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!
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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:
- 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.
- 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.
- 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!!!!
- 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.
Think maybe Mohammad Akbar and Reza Akbar are related or one and the same person?
