, LLC 415 N Grand Ave. Pueblo, CO 81003 Director Special Projects 719 546 3333 work 719 546 3334 fax kreilly@ddmktg.com

DD Marketing-Dan DeRose-Forba Web Address

So the DeRose's say they actually sold all their various clinics under all the name variations I've wrote about to FORBA.

In a few prior posts I've shown where they did little more than file Corporate Name Change forms in Colorado, the change the name of the door at the Nashville, TN Church Street Address, right.

And from all the "press" the companies (really one or two companies, just name changes remember) it's reported that FORBA (Holding, LLC, INC pick one..) bought all these clinics and the great growth of Small Smiles Across America started.

Wonder why Dan DeRose's (right) company, DD Marketing in Pueblo, CO, 415 N. Grand, AV had his website promoting DD Marketing at......


.....are you ready......

Forba.com in Jan. 2007.

Of course it's not that way now, but it was.










...and it's an exact copy if you were to go back and look at what ddmktg.com looked like in Dec. 2004 you would see the exact same website. It's been redesigned since, but not by much.

DDM-DD Marketing says:

....DDM has been successful in the management of Capital Campaigns for a variety of projects across the country. Grant writing, donor prospecting, donor research, pledge management, auditing, day to day staffing and special event planning are a few of the areas of expertise DDM brings to each contract.

Hmmm...............

DD Marketing also has a division called The Media Center.

Here's what they say about it:

The Media Center is the advertising division for DD Marketing's projects. Media Center's services include concept & creative development, graphic design, video and audio production, media buying, web, research, data-mining and direct mail. Recently their Beyond The Medal of Honor film documentary received two Emmy awards and four nominations. To learn more go to: www.beyondthemedal.com

Contact The Media Center: brad@mediacentercolorado.com

Dan is the original Agent and Incorporator of FORBA, Inc.

More Trouble for FORBA-Small Smiles-Michael and Ed DeRose

Man these guys are in deep poo poo all over the place aren't they. Everyday there is breaking news, keeps a person busy for sure. My goodness there's so much crap on these people a person would need a novel the size of War and Peace to get it all lined out.

Torturing Children, Not paying their employees, ripping off our tax dollars, have more corporations than 5 people could keep track of... on and on!

From all the visits to this site over the last few weeks, especially today and yesterday, the folks at Creighton University are a bit bent outta shape over the shame the DeRose's have brought the the university.

In case you aren't aware, Michael and his dad Ed and mom, whatever her name is have their hands and name on all sorts of things at Creighton. Honors here, and honors there, and seats on this and that. Guess they've given millions of dollars to the place.

Wonder how the folks at Creighton feel about how they got all that money the DeRose's gave? Do people not ask where it came from anymore? I mean, really, wouldn't a person ask if these people were putting themselves out there to helping the poor, how they had so much money!

Look at 'em. They have now cheated their own employees out of money to live high on the hog! Aren't you people sick to death of the DeRose's, Small Smiles and FORBA??

C'mon!

http://phoenix.bizjournals.com/phoenix/stories/2006/10/16/focus4.html
October 2006
News Release From the Department of Labor

Pueblo Children’s Dentistry Company to Pay More Than $343,000 in Back Wages to 523 Employees

Agreement with U.S. Department of Labor Settles Overtime Pay Violations

PUEBLO -- Forba LLC., doing business as Small Smiles Dental, Pueblo, Colo. has agreed to pay $343,479 in overtime back wages to 523 employees following an investigation by the U.S. Department of Labor’s Wage and Hour Division. The Pueblo-based firm operates 27 children’s dentistry offices in Colorado and nine other states including Arizona, Georgia, Idaho, Indiana, Massachusetts, New Mexico, New York, Ohio and South Carolina.
“This investigation reflects the Labor Department’s commitment to ensure that employees receive the full wages they have earned,” said Alex Salaiz, Wage and Hour Division district director in Denver. “Employers must make sure they pay their employees for all hours worked and that the exemptions allowed under the regulations are properly applied.”
The employer violated the Fair Labor Standards Act (FLSA) by failing to pay for all hours worked and by erroneously classifying non-professional employees and clerical staff as exempt from overtime.
The company agreed to future compliance and payment of all back wages.
Enforced by the Wage and Hour Division, the FLSA requires that employers pay covered workers at least the federal minimum wage for all hours worked and time and one-half their regular rate of pay for hours worked more than 40 in a single workweek. Employers also must maintain adequate and accurate records of employees’ wages, hours and other conditions of employment.
For more information about the FLSA, call the Department of Labor's toll-free help line at 1 (866) 4US-WAGE (487-9243) or contact the Denver District Office at (720) 264-3250. Information is also available on the Internet at www.dol.gov/esa/whd.

DeRose Children's Dental Clinic-Nashville TN-FORBA-SANUS-Trail

According to the Colorado Secretary of State's Website the DeRose's, Michael A and Edward J. incorporated a company called DeRose Children's Dental Clinic in 10-1-1975 located in Nashville, TN at 618 Church Street, Suite 520.

And guess what, this corporation is still in good standing with the state so evidently it's still up and running and filing annual tax returns and reports, however it looks like it did a name change Dec. 10, 2001. Looks like there may have been a trade name change at some point to Edward J. and Michael A DeRose, Inc or visa-versa.

But here is where it really gets interesting. The DeRose Duo say they have no affiliation with Small Smiles whatsoever right? They changed the registered agent of Corporation above in 8-17-2007 to National Registered Agents, INC in Denver, but the paper was delivered to the CO Secretary of Sate via a Linda Zoeller at the same old Nashville, TN, Church Street Address.

That's 32 years at that same address! WOW, could FORBA have an address on Church Street in Nashville?

On 12-7-2007 they filed their annual report with the CO SOS and still listed DeRose Children's Dental Clinic as the name and Nashville, Church Street as the address. Hmmm....

Are you ready... Here's the Biggie!! Ready??!!

Trade Names Listed under this Corporation and FORMED on 9-17-2007, just a few months ago:

Small Smiles Dental Centers Of Pueblo
Small Smiles Dental Clinic Of Pueblo
Small Smiles Dental Center
Small Smiles of Pueblo

....and the True Name of Registrant is....

DeRose Children's Clinic mailing address at the Church Street Address in Nashville, TN!

So I take the time to look up FORBA and I find a few names, one, FORBA Management involved Dan DeRose, but was dissolved in 2001 or 2002.

However! There is still:
FORBA, LLC, FORBA, INC and FORBA Holding, LLC, there is also FORBA Group incorporated in Delaware, as the others are, on 7-9-2007 are but I don't have info in it at this time, give me a bit.

Let's start with FORBA Holding, LLC- The documents say it's TRUE NAME IS-Sanus
and it's annual report file in November 2007 is still the old DeRose Children's Dental Clinic in Nashville. Linda Susan Zoeller still doing the document filing.

FORBA, LLC says it was formed 10-01-2002 and at present it's delinquent in some of it's filings. It also says that Daniel E. DeRose is it's registered Agent and It's True Name is LICSAC, LLC. (cute). By the way, it's a full year late in filing it's annual report with the State of Colorado, however I bet it gets filed soon since so many FORBA dudes hang out here.

LICSAC, LLC is also delinquent in it's state filings and there's Danny boy again, listed as the registered agent. It was formed 10-2002. It's two years delinquent in it's state filings so it's not in good standings with the state of Colorado either.

So what we have here is FORBA Holding, LLC is really Sanus.
FORBA, LLC is really LIC SAC, LLC (guess they thought we would get confused trying to say that one a couple of times real fast, instead say it slowly..nothing but class, this bunch!)

Sanus Holding says it was formed 9-25-06 and has the same Church Street Address as above. Yet according to the press releases (aka propoganda) they say Sanus MOVED to Nashville, and FORBA moved to Nashville, whatever, but in reality it was nothing more than names being changed on the office doors.

It's in good standings thanks to Linda Susan Zoeller, wow, didn't she work for DeRose Children's Dental Clinic, well yes she did!

Now we have Sanus Services, INC and guess where it's located, yep, Church Street in Nashville, TN. Busy place, that 618 Church Street, Suite 520! Sanus Services goes under the name FORBA Services...located...well you get the picture now right? Once again, this is in good standings thanks to Linda. I bet she spends most of her days trying to figure out what to file in what name and in what state, hope she's paid well to keep her mouth shut.

After a while it looks like the DeRose's got wise and just used a company that does this kind of thing to be it's registered agent. The Corporation Company aka The United States Corporation Company aka CSC-Lawyers Incorporating Service

So there you have it, the paper trail so to speak and it all leads right back to Edward J. and Michael A DeRose with Danny DeRose getting used a bit in the mix.

I've got way too much time on my hands don't I?

I bet Tish Ballance wishes she had done her homework before getting into business with these guys.

And they say they have nothing to do with "Small Smiles" Whateva!

Smile Starters Dental Clinics-Dr. Raf Rivera cohort of Michael DeRose and Tish Ballance Since 2002

In an Email I was told:

The dental clinics in NC started out named the Medicaid Dental Centers.

They changed the name to the Carolina Dental Centers.

They just renamed the clinics again to Smile Starters.

Mike Derose and Tish Ballance just sold the clinics to a Dr. Rafael (Raf) Rivera, Jr. after paying the 10 million dollar fine to the government.

They are trying to say that since they sold the clinics they are all under new management and are hoping that the bad press will go away.

Dr. Raf Rivera has been working for Derose and Ballance since 2002. He was involved in the NC Dental board case involving excessive treatment, etc...and he did treatment that you hear about on Small Smiles and Kool Smiles, etc..

Hope this helps.

I'm trying to confirm this.

There is a Dr. Rafael Rivera, Jr NC dental license number 6870 in Charlotte, NC whose licenses was issued 6-26-1998 and is up for renewal in March 2009 and has no Dental Board Actions listed at present.

Dr. Michale DeRose was issued a NC dental license in 6-15-2001 and is on probation as listed on the NC Dental Board site.

Small Smiles Again Under Fire in Albany, NY 4-1-08

Attn: State Investigators
If there is a Small Smiles Clinic in your state and you are not investigating them, you should be. There is a clear connection between Medicaid Dental Clinics, Small Smiles and Kool Smiles. At the end of this article you will see exactly what the connection is.


Two Employees Speaks out about Small Smiles Office in Albany New York.

Video May Be Disturbing

Part 1 of Investigation:

CBS Channle 6 WRGB New Albany, New York, April 1, 2008

Picture a young child strapped into a dental chair, unable to move his arms or legs.
As the cold, metal instruments invade his trembling mouth, the boy's heart begins to race: 200 beats per minute. 225. 250.
Now, he's sweating, throwing-up and urinating his pants - frantically scanning the room full of masked faces for some sign the pain will come to an end.
But it does not. The dentist keeps on working
"That's Small Smiles," said Nicole, a former assistant at the Colonie children's dentistry clinic. "Don't bring your kids there."
Speaking on condition of anonymity, former employees Nicole and Holly detailed a list of allegations against the clinic and its lead dentist, Dr. Maziar Izadi. They include:
-Rushing through procedures, even when children are vomiting and urinating

-Allowing children's heart rates to go dangerously past 200 beats per minute

-Performing unnecessary procedures, such as placing crowns on baby teeth that are about to fall-out

-Needlessly placing children under a papoose board, a device that immobilizes their arms and legs

-Discouraging parents from sitting with their children during procedures

-Failing to properly sterilize instruments


"They were constantly pushing production," Holly said. "I think they do it so they can make a fast buck."
Holly and Nicole allege staff members, notably Dr. Izadi, earn lucrative bonuses for achieving certain production numbers - a claim the company denies.
Dr. Izadi did not return CBS 6 phone calls, and ran to his car when approached by CBS 6 reporter Steve Flamisch and photographer Chris Cornell in the Small Smiles parking lot.
A receptionist forwarded our call to Small Smiles corporate spokesman Don Meyer, who said that a review of 40 charts found that all procedures were "necessary and proper." He acknowledged, however, that the doctor who performed the review is a Small Smiles employee, and not an independent expert.

To be fair, Small Smiles did take swift action when informed of allegations that several employees may be using crack cocaine and marijuana, allegedly during their lunch breaks.

A corporate team promptly flew-in from Colorado and drug tested the entire staff. Meyer confirmed there were terminations, but he would not say how many - nor would he say whether anyone had been tested at the time of their hiring. Former employees allege no one is tested.
A government source confirmed that state officials are looking into the list of allegations against Small Smiles.
The company's clinics have also been the subject of news investigations in Denver, Rochester, and Washington D.C.

According to reports, FORBA, LLC began in Pueblo, CO, then was taken over by Sanus, a holding company in Nashville, TN, but a large portion of it's firm would continue to operate out of Pueblo, CO.

Hmmm.. Isn't that where Michael DeRose, DDS, owner of a 3 million dollar home, who was fined $10 million dollars this week lives? Well, yes it is as a matter of fact.

Now isn't William A. Mueller, DDS an old buddy of Michael DeRose's? Well, yes he is, they co-owned several clinics together back in the day. Including Smile High Dental Clinic in Colorado.

Isn't William A. Mueller associated with FORBA, LLC from it's conceptions? Well, yes he surely is. see here . and here And look, a one Edward DeRose in with FORBA. This Eddy could be related to Michael DeRose, well I bet he is don't you?

And look here! See how many founders of Kool Smiles are formerly associated with Smile High Dental Clinics out of Colorado. Looks like at least two. Dr. Tu Tran and Dr. Tim Pham.

And look here. FORBA says he operates 42 clinics and has 750,000 patients a year.

And here is where we find ourselves at Arcapita, Inc. Arcapita Bank. Where it acquired FORBA for 435 million dollars.


I found this at topix:

I work for Kool Smiles, a sister corporation of Small Smiles and all I can say is that their "philosophy" is awfully confusing. They say that they do not NOT allow parents to go back with their children during treatment, yet when we had people from our corporate office visiting us one week, we were reprimanded endlessly for having parents in the back office and they even went so far as to have additional training for employees to learn how to "handle" those parents who want to accompany their child. We also have a consent form somewhere in a packet of forms that every parent is required to fill out every six months, that allows us to use restraint techniques, voice control, and hand-over-mouth on their children - if they are anything like me, they probably don't really read all of the forms they are signing and have no idea of what is really going on with their children in the back office. I can also tell you that it is not just done in the event of an emergency - it's usually done on smaller children who are afraid, and is used to control the child for long periods of time to complete the most dental work possible in the time alloted. I have only witnessed a couple of instances where it was actually beneficial for both the dental team and the patient. The majority of the time the child is terrified, screaming, crying, spitting, and choking thru the entire procedure, while the doctor and the assistant speaks to them in an angry tone, then is sent back out to their parent soaking wet with sweat and exhausted from the ordeal they just went thru. This whole practice is not only traumatic for the patient and upsetting to the parent, but nerve-racking for the dental auxiliary working on the child, which often results in poor quality dentistry. Not to mention the dentisit's they hire are usually fresh out of dental school and are not experienced enough to handle the fast-pace and large patient load demanded of them. I enjoy working with children and I love working with the under-served community because they really need the help and have little other options, but now that I'm starting to see and feel the other side of corporate dentistry, I'm really disappointed - even disgusted at times.

Awe. The Internet is a wonderful thing!

update 3/1/2010

Dr. Maziar Izadi is now practicing what he calls dentistry at Allcare in New York.  Wonder why they hired him, he's a terrible dentist according to all reports.  

Small Smiles Albany New York Investigation Part 2 4-1-08

CBS Channel 6 WRGB New Albany, New York

Small Smiles Investigation Part 2
4-08

Small Smiles Clinic Investigation Report, Methods Crticized-Wichita, KS

In Kansas, Corporate Dentistry is Illegal and that is exactly what Small Smiles, Operated by Forba Management is doing. Other dentists wants these people gone and have filed complaints of Corporate ownership against Small Smiles Clinics in Kansas.

Forba is saying someone else owns the clinic in question, and they just "manage it" but the Kansas Dental Board is looking into this as we speak.

At the Forba website they do not list the clinics locations in Wichita, Topeka or Kansas City, However, job opening for these locations are listed at Forba. Obviously, Forba Small Smiles is trying to operate under the radar of Kansas Law.

Want to take a guess as to what shined the light on these crooks, Using Papoose Boards on Children!

They better be looking into Ocean Dental, as they have clinics in Kansas as well!

Read the FULL and eye opening story below.

What have I been trying to tell everyone!

Dental Clinic's Methods Criticized
The Wichita Eagle (Wichita, Kan.)
2008-03-16

By Karen Shideler, The Wichita Eagle, Kan.
Mar. 16--A Wichita dental clinic that serves mostly low-income children is drawing criticism from some parents and other dentists, in part for using procedures that the critics say traumatize its young patients.
They say Small Smiles Dental Clinic of Wichita routinely restrains children during treatment, does not allow parents to accompany their children to treatment and does work that doesn't seem necessary.
In addition, the dentists are concerned that Small Smiles tries to give the impression it is staffed by dentists who are specialists in children's care. And, they say, it is corporate dentistry, a practice not allowed in Kansas.
Small Smiles dentist Reza Akbar, in an e-mailed statement, said, "We are proud of the high-quality, compassionate care we provide.... Last year, we served more than 11,000 children, and the feedback I have received has been overwhelmingly positive. I am unaware of any concerns raised by parents."
Akbar is the owner of the clinic, according to a Small Smiles spokesman.
Small Smiles, which opened in 2005, turned down requests for interviews or visits. An out-of-state spokesman for Small Smiles, who asked not to be named, said by e-mail, "This is a concerted effort by the company to focus on patient care in the midst of recent scrutiny."
In November, ABC News and an affiliate ran stories about Small Smiles offices in the Washington, D.C., area. The stories told of frightened children, the use of restraints and the prohibition of parents in the treatment area -- the same concerns echoed by parents and dentists in Wichita in interviews with The Eagle.
Many Medicaid clients
Small Smiles' advertising notes that it serves Medicaid and HealthWave children. The Small Smiles spokesman said 98 percent of Small Smiles' Wichita patients have Medicaid or HealthWave, programs that provide medical and dental coverage for low-income children and some others who meet income guidelines.
Many dentists do not accept Medicaid patients or accept only a few because the reimbursement for their care is less than what is paid by private insurance. But Crystal Walker, a pediatric dentist, said four of the five pediatric dental practices in Wichita do accept Medicaid patients. Some general dentists also take those patients, and dental care is offered to Medicaid patients at GraceMed and some other clinics.
In 2007, Small Smiles got more than $4.5 million in Medicaid and HealthWave dental payments from the state, according to the Kansas Health Policy Authority. The clinic declined to say how many dentists it employs.
The clinic uses what amounts to assembly-line dentistry, some say.
"They go in, they do the cleaning, they do the diagnostic, they get everything done that they can in one day," said pediatric dentist David Brown.
"It was like an assembly line," said Shelbi Meisch, whose daughter was a Small Smiles patient. "There was just nothing about the experience that felt like you were getting good care."
Restraining patients
Though parents said they were not allowed to accompany their children into the treatment area, the Small Smiles spokesman said that's not policy: "Parents decide in consultation with their dentist whether or not to be present during their child's care," his e-mail said.
Jeff Davis said he and his wife were asked to sign a consent form giving Small Smiles permission "to do everything from yell at the child to physically restrain them to tie them down."
Meisch, as well as Delicia Akbar, whose children also were Small Smiles patients, said uncooperative children -- including theirs -- are immobilized in a "papoose board." Akbar isn't related to the Small Smiles dentist.
The Small Smiles spokesman provided a copy of a consent form used at Small Smiles in Rochester, N.Y., and said the one in Wichita is similar.
It asks parents to agree to "protective stabilization," described this way: "The child is wrapped in the device and placed in a reclined dental chair." Pictures on the form show a child with what looks like a blanket and a shaped back piece.
Medical suppliers describe a "papoose board" as a rigid board with wide fabric straps that have Velcro fasteners. Separate straps hold limbs inside the wrap, providing a snug-fitting restraint that immobilizes the patient.
The Small Smiles spokesman said, "Our records indicate that protective restraint was used in fewer than 3 percent of all patient visits in Wichita last year."
Akbar took her three children to Small Smiles. She read and signed the consent form "but my understanding of the restraint was not something.. to strap them down." She said the papoose board was used on her 9-year-old.
"I didn't even think anything negative until the kids came out and told me what happened," she said.
Papoose boards have a limited place in dentistry, three Wichita pediatric dentists said, and may be appropriate for special-needs children, for example. But there are other ways to get children to cooperate, they said. They don't use papoose boards.
Walker said she uses a "tell, show, do" approach to familiarize a patient with treatment. But she said that nearly every former Small Smiles patient "will not even lay in the chair" at her office because they're so frightened. Many need sedation for routine care because of their fear, she said.
Concerns about care
Another pediatric dentist, David Brown, said his main concern is "the patients that leave there absolutely terrified." In addition, he voiced concerns about the care provided. He said he has had parents who were told at Small Smiles that their child had seven cavities, "and I personally have not been able to find seven cavities."
Meisch said Small Smiles dentists wanted to put crowns on several of her daughter's teeth, including two front baby teeth that were loose. She said she asked that those two teeth be pulled -- and the dentists pulled others as well, including a molar that has necessitated a dental spacer. "They didn't listen very well," she said.
The Small Smiles spokesman said the clinic provides care according to the guidelines of the American Academy of Pediatric Dentistry. "The appropriate treatment plan is determined by dentists and is based on the dentists' professional judgment," he said in the e-mailed statement.
Small Smiles' advertising says it provides care to "children from their 1st tooth through age 20."
Only dentists who have had extra training may call themselves pediatric dentists.
"They do seem to market to children," said Betty Wright, executive director of the Kansas Dental Board. But by noting at the bottom of its ad that its dentists are general dentists, Small Smiles complies with Kansas law, she said.
Corporate connection
Nationwide, Forba, a dental management company based in Nashville, Tenn., owns Small Smiles. Its Web site does not list the clinic in Wichita -- or the ones in Topeka or Kansas City -- among its locations. But job openings for all three sites are posted on the Web site.
The Small Smiles spokesman said Akbar owns the Wichita clinic.
"The clinic receives assistance regarding marketing, human resources, policy, information technology, collections, and other administrative functions under a management services agreement with Forba," his statement said.
Kansas law prohibits corporate dentistry, in which a practice is owned by someone who doesn't practice there.
Wichita orthodontist Kendall Dillehay said he had filed a corporate ownership complaint about Small Smiles. He was told his complaint would be investigated and that he'd be informed of the results.
Dental complaints are investigated by the Kansas Dental Board. For action to be taken, Wright said that she would need to see evidence that Small Smiles is not owned by Akbar.
Wright said no disciplinary action has been taken against Small Smiles or its dentists, nor were there any pending disciplinary orders.
Investigations are confidential, she said, so she would not say whether any were or weren't under way.
Reach Karen Shideler at 316-268-6674 or kshideler@wichitaeagle.com.

-----




Here are just a few comments from parents who have been to the Small Smiles Dental Assembly Line Clinic:

1. I worked at Small Smiles when they first opened in Wichita. It was no less than hell on earth for children. They do everything and more to the kids that is mentioned in the article. I quit within 2 weeks because it broke my heart to work there. I would never recommend anyone to take there child to this office.
2. This sounds like child abuse to me. They should be thoroughly investigated like Tiller was. Where is the justice in supporting unborn babies? Why don't they support those whom are already born? Nola Foulsten needs to look into this business. Whether parental consent was given or not. Kudos to the previous poster for quitting. When my daughter got braces she told me she had friends who had went there and that the people there were extremely mean. I'm glad I took my kids both to Dr. John Hullings he's the greatest orthodontist in town. Front office staff isn't so nice, but the ones working on your teeth can't be beat. I've never been not allowed to view any and all treatment my kids' received.
3. Reza Akbar??? It sounds like third world dentistry to me, where abuse and a lack of civil rights are a way of life. And if, as they say, "And, they say, it is corporate dentistry, a practice not allowed in Kansas", why is it being allowed. This place of torture needs to be shut down. The trauma the children are being subjected to will follow them the rest of their life. I am 65 and still don't like to go the a dentist because of bad dental experiences as a child. WAKE UP WICHITA!!!!
4. So Small Smiles takes medicaid, a govt. program. It looks like the govt. and medicine are great together. It will be wonderful when the government takes over health care via Obama or Clinton.

There are many other Small Smiles complaints at the Wichita Eagle, you can read them here.

Dr. Mohammad Akbar, Peublo, CO. in the name of Small Smiles of Wichita Health Care contributed to State Representative Candidate Bob Bethell 2006 Campaign. See Here

Think maybe Mohammad Akbar and Reza Akbar are related or one and the same person?

Congressman Dennis Kucinich Call Small Smiles a Dental Mill

Congressman Dennis Kucinich said Small Smiles?FORBA had found way to make money off poor children by creating dental mills to make a buck while blasting Medicaid for not doing more to improve dental care for children on mediciad.

"Medicaid Officials in Congress [02/14/08]"
-----------------------------------------
Small Smiles - Congress

A year after 12-year -old Deamonte Driver died of tooth decay, Medicaid officials were called before congress in February to explain what they've done to improve access to care for poor children.

Four out of five dentists refuse to treat Medicaid patients because reimbursement rates are so low. The congressman heading up the hearing blasted Medicaid for doing little to improve rates.

He pointed to the I-Team's reports on Small Smiles Dental clinics as an example of what can result.

Congressman Dennis Kucinich said "Small Smiles conceived of another away to make a profit: a
predatory mill where multiple, sometimes unnecessary procedures are imposed assembly line style on children for little regard for their welfare or proper dental practice."

Medicaid officials told congress today they are trying to make more dentists available for poor children, but conceded they have a long way to go.

Small Smiles-FORBA-DeRose Update From Roberta Baskin, WJLA TV

More Damning Evidence Keep Pouring In to I-Team Investigation.

Don't forget, even though this local investigation mentions Small Smiles, they go under the Name Smile Starters Smile High, Medicaid Dental Centers, FORBA, DeRose Children's Dental Center, Small Smiles Center/Clinic of Pueblo, and others. And if you read below in my previous post, more of these Dental Offices catering to children are jumping on this same bandwagon! Beware!

February 28, 2008

Roberta Baskin, of WJLA TV, broke and continues to follow the Small Smiles Dental Abuse and Fraud Investigation. Here is the transcript of Roberta’s latest installment.

ANCHOR:

RESTRAINING CHILDREN, PERFORMING UNNECESSARY TREATMENTS, HIRING UNLICENSED XRAY TECHNICIANS... THESE ARE ALL EXAMPLES OF THE SUB-STANDARD DENTAL CARE OUR I-TEAM FOUND AT THE SMALL SMILES CLINICS IN THE WASHINGTON DC AREA, AND ACROSS THE COUNTRY. WE'VE BEEN TELLING YOU HOW THE CHAIN OF CLINICS PLACES PROFIT OVER COMPASSIONATE CARE FOR MEDICAID CHILDREN. NOW ROBERTA BASKIN AND THE I-TEAM HAVE UNCOVERED MORE.... ROBERTA?

ROBERTA BASKIN:

SOME OF YOU WHO SAW OUR EARLIER REPORTS HAVE COME FORWARD WITH NEW EVIDENCE OF THE SMALL SMILES SCHEME TO BILL THE TAXPAYER-SUPPORTED MEDICAID PROGRAM FOR WORK THAT WASN'T NEEDED - OR WASN'T EVEN DONE.

STORY: Six year old Kayla Mason brushes her teeth day and night.



She's never had any cavities. That's why her mother, LaTasha Mason, was dismayed when dentists at Small Smiles in Oxon Hills said they found THREE.

LaTasha Mason-"I was like, oh my goodness, I was surprised, I really was. And they were like, well, the lady that called me back, she was like, well that's nothing compared to what we usually see."

She then had Kayla examined by a different dentist.

Mason-" And she gets up to leave and I'm like , well, what about the cavities?"

Turns out, there weren't any.

Mason-"I was really astonished, to say the least."

Mason is upset Small Smiles planned to drill into her daughter's teeth for no other reason than to profit from it.

Mason- "It's, it's just sickening." "(that's) the only thing I can think of, why they would want to drill in these baby's mouths, is for money."

Particularly upsetting is her feeling that Small Smiles lied to her.

Mason- "One maybe, that could have been an honest mistake. But three? Absolutely not. Three is not a mistake, I'm sorry."

And when this family went to Small Smiles for a check-up, dentists saw four girls - and apparently 24 cavities.

Cheryl -" I felt like a bad mother." Cheryl assumed her children hadn't been brushing.

Roberta -"Were you in trouble?"

Rachelle -"Yes"

Cheryl -"I told them all of their teeth were going to fall out if they don't listen to me and brush their teeth. I called them "yuck mouths."

Roberta -"Yuck mouths?

Cheryl-"Yuck mouths."
Most of the work was completed, except on Rachel, who was told to come back for several more fillings. In the meantime, Rachel's mom heard about our Small Smiles investigation, and switched to Dr. Robert Camps.

Dr. Robert Camps - "I'm glad it wasn't done, because it shouldn't have been done. Roberta -"Four fillings that she would have gotten on teeth that are perfectly fine."

Dr. Camps -"Correct."

And that's not all. When Dr. Camps examined Rachel and her sister Rebecca, he realized - Small Smiles didn't DO all the work they charged for.

Rebecca's chart shows 8 cavities filled…but that's not what she remembered. "I didn't see any drill or hear any drill.

Roberta -Did they numb you?

Rebecca -"I didn't feel a numbing (or anything)."

And Dr. Robert Camps didn't see the work either. "these are not fillings." "I feel like they did more like a sealant, (where they didn't really drill into the tooth)." To be sure, Dr. Camp took x-rays.

Plea from I-Team, asking the public to keep the stories coming I, please help I-Team help the children. You are the eyes and ears! click here

ABC 7, WJLA TV is in the Washington, DC area, so all of our law makers watch this news.

Report by phone at 703-236-9559

Former Dentist With Small Smiles Confesses

WARNING: Video at the end of this report may be very disturbing.

2-15-2008
(Rochester, N.Y.) - Last December, 13WHAM showed a disturbing video tape of children strapped in restraints undergoing multiple root canals while their parents were kept out of the room.

Now, the man who once ran the Irondequoit Small Smiles Branch is speaking out for the first time.

He was jailed for fraud. In a follow-up to our 13 WHAM News investigation, he told Jane Flasch that some of the procedures that so traumatized children weren't even necessary.

Rochester's Small Smiles dental office opened with a promise to serve children who don't get regular dental care. Clinic director, Dr. David Gardner, was hauled into a Monroe County court 14 months later.

Gardner pleaded guilty to grand larceny and left Rochester for prison. Now, he wants to come clean about what he says was going on behind closed doors on Ridge Road in Irondequoit.

"Taxpayer dollars are being wasted because they're paying for treatment that's not getting done, treatment that doesn't need to be done, and children aren't being treated like children," Gardner said.

Ashley Sones was a patient during that time. Nine of her teeth were extracted. Another dentist reviewed Ashley's x-rays.

He confirmed that at least two of her teeth could have been saved. But, her file did not contain enough information about the rest.

She never did get partial she was promised; it was denied.

Some very young Small Smiles patients had metal caps, crowns, and root canals. Dentists dispute whether root canals and crowns are the best treatment option for young patients.

However, Gardner said he was under pressure from the corporation to make $1 million every year.

"The biggest thing you can do is those baby root canals and crowns because it’s $220 that Medicaid does not question. It’s just $220, $220, $220," Gardner said.

The Rochester office would not allow cameras inside.

Gardner said they routinely used another controversial technique to restrain children. On an attached video taken at a Small Smiles in Maryland, you can see a small child strapped to a papoose board which holds his body and arms immobile.

Gardner said papoose boards were encouraged in order to complete four or more root canals at a time. Even though it made kids frightened and stressed.

"Stressed out enough to wet their pants, sweat completely through their clothes, be all wet," Gardner said. He said he was told, “Clean them up as best you can before you give them to mom and dad."

Ashley Sones said both she and her younger brother Wesley were physically held down.

"My heart was racing,” she said. “It felt like blood was rushing through my body."

Their mother never even knew. It was Small Smiles policy not to allow parents to be with their children.

"I trusted them,” said Ashley’s mother Wendy. “That's their job."

Since our reports first aired in December, Small Smiles changed its policies. It now allows parents to be present with their children for procedures.

While it still uses papoose boards, the policy is clearly posted and parents can refuse. As for Gardner, the company characterized him as someone with an ax to grind.

Gardner confessed to billing Medicaid for work he did not do.

Investigators say Small Smiles cooperated in the investigation against Gardner and repaid nearly half a million dollars.

Gardner has surrendered his medical license and now sells RVs in Indianapolis.

He says he was pressured into the Small Smiles way of doing business with the understanding that if he were caught, he would be taken care of.

"I've lost my career, I've lost my livelihood," he said.

A member of the Pediatric Dentistry Program at SUNY Buffalo conducted an independent review of the Small Smiles Rochester office last month.

He concluded that restraints, crowns, and other procedures are being used in the proper manner.

Nevertheless, we were not allowed to see a copy of the review documents.

The reviewer spent only half a day at the clinic and did not interview parents. Criminal investigations are underway in several states including New York.

Small Smiles is the name of the clinics in the Rochester NY area, however they also go under different names including Kool Smiles, all managed my FORBA, LLC out of Nashville, TN a subsidiary of Arcapita Bank based in the Middle East.

See this dentists Plea Agreement, Read about his bonus paid to him from Small Smiles, and more here






Since the report aired, Small Smiles has changed its policies, now allowing parents to accompany their children during procedures. Small Smiles cooperated with authorities, repaid close to half a million dollars.

Continue here

More Disturbing Allegations Against Small Smiles

Small Smiles is under National Investigation due to an investigation siting barbaric treatment of children in it's dental offices across the nation according to ABC-7 news.


Here is a transcript of the latest report from ABC-7 I-Team Investigation in the DC area.
Date:2-11-08

This is Brandon from N. Carolina showing off his mouthful of baby root canals capped in metal.


And Daniel from Colorado with abrasions and welts from visiting the dentist.


And Miguel from Maryland, strapped down on a papoose board while his mother is forced to wait outside.


Miguel's treatment was not an isolated case. The I-Team has learned that routine use of papoose boards in the Small Smiles network of clinics has injured and traumatized children, and may have played a role in this child's death.


At least a dozen states have launched civil or criminal investigations, many


of them prompted by our reports.


In Arizona…4 year old Jonathan strapped in restraints died from an overdose of anesthesia while this dentist performed five baby root canals.


Dr. Matthew Nolen: "No comment."


The state investigation found that Jonathan was restrained "for no justifiable reason" and his symptoms "could have been masked by the papoose board." The dentist's license was revoked.


Roberta Baskin: "Does the Small Smiles home office encourage the use of these papoose boards?


Doug Gardner: "Yes."


In New York Doug Gardner lost HIS dental license after being convicted of Medicaid fraud for double billing at a Small Smiles clinic.


Doug Gardner: "When you're throwing that much treatment at Medicaid that quickly, they can't check everything."


The I-Team tracked Gardner down to Indianapolis, where he agreed to speak out about Small Smiles practices for the first time.


Doug Gardner: "Taxpayer dollars are being wasted because they're paying for treatment that's not getting done, treatment that doesn't need to be done, and children aren't being treated like children."


This Small Smiles patient remembers being physically held down in the Rochester clinic two years ago.


Ashley Sones: "I was sweating. My whole body was shaking. It was like I was having a seizure."


Gardner says it was not uncommon.


Roberta Baskin: "How stressed out did these patients get?


Doug Gardner: "Stressed out enough to wet their pants, sweat completely through their clothes, be all wet."


Roberta Baskin: "And how are you told to manage that?


Doug Gardner: "Clean them up as best you can before you get them back to mom or dad."


That's another Small Smiles policy. Separating parents from children during dental procedures. In North Carolina Brandon's mom couldn't imagine what was taking three hours until he emerged with 16 baby root canals and steel caps.


Christy Dillbeck/Brandon's mother: "I couldn't stop crying cuz I was very upset and wanted to see him."


In Colorado, these police photos are evidence of young children bruised from restraints. Daniel had 8 teeth drilled and capped in one sitting.


Beatrice Ponce/Daniel's mother: "He just hears the word 'dentist' and he starts to cry and scream that he doesn't want to go in."


Dentists tell us baby root canals and caps may not always be the best treatment option for young patients, but DO result in the best reimbursement for Small Smiles.


Doug Gardner: "The Small Smiles way of taking care of children is to maximize every dollar that they can, during that patient visit, at all costs."


After Gardner's clinic was audited, Small Smiles paid back $444,000 in overcharges.


Gardner: "I've lost my career. I've lost my livelihood." "I'm unemployable now."


Except as an RV salesman in Indianapolis… where he can't forget the pressure from Small Smiles to break a million dollars in profits each year.


"The biggest thing you can do is those baby root canals and crowns cuz it's $220 that Medicaid does not question. ...its just 220, 220, 220, 220, 220."
-----------------------------------------------------


AS A RESULT OF OUR REPORTS, THE MARYLAND ATTORNEY GENERAL HAS LAUNCHED A CRIMINAL INVESTIGATION OF SMALL SMILES.


THE CURRENT MANAGEMENT COMPANY, FORBA, TOOK OVER THE CLINICS IN SEPT 2006 AND SAYS IT CAN'T BE RESPONSIBLE FOR THE PROBLEMS THAT OCCURRED BEFORE THEN.


THEY DECLINED AN ON CAMERA INTERVIEW, BUT TELL US THEY'RE UNDERTAKING AN INDEPENDENT INVESTIGATION IN MARYLAND AND THE DISTRICT.

At the site above you can read a couple of so called statements from the folks at FORBA. They really don't say a whole lot...other than a lot of blah blah blah. What I find most interesting is what they Do Not mentions.

Here is FORBA-Small Smiles-Kool Smiles Latest Statement...like I said... a lot of blah blah blah. I did note that the press release is from the renowned Rubin Meyer, a "marketing" and "communication" firm in Washington DC. Here is what Ruben Meyer says at their site as to exactly what they do:

Many companies face challenges from regulators and policymakers in Washington and must navigate what can be a difficult business environment. The days of the back-room deal are gone. Today it takes hard work, creativity, and a clear message to get the job done in Washington.

Maybe it's just me but I read that as "Lobbyist". What is clear is that these people at FORBA-Small Smiles-Kool Smiles whatever have some really big bucks to spend to hire these people for their press releases.

Date: 2-8-08
Don Meyer
Donald.Meyer@rubinmeyer.com
202-834-6859


STATEMENT OF FORBA DENTAL MANAGEMENT
Nashville, TN – FORBA Dental Management, management company of Small Smiles
Dental Centers, released the following statement today:
“The current executive leadership and ownership of FORBA Dental
Management, the management company of Small Smiles, has been in place
since September 2006. Since that time, our objective has been to provide highquality
dental care to children in underserved communities nationwide, and we
have taken steps to improve the policies and culture of the company to meet
that goal.
“Most recently, we have launched a number of initiatives, detailed in previous
statements to WJLA, to improve care and ensure a positive experience for
children and parents at Small Smiles Dental Centers.
“Under our management, Small Smiles’ 1,600 employees and caregivers
work tirelessly to ensure that underserved children receive the highest
quality, compassionate care at our facilities nationwide.”

They fail to address the fact that they are also called Kool Smiles in many states. At this point in time Kool Smiles are popping up on every street corner. You can do job searches and Kool Smiles are looking for employees in many states across the US. Not so many under the name Small Smiles. Wonder why that is exactly?

My hat's is off to the people at ABC-7 Investigation team. Forba has posted another great statement with general denial on the website of WJLA under the comments section, however I wonder why they keep making "statements" and won't answer some  hard questions.
  Amazing though how since this latest report has come out, there are people signing up on the comments section to basically stick up for FORBA, wonder if they might me part of the new marketing machine, ya think? Do these posters actually think people are stupid or what?

Water boarding is all over the news as to whether it's an appropriate torture for murders at Gitmo. I tell you what, I'm more concerned about "Papoose Boarding" right here stateside and this is being done to our very own children buy dentists across the US.

It certainly isn't just these dental chains who are making the news, it's your local private dentist as well.

The Smile Behind Small Smiles

Meet, Atif A. Abdulmalik, of Bahrain. He is the CEO of Arcapita Bank, formerly Islamic Investment Bank until it changed it's name in early 2005. This is the company behind FORBA, LLC, or at least one of them.

FORBA, LLC is Small Smiles.

I don't know a lot about Venture Capitalist, Holding Companies nor how they all operate change hands, move about or hide.

Here is what I have found out here on the net:

There was The Carlyle Group, American Capital Strategies, and Arcapita Bank who got together and created Small Smiles Holding Company to purchase Sanus Holding who had just acquired FORBA in the fall of 2006.

In a press release found in a Nashville newspaper it states that Sanus Holding acquired FORBA, LLC and moved it's office to Nashville.

Then there is a report in January 2007 "Arcapita Bank, an Islamic Investment Firm and it's affiliated acquired Sanus Holding.

I don't know how all this worked but what I can figure out is that all of the medicaid and other state insurance programs who are billed for work done (necessary and UNnecessary) from Kool Smiles and evidently Small Smiles is headed to Bahrain, off the coast of Saudi Arabia.

Looks like our tax dollars are padding the pockets of another Islamic country via abusive dental care.

Abusive treatment of our kids and their teeth, over billing our medicaid system and no telling what else I've not discovered yet is just a kick in my teeth!

Don't take your Kids to these Dental Chains for heavens sake!

Children Dental Clinic, Does Not Mean Pediatric Dentist

Over the course of the last few days I looked into, read, reread, watched reports from news organizations across the Internet on some of these Dental Clinics designated for treating children and some even taking children on medicaid or state insured children only.

Some have sweet websites with smiling children splashed on each page and show the kid friendly decor and the happy smiling faces of the dentists and staff.

Small Smiles, Kool Smiles, Smile High, and Ocean Dental are the main clinics I've looked at in recent days.

Something I thought was a bit misleading to parents and the children treated is even though they are geared toward children, designed specifically for children does not mean they employ Pediatric Dentists or owned by Pediatric Dentists. Most I've looked at are only trained in General Dentistry.

Now I'm not saying by any means they don't have a clue about dentistry. Nor am I saying they took correspondence course to get their licenses. Many may well have attended wonderful dental colleges. I'm just saying because the clinic/office is decorated in cartoon characters doesn't mean they are Pediatric Dentists.

For example there are job ads online for Ocean Dental looking for dentists, assistants, office and administrative personnel. However, the critiria for the dentist do not ask or require them to be actual Pediatric Dentists, with the 2 extra years of training for treating children dental issues.

In their ads they never say they are Pediatric Dentists-(Pedodontist) they say something like "General Dentistry For Kids and Young Adults" so they are not breaking any laws to my knowledge.

It's just the whole set up makes you think you are getting a pediatric dentist to treat your children, so buyer beware.

It's not hard to find out if they are licensed in Pediatric Dentistry. All I had to do was check out the company sites, see the names of the dentists at different clinics or who owns the clinics and check to see if they hold a Pediatric License or a member of the AAPD. Pretty simple really. Many of them will list the dentist's name, where he/she went to school, what association he/she's a member of..etc.

I'm getting a bit off subject here though messing with this kind of information.

My complaint is "STOP STRAPPING DOWN CHILDREN FOR DENTAL CARE"

Papoose Boads For Dental Care-Are You Kidding Me!

There's just something about the Papoose Board that seems ... unfair, really really sneaky and a betrayal, and a ruthless display of dominance.

Dental procedures rooted in child intimidation include parent separation, use of papoose boards and negative verbal manipulation.

Although an intimidated child may be a compliant patient, the long term needs to establish a confident and trusting relationship can too easily be compromised.

From reading the reports on the web, I'm not the only one to feel this is just wrong. Some states such as Colorado have passed strict guidelines for the use of these for mentally and physically handicapped children and only as a last resort.

But many dentist are using them as standard procedures to get the job done as quickly and easily as possible. One dentist interviewed said it was more cost effect to tie up the child rather that another method or a combination.

Caution This Video May Be Very Distrubing:



On January 2, 2008, this particular Dental Office as now changed it's policies! THANK GOD!
See more here.

Update: 5-6-2008
But have they changed their ways? NO They Haven't! As of today, there are still report after report across the Internet saying this practice at Small Smiles, Kool Smiles, Smile Starter as well as private practice dentists that suggest it's status quo!

Even companies selling this things clearly state they are for use as a "Last Resort".

There are laws to stop the restraint of our elderly what on earth makes anyone here think it's ok to do it to our CHILDREN!

Imagine a visit to a dentist office where you walk back to your room for you own dental care and see a child strapped down, struggling for his life and the dentist, office personnel and the child's parents look up with a smile. (I didn't look back with any thing close to a smile!) I wanted to call Child Services!

Dentist's now have a new little gadget called a "dam" they put in your mouth to make it easier to get in and work. It restricts air flow from your mouth and all you are left with is what you can manage to breath through your nose.



Now we adults can manage that, but a child has a bit more trouble. Especially when they have been thrown in the basic flight or fight emotion and screaming is more important that anything.

Please tell me how a child is supposed to communicate to a dentist tied down, hand, feet and body restrained and this contraption in their mouth supposed to tell a dentist that they are not numb, that they have hit a "hot" nerve or they are about to choke. I would say that any dentist that does this to a child really doesn't care about anything other than drilling some hole, real or not, and making some fast bucks.

Add to the crying hysterically from the event, the nose becomes clogged and now the child can't breath nor move, so it's not far from death for the children, as they see it for sure. They certainly have no trust with those around them cause they are clearly the enemy!

The restraints do not do the job alone, so if you think the dentist just gently wrapping your child in a loving blanket for comfort is what's happening you are dead wrong!

It's only a way of gathering up the flying arms and legs making it easier to use other physical force to hold the child still. The child can still thrash around. Sometimes the dentist will enlist the parents to assist but many time they will tell you that the parents distract the child so you are asked to leave.

While trying to stop the thrashing around (since they are fighting for their lives) they put their arms over their face to try to restrain the head further. Sometimes they add HOM-Hand Over Mouth - which further panics the child. The child is sure something terrible is going to be done to him, they see this kind of action in cartoons on tv everyday and it never ends well.

Don't try and tell me that putting your hand over the mouth of a child tied up is ok, and that you can assure me through their thrashing about the dentist will not block the only air way they child has-his nose. In dental lingo it's called HOME method of controlling a child. (Hand Over Mouth Exercise)!


Guess how they get the child to open their mouths, they pinch their nose. So you have a child strapped down and no way to get air! How more cruel is that! They call this little technique HOMAR (Home Over Mouth Airway Restriction)


A dentist in Florida had been prosecuted because a child's arm was broken while trying to restrain a child, and yes, he was using a papoose board.

I admit the device would serve its purpose well for what it is used for (pediatric purposes) saving life and limb, but there is no excuse to use it to work on a child's baby teeth.

Call it what it is…A restraining board. In this current usage it has nothing to do with a Papoose…which by the way is: A papoose (from the Algonquian papoos, meaning “child”) is an English loanword whose present meaning is “an American Indian child” (regardless of tribe). The word came originally from the Narragansett.

Using the term Papoose is supposed to somehow sooth the real idea of the straight jacket for children in hopes that makes it more acceptable to use.

Dr. Frank Carberry has been a dentist for 40 years and has worked with children in Third World countries. He said he's treated children with major tooth decay without ever resorting to restraining devices.

"I've got five grandchildren,” he said. “I can't imagine the psychological trauma on that child.”

I don't know when this practice started, nor who ever thought it was a great idea, but I know I certainly never would ever have considered torturing my children in this manor for a baby tooth!

A recent study among dentists showed that only 14% of them condone restraints such as these for dental care of children. It jumped to 20% if the child was pre-medicated.

Also a study indexed at medline.com showed that adults who experienced HOM or any other kind of restraint for dental procedures were 50% more likely to never see a dentist again!

In Europe, dentistry is now seeing that this type of treatment is uncalled for and abusive.

"Dr. Kevin J. Urbanek has a complete review of this abuse here. He states: In summary, research exists that demonstrate physical restraints are both potentially harmful, and are being increasing rejected by both practitioners and patient guardians. Alternatives such as medications are currently being explored and should be strongly considered instead of using physical restraints."

What needs to be studies is the long term affect on the children who suffered this kind of trauma!

The American Academy of Pediatric Dentistry warns that stabilization devices like papoose boards have potential to seriously harm patients and should only be used in extreme cases where a patient is a danger to himself or his care givers.

One study from the AAPD showed that younger more inexperienced parents would more likely to consent to the use of the PB. (Papoose Board) Where parents 35 years of age and above were much less likely.

Dentists are far too often using the "danger to himself or his care givers". Dentist are not taking in to consideration as to the real urgency of the procedure. Just the cost savings of a quick treatment.

Some dentists use the argument they clearly informed the child and the child agreed to putting on the restraint. Come on, No child thought they would be tied up and tortured when they agreed to this!


Filling 4 year molars on a 5 year old child does not constitute Extreme Case!

Long Term Damage:

Death- A few children have died from being strapped to one of these boards because the dentist could not see the lethal allergic reaction the child had to the lidocane. Here's one story.

One woman says, "now I suffer from mild-moderate claustrophobia. I'm not saying this is always the wrong choice, but I wouldn't wish this upon anyone."

Other children report nightmares, not wanting close contact such as hugs, and one child refuses to sleep with a blanket to cover him.

One little girl told her mother that she dreams every night she is in a coffin and wakes up gasping for air. This has disrupted the entire family to the point they have had to seek professional care with biofeedback to help the child over come these fears.

More than one child has ended up with broken arms and limbs from fighting the restraints.

Many children and been brought into full blown Asthma attacks and seizures due to the trauma of papoose board and pediwrap boards. Your dentist office is NOT equipped to handle this kinds of emergencies.

Read the story of this poor child in Charlotte, NC

Are those fillings this important to you, are you willing to kill, maim and mentally damage your child over a filling, cap or other non emergency dental work??

Find yourself a qualified Dentist, or keep them at home!

Here's another story of Dentist who have lost licenses from this practice.

Here a mother explains the trauma her child experienced:

At 2 1/2 years old, I took my son to the dentist for the first time. All he had done was a brushing and teeth counting. He hated it! He kicked and screamed, and begged to get up.

About 3 months later he had a horrible accident in which he fell and pushed his four front top teeth up into his gumline. He ended up having to have the left front tooth pulled. In order for the dentist to do this she had to place him in a papoose board and strap him down. He freaked out! He screamed like he was on fire, he threw up, he gagged, and he hyperventilated to the point of almost passing out.

You know what really burns my butt, it's these parents worried about the violence on TV, cartoons and children's classic fairy tales, but would take their children to the torture chamber, aka, poorly qualified Dentist!

A Report from California:

A trip to the dentist probably doesn't rank high on anyone's to-do list. Now, imagine if your dentist skimps on appropriate amounts of anesthesia before submitting you to painful procedures.

That's just one of the things California Attorney General Bill Lockyer is alleging in criminal complaints against 20 dentists throughout the state. He's charging them with defrauding the state Medi-Cal System of $4.5 million, health benefits and workers' compensation fraud, conspiracy, grand theft, child abuse, elder abuse, assault and intentional infliction of great bodily injury. (due to using these restraints sweetly called Papoose Boards)

Here is another mother's experience using these typed of dentist, her child busted a blood vessel:

I have a 3 year old and when he went in for a cleaning, the experience was good- probably 4 stars-the nurses were kind but I felt like the Doctor was a little cold. We had to bring my son back for a root canal because of a dead tooth and the experience was traumatic, horrifically scary for my son and we will not go back.
The Doctor did not discuss the possibility of any type of sedative with us for this procedure nor did he tell us in advance that my son would be placed on a board and basically placed in a straight jacket. While that may be necessary to complete the procedure, letting parents know what to expect is critical to a good experience. During the procedure, my son, who was so scared that he literally popped blood vessels in his face and neck was told in a firm voice by the dentist "You are yelling at me. You can't yell at me any more. I can't do my job when you are yelling." While certainly, yelling is going to be difficult to deal with, as a doctor who sees patients this young and chooses to perform these types of procedures on them, a certain amount of empathy is required to be considered a good dentist. If my children were older, I'm sure the visits would all be good ones. However, my fellow is 3 and I am disgusted.

Another outraged mom:

My son had 2 cavities. I took him to my dentist and as soon as he got in the room the strapped him to a papoose board and 4 ppl worked on his mouth. No one tried to comfort him. They just held him down with the papoose board which looks basically like a strait jacket. It made his arms and legs immobile and his head was between two boards. When we left he was hysterical. His lips were bruised. I did not sign any consent form for them to do this. I decided I was not taking him back to get the other cavity filled there ever. This is 2009, and is ridiculous! Clearly it was not for the comfort or safety of my child, it was for the convenience of the dentist.

Here is a quote from a parent on a message board that pretty much sums up my feelings and anger on this issue:

"A cavity is not worth a lifelong traumatic memory like this. If I found out the dentist covered my daughter's mouth and told her to shut-up ...I'd give him the beating of his life right then and there and then warn him if he called the police he'd get 100 times worse when I got out of jail."

Have any of these Pro Papoose Board Supporters even considered the

psychological safety of the patient!

updated: 1-15-2008

This may be one reason some dentist resort to papoose board instead of other types of sedation for persons under 13 years of age. Permits, Education, More Training. Below is from the Kentucky Board of Dentistry.

Dental Anesthesia Permits

Any dentist who wants to administer general

anesthesia, I.V. conscious sedation, or oral

sedation for patients under the age of 13, must

first secure a permit from the Board. To

receive a permit, an application with supporting

documentation of education and experience

must be submitted along with the permit

application fee. An office inspection must also

be done before anesthesia can be performed in

a dental office. A permit will not be issued for

any of the above types of permits until all

requirements have been met. Until a permit is

issued, anesthesia cannot be administered.

University of Louisville is requesting your

participation