Wednesday, August 04, 2010

Smile Starters Still Abusing Children and Keeping Parents From Going Back With Their Child; After The First Two Visits Of Course.

Here is the story of a child who went to Smile Starters in North Carolina.  Her name is Kathy and she's 3 years old.  This is a sad story.  They make the mother feel as though she's a bad parent, they use the usual scare tactics and they've even blamed the child for not behaving properly.
Smiles Starters is part of the DeRose family of clinics, with Dr. Raf Rivera listed as being the owner.  Dr. Raf was a long time employee of Dr. DeRose and Dr. Ballance. 
When they got into trouble in North Carolina, Dr. Raf came to the rescue, offered up his name and they never missed a beat.  Wonder if DeRose and Ballance have paid the $10 million settlement yet?  If you have a child you has suffered at the hands of these ruthless creatures disguised as a dentist, contact Moriarty-Leyendecker.

The place I take my DD (dear daughter)is called smile starters and they pulled my DD's top 4 out . Caps on all but 1 tooth which was sealed and the bottom 4 has porcelain crowns in the back of them. And now her bottom 4 is going bad . And I cut out almost all sugar brush 3 times or more a day and she only has water or milk nothing else.
This place is the only one that takes Medicaid. And this next appointment I was told I can't go back with her that only 2 appointments the parents are allowed. They had to use a papoose each time cause she kicks.
But now I dread the appointment that is coming up this Friday (July 30, 2010) because they talk very stern to me the other times acted as if I was the worst parent in the world.
If I could find another place I would but there isn't a place that will accept Medicaid And I know they would want to put her through another oral surgery to pull those 4 bottom teeth and she had her first surgery last Dec.
I know her teeth are bad from genetics and they looked rough and I am caught in a hard spot cause I don't want them to report me for neglect and it states that they can if I miss a certain amount of appointments and I already rescheduled it .
And the health departments dental clinic is not equipped to  handle my DD's tantrums she has ( she kicks , scratches, cries, and pukes). She even has these when I brush her teeth.
I wish they was more equipped because they are nice to me about everything and didn't talk harsh to me . As soon as she grows out of these tantrums she has she is going to them.



Before














After















After
















Now what is it they say about needing to put crowns on teeth to hold the place for the permanent teeth?

I've also seen reports lately where parents are being asked to sign a waiver to let their child go back alone!

Mom Tells Of Recent Kool Smiles Experience In Massachusetts

A mom writes about her experience with Kool Smiles in Massachusetts.  This incident happened the week of July 26, 2010.  If you would like to read this and the numerous comments and other experiences, click here.

If your child has been injured from dental treatment such as almost happened to Kelly, contact Moriarty-Leyendecker here.

I took my kids to the dentist and I am in shock!  My kids have state insurance so I can only go to a few dentists that take Mass Heath. 

So we went to Kool Smiles.  I am ON my kids with brushing and flossing, they eat very little sugar and their teeth look pretty good.  My oldest had 2 spots that looked like they might be little cavities starting. But sadly I was not surprised cus the antiviral meds she has been on for 5 yrs has "stripping enamel of teeth" listed as the 2nd common side effect.

Well guess what?? Kool Smiles said my oldest needs 4 fillings, 2 root canals, and five crowns and my 4 yr old they said needed 3 fillings and 4 crowns!  WTH??????? On baby teeth! They are just trying to rob state insurance by doing procedures that do not need to be done.

So, I called my dentist (who does not take Masshealth) and they said they would give me a 2nd opinion for $30.  I am taking the girls in Wednesday.  But, my dentist was appalled!  He said he has never done a crown on a baby tooth and root canals on baby teeth are usually only for extreme cases! 

I am so pissed! If I can prove my kids do not really need all this dental work done i will be reporting Kool Smiles!

GRRR....Okay vent over! LOL!

UPDATE:

So we went to my dentist today.  And the verdict is-        Kool Smiles SUCKS! I already knew that though! LOL!

So, Caitlin does have some bad cavities but NOTHING like Kool Smiles said.  She has 2 small cavities on the top that should be filled and she does have 2 bad cavities on the bottom that if they were permanent teeth would need root canals.  But, since they will fall out in less than 2 year it makes more sense to have them taken out and have spacers put in.  Because the cavity is deep it could cause damage to the permanent teeth underneath if not removed.  They are her 1st set of molars and should not cause any movement in her other teeth by being taken out.

The dentist said her teeth had no plaque on them her gums look great and her permanent molors that have came halfway in looked great.  So, she said it was probably the meds that caused these cavities and if we keep doing what we are doing her teeth should be good.

And the best part is she told me about a great private dentist who takes Masshealth.  When I called them they were not taking new patients, but my dentist called them and they are gonna see both my girls!

So, to summarize we went from Kool Smiles saying she needed 4 fillings, 2 root canals, and 5 crowns to my dentist saying she needed 2 fillings and 2 teeth out! Big freakin jump! huh?

And I called Masshealth and reported the abuse and they  and now have to send someone out to investigate.  And they are sending me papers to file a formal complaint.  And I am calling my local news station ( I have several connections there) and am going to try to get them to do an investigative report.  My dentist said they see this often from Kool Smiles or Small Smiles and on a regular basis from there group.  These kid dentist mills HAVE to be stopped!

Thanks for all the support girls!  I am So glad I got my happy ending!

Tuesday, August 03, 2010

Has Jason Owen Quit, Been Fired or None of The Above?

Did Jason Owen quit or give his notice?   Probably neither. 

There is a new ad out for a Regional Manager in Atlanta.  Maybe he is about to be replaced and just does not know it yet.  As with the Ohio ad, they need this new person because they have "growth plans".  Mmmm....Ok, whatever.  
Jason Owen


It was my understand that Jason Owen was/is in the process of finalizing the "Bait and Switch" contract FORBA is giving serious consideration implementing.  


Maybe Jason is moving on up in the Corporation, he is a real go getter.  Not so kid friendly though.  Reports of him having a melt down on sorts in an AZ clinic because the kids in the waiting room were too rowdy.  


He should hang around for their time in the operatory!  


While I am here, now is as good a time as any to bring a bit more of Jason to light.


Jason Owen -
DOB - May 16

Education - MBA in Finance from Georgia State University 2000Georgia Southern University 1995
Brookwood High School 1991
Parents - Jerry and June
Married - Wife Debbie Ritzler Owen - (DOB August 31)on April 17, 2004 in Maryland where they wre           living.
                 Debby -
                 Former banker in NYC where her and Jason met.
                 Parents - Pete and Jane-Divorced
                 Brothers - Tom - chef and Dan - land steward in Mashomack
                 Sister - name unknown
                 Marathon runner, loves gardening.
Children - 3 (1 girl from former relationship and twins with Debby.  Twins born 2006.
Brother - Brandon  
Pets - Scout and Brooklyn
Illness - Crohn's Disease - had surgery in February 2009 at Mayo Clinic in Rochester, MN
Moved to Atlanta in February 2007 
Employment - Sun Trust Bank, Atlanta GA  1995-1998
                         Hanger Orthopedic, VP and Treasurer June 1998-November 2007 (9+ years)
                         FORBA Holding SVP Regional Operations - November 2007 to Present
Friends - Thinks he and wife, Debby are besties with Michael and Nina Lindley.
Other Housing - Jason has an apartment in Nashville for he and/or the family to stay in when he's working at the Corporate office.



Monday, August 02, 2010

Ohio Regional Manager Needed At FORBA - July 2010

One just has to love this post for a position with FORBA.  They are planning expansion and now needing regional managers...  Ok, whatever.

Regional Manager, OH


If anyone does apply be sure to ask about contract changes in their future.  Consider permitting an attorney look it over before you sign it, since they are famous for 'imprisoning' employees.  

Check out the Non-Compete section if any, you may be locking yourself out of a job within hundreds of miles if you find you do not like the job.  Then what will you do?  Will you have to uproot your family;  better think about it.

Look closely at any Confidentially Agreement, remember they may require you to keep secrets that should NOT be kept.
 
Be especially vigilant; watch out for any
Non-Disparagement clauses!  Not good!  I would say in most circumstances it is a gigantic red flag, and I would run like the wind.  It is like signing away your First Amendment right to free speech at a time where it could be the  most crucial.
 
Also, ask about the contract they are going to need you to sign where you have to answer to the government.  It is their Corporate Integrity Agreement, and it is a doozey.

Related Atricle
Attn: FORBA Small Smiles Employees

Sunday, August 01, 2010

Skin Care Now Gets "Endorsement" From Pueblo Chieftain-No Big Surprise

It must be official; it is in the Chieftain, right?  More swift and easy health care, brought to you by Dan DeRose, Mike Roumph and the usual crowd and promoted by the Pueblo Chieftain.  Consistently the Chieftain appears to be the DeRose & Company's own propaganda publication.

Pueblo Chieftain, July 31, 2010

The building is owned by Pueblo businessmen and community leaders Dan DeRose and Mike Roumph. Pollock and Sbarbaro lease the building, and also have a management contract with a company comprised of DeRose, Roumph, Sbarbaro and Rich Lane, also of Pueblo.

Once again, the Chieftain had the gall to put the citizens of Pueblo at another health risk, brought to you by a DeRose "gang".   Talk about a "puff" review this is not a story it is an ad.


A quick overview is this; Dan DeRose and Mike Roumph, the two of the ring leaders in Medicaid Fraud and abusing children for profit through their Small Smiles Dental Centers were managed by FORBA, which they also were a part.  Have now partnered up with two more doctors; Dr. Jamie Pollock and Dr. Jim (kill 'em during the stress test) Sbarbar.  Dan and Mike are supplying the building and 'management' and Pollock and Sbarbar are providing the medical service.  NOW, does this sound like a scam or what?



Posted: Saturday, July 31, 2010 12:00 am
   It could take weeks, maybe even months, to have a Pueblo dermatologist look at a suspicious spot, mole or growth on your skin.

   You can telephone Skin Care Now and get in to see family practice physician Dr. Jamie Pollock the day you call or the next day — guaranteed.

   "We are here to give quality service, to study basic skin conditions the same day or the next day," said Pollock, co-owner of the center at 415 N. Grand.

  "We screen for atypical skin issues, then decide on treatment." Pueblo cardiologist Dr. Jim Sbarbaro also is a co-owner.

   Pollock explained that if a skin growth appears suspicious, he will biopsy it and send the sample to the lab.

   "If it comes back malignant, there are several options," he said. "We could refer the patient to a dermatologist or perhaps a plastic surgeon, for example."

   Pollock emphasized that he was educated as a family practice physician and that he in no way intends to supplant local dermatologists in treating skin conditions.

   "We're not trying to compete with someone with more training," Pollock said. "This is the first stopping point, a staging area for specialists.

   "If you wake up with acne, or if you have a spot that you'd like someone to look at right away, this is the place to come."

   Why not just have your family doctor do that?

   "First, there aren't many family practice physicians. Secondly, not all are willing to do the procedures."

   "They refer the patient to a dermatologist, and that may mean the patient has to wait weeks, usually months to see the doctor," he said. "This is a problem typical in many specialties, not just dermatology. There is a great shortage of specialists in Pueblo and nationwide.

   "We help not to delay the diagnosis. You haven't waited three months to see if you have a problem."

   About half of the patients who have visited the center so far have been Medicare or Medicaid patients. Sometimes, Pollock explained, such patients lack a family physician that they can see.

   Pollock, who has been in Pueblo since 2004 and completed his residency at St. Mary-Corwin Medical Center, said he also intends to "do some family practice, to an extent. That's important, too, to look at the entire patient, to study their conditions, the medicines they're on.

   "A patient can have a benign spot, but it might be a herald of a malignancy inside."

   "But the focus of the practice is on skin care that is available — now. We will answer the phone within three rings. We will see the patient that day or the next day. Plus, I'm on call."

   The new center — which markets itself as offering "treatment and diagnosis NOW for acne, rashes, moles, eczema, psoriasis, wart treatments, rosacea and suspicious skin spots — employs six staffers in addition to Pollock. It has eight examination rooms and plenty of parking in back.

   The building is owned by Pueblo businessmen and community leaders Dan DeRose and Mike Roumph. Pollock and Sbarbaro lease the building, and also have a management contract with a company comprised of DeRose, Roumph, Sbarbaro and Rich Lane, also of Pueblo.

   Lane explained that the management company provides accounting, advertising and marketing services.

   "If this meets a need, and we believe it will, then we might consider offering similar services in other locations," Lane said.

   The center's phone number is 924-8448. There will be an open house at the center from 5-7 p.m. Aug. 12.

Thursday, July 29, 2010

CanHouse Studios and Ballancing Act

You gotta love Letitia (Tish) Ballance's creativity for her business ventures in Waynesboro, NC.

CanHouse Studios, LLC (this sounds like the name of a porn production company to me)  This is a new one, just set up this month.

Ballancing Act, LLC  (this one I bet is dead on...lol)

Wednesday, July 28, 2010

Here It Is July 2010 and States Are Still Not Cracking Done On Kool Smiles-More Bad News

Have you been wondering how things are going at Kool Smiles?  Are they cleaning up their act?  You decide. Well here is a review of the Kool Smiles in New Bedford, MA:

From one Mother to another, here is a brief description of my experience with Kool smiles. One afternoon I was brushing my two year old sons teeth when I noticed a small pin size hole in one of his canine teeth. I immediately got online to find a dentist for my son that would accept my health insurance and when I came upon Kool smiles in the list of providers I was ecstatic! I had seen their commercials on television and I knew it would be a great place to bring him because the entire place was geared toward children his age. I called to setup the appointment which I was able to get very quickly (now I know why). We arrived the morning of our visit and my son could not have been more excited to find a little climbing area with a slide and other children to play with while he waited, I thought "what a great idea to make the dentist seem like a fun place to try to ease the fear of the little ones instead of having them sitting in a waiting room fearing what would happen when it was their turn". I filled out the usual new patient paper work and after about 40 minutes we were in the room getting x rays and an exam. When the dentist came in the room to examine my sons teeth and look over his x rays she had found that he had six cavities in his mouth and she decided that it would be appropriate to grind down all six teeth and put metal caps on each one of them, I expressed my concern that the cavities were so small they were hardly noticeable to the naked and eye and I didn't see why such extreme measures needed to be taken for such small holes. The dentist had explained to me that they are not able to fill cavities in young children's mouths because they don't last very long when the cavities are "so deep" and that in their office they will not fill them because it isn't their policy. I was very disheartened with their solution to fix my two years old's teeth so much so that I had decided to go and get a second opinion. I called a new office and got an appointment for four weeks later. When I brought him to this dentist the cavities had gotten a lot worse because they were untreated for several weeks while I was waiting to have him seen. We went in the examination room and and had the same exam done, and they reviewed his x rays and the dentist told me that the cavities were so minimal that he wouldn't even need to use Novocaine to get them filled since they were only on the surface and had not reached the nerve (mind you kool smiles couldn't fill them because they were "so deep"). He said there was no way that he would need to have any of his teeth capped because the cavities were so minimal. Walking out of the office that day I had felt such a huge sigh of relief that my toddler didn't have to have his teeth ground down and metal caps placed over them!  Needless to say I would NOT recommend Kool smiles in anyway they are money hungry and would go as far as putting an innocent two year old through many painful unnecessary trips to the dentist to be left with a mouth full of metal caps just to make a buck. Please don't fall for their commercials... the way they get their money to pay for them is completely disheartening and unethical.

Monday, July 26, 2010

Up A Creekview - William Nash, DDS

The William Nash, DDS that appears on so many of the Small Smiles, PC and PLLC filings at state Secretary of State sites is 

William Nash, DDS
1450 SAM DAVIS RD
SMYRNA, TN 37167

You can find his name and address at the Nebraska Secretary of State site by searching Small Smiles.  He's listed as President and Randy Ellis, DDS as director.

Dr. Nash also has a clinic in Smyrna, TN called Creekview Dental.  Amazingly, Creekview Dental has the exact same address as William Nash, DDS on all of FORBA's Small Smiles clinics.

Dr. Kenneth Knott began as being the only person on the Board of Directors.  In the original Article of Organization it states the President shall be a shareholder and a director.  Joseph Bower, Esq was VP.

By March of 2008 Dr. William Nash was President and Kenneth Knott was secretary.  Wow, that was a demotion!

Presto Chango in September 2009, William Nash, DDS was demoted to secretary and Randy Ellis, DDS took over the presidency.  Wooo Hooo.. But what,  oh what happened... to Kenneth Knott,.... oh that's right he was fired along with Robert Andrus in or about September 2008.

The "Professional employees" listed on the  "Professional Certificate" since 10-2006 were:

  • Joseph Brett Carranza, DDS (he was there in 2008 but abcent from Professional Certificate by the 2009 filing)  I guess he had a 'come to Jesus' moment and got the heck out of there. However, in googling Dr. Brett, his address comes up as 618 Church Street, Suite 520, Nashville, TN., FORBA Holding's address and I can't find that he is practicing anywhere else, so maybe he's still there.  I dunno.
  • Carl Trout, DDS
  • Preeti Singh, DDS (who has a Scottsdale, AZ address)
  • Christopher RJ Wieseman, DDS
  • Jamie Lynn Bass-Schwaniger, DDS
  • Julie Cariglio, DDS
  • Maria Nosworthy, DDS

By March 2010 William Nash, DDS was back in as president and Randy Ellis, DDS to secretary.

Clearly that don't have a clue who is what do they?

Dr. William Nash, DDS and Dr. Randy Ellis, DDS should probably read those Articles and pay special attention to Article X part D.

BTW, FORBA is looking for lead dentists and associate dentists for the Nebraska clinic with a $15K signing bonus.  Before you bite, you should read the Bait and Switch posts below.

Anyway, just want to make sure no one forgets those who lend their name and professional licenses to the fraud and child abuse perpetrated by FORBA and it's dental clinics.

Parent Wishes She Had Googled Dr. Robert Andrus Before Going To Giggles Dental In Colorado

A parent posted this comment on the Giggles Dental post, I thought it was worth posting here so everyone realizes Dr. Robert Adrus is using his skills, learned by the DeRose bunch and Forba training sessions, to good work.   I am amazed he was fired for credentialing fraud, when their whole business plan is based around fraudulent behavior and abusing children.
Dr. Robert (Bob) Andrus

I hope this mom first heads to Giggles and obtains her children's records, asap or quicker.  Second, files a complaint with the dental board so they will investigate, they know Dr. Adrus.  Third takes the records and the x-rays from Giggles Dental back to her dentist at "A Wild Smile" for comparison.  Forth, files a complaint with her dental underwriter, whether it is a private insurance carrier or Colorado's Medicaid program.  Don't forget each state has a Medicaid Fraud Control Unit
The quicker this mom makes the complaint, the quicker the next child isn't overtreated.   Everyday, all day long,this is happening to children visiting Giggles Dental.  This crap has got to stop! 
I used to drive 25 minutes to A Wild Smile, and I was always very pleased with their work. I switched to Giggles because it is only 5 minutes from my house, but it has been nothing but trouble. None of my kids (ages almost 7, 8, and 9) had ever had a cavity before. On our first visit Dr. Andrus said my youngest had 1 small cavity - not unbelievable considering her age. We came back and got it filled, no problem. On our second cleaning visit, I was told my oldest daughter, who'd had her molars sealed at Wild Smile, needed to have her teeth resealed. I didn't realize sealant didn't last, so he resealed them. He also told me my youngest had 1 very small cavity and two naturally occurring pits in her back teeth that he felt should be filled even though they weren't cavities. Fine. I took her back and had the pits filled, she didn't need anesthetic. My husband took her in for her the actual filling a month later. She came home with three fillings! Or so the bill said. In addition to that, within minutes of leaving his office, my daughter's lip developed an enormous and disgusting canker sore. He said she bit her lip, but that is what the cotton roll is supposed to prevent, right? I think he clipped her with some dental tools, but I can't prove anything, so I just treated it with peroxide. I didn't bother to fill the prescription he gave me for Children's Tylenol with Codeine - it seemed like a ridiculous prescription for a canker sore. Anyway, I reminded him that he told me my daughter had one cavity and two pits - he said she had 3 cavities and 2 pits. If I had been told that my daughter who'd had the only cavity out of all my kids now had three cavities six months after her last cleaning, I would have remembered that and had a fit on my kid!
I wish I had Googled this guy before I left a perfectly good dentist merely for a convenient drive from my house. I'm just lucky it wasn't worse.
It worked out perfect for the dentist in this case since the same parent who came the first time, was not the one who brought the child back for treatment. 
This is just a small example why it's so important to track these dentists who have been employed by FORBA Small Smiles, Kool Smiles, Dental Dreams and all the other mills.

Sunday, July 25, 2010

Inside The Mind Of A 4th Year Dental Student

I ran across this blog and got a quick glimpse into the mind of a 4th year dental student and his attitude toward children and clearly if he's not being taught this stuff at the University of Illinois - Chicago School of Dentistry he is not being taught the proper way to handle them.
  • "Man Handle"
  • "Going Medieval on them"
  • "Papoose their ass"

Sunday, July 25, 2010


Profiling the Pediatric Patient

After spending four weeks (with one more to go) at a clinic devoted solely to pediatric dentistry, I have begun to notice that every patient falls into a specific pre-determined (by me of course) category. Allow me to elaborate:
KEY:

Tell-Show-Do = this is when you show the kid everything you are using (aside from the needle) and explain what it does. For example, I will let them see the mouth mirror before I use it. I will show them my “tooth fixing wand” (the highspeed) and show them the noise it makes and even spray their arm with the water a little so they see what it feels like. This goes on as necessary.

N2O = Nitrous Oxide, a commonly used anxiolytic in the medical setting.     Easy to use, easy to remove the effects, and pretty much no chance of killing someone.

Manhandling = when all else fails, you just go medieval on the kid to get the job done. This includes papoose boards, head holding, mouth props, and half-assed dentistry. Really, there is no way to do a great job on a patient with zero compliance. You just need it to last long enough for the permanent teeth to get in. Manhandling is more commonly used for the 6 and under crowd but there are always exceptions.
Difficulty = a generic scale of how tough the kid is to work on. Scaled out of five. One being easier than an adult, and five being extremely tough (general anesthesia candidate).
And now for the profiling!

The Vomiter:
This patient, like most kids, wants nothing to do with the dentist. Once you papoose their ass and headlock them with two assistants, they still find ways to defend themselves. Frankly, they try to puke all over you. And it isn’t friendly gurgling puke, it is projectile – get in your eyes puke. What’s worse is that they inadvertently could kill themselves by choking on said puke. So you need to brave it out to suction all that shit up (god bless the assistants). The only way to tackle this patient is to wait out the vomiting because they will eventually run out of ammo.
Tell-Show-Do - ineffective
N20 - ineffective
Manhandling - marginally effective
Difficulty = 4/5

The Old Man:
This patient is actually pretty relaxed. Nitrous can work wonders sometimes. They may still get crotchety during the injection, but afterwards they will just sleep – THE ENTIRE APPOINTMENT. A real treat to work with. Only annoying when mom comes back and thinks I OD’d her kid on nitrous…bah.
TSD - unnecessary
N20 - extremely effective
Manhandling -unnecessary
Difficulty - 2/5

The Stoner:
A close relative of “The Old Man,” this patient wants nitrous and wants it bad. It may be hard to associate a 9 year old with a 25 year old pot-head. But when one sees these kids craving the “magic nose,” one can’t help but make the comparison. These patients generally are pleasant to work on because they are riding the good waves of N2O. I’ve even had kids laughing while getting a block…crazy.
TSD - Pointless, they aren’t listening
N20 - EXTREMELY effective
Manhandling - unnecessary

The Question Asker:
This patient simply doesn’t shut-up. They constantly need to know what you are up to. N2O is only marginally effective because they never stop talking. TSD is only helpful to a certain extent because I still haven’t found a pleasant way to show them the 25gauge needle. I am good at hiding it like a magician though. These patients can be really easy or really tough – they are unpredictable.
TSD – Marginally effective
N2O – Marginally effective
Manhandling – Effective when necessary
Difficulty – ranges from 2-4
Difficulty - 2/5


The Victim of Circumstance:
Perhaps the most depressing patient to work on. This is the kid who shows up with cheetoes all over his teeth and a bag of skittles in his pocket. This is the patient with parent’s that are ignorant, negligent, or just suck at parenting. “I can’t get him to shut up at night without giving him a bag of Doritos and a pepsi” is the most ridiculous thing I have ever heard. Suck-it up and lay down the law. These kids are generally too young to know any better, so it is really the parent’s responsibility to take care of them. Unfortunately, I see a lot of neglect going on.
TSD – variable
N2O – variable
Manhandling – variable
Difficulty – variable

 The Momma's Boy:
This patient generally arrives clinging to mom and is too old to be exhibiting such behavior. They generally freak out once detached and go one of two ways: total meltdown or total calm. Again, a bipolar patient type. If they freak out, being extremely stern often solves the problem immediately. Parents are not allowed in the operatory if the kid is 5 or older so this type is always a wildcard. After the procedure they always run straight back to their leech like hold on mom’s leg.
TSD – Effective to Useless
N2O – Effective to Useless
Manhandling – always effective
Difficulty – 2 to 4

The Screamer:
Name says it all. This patient screams the entire appointment with variable pitches. Surprisingly easy to deal with if you aren’t fazed by the noise. The papoose is usually all that is necessary, they rarely thrash their heads around.
TSD – ineffective
N20 – ineffective
Manhandling – very effective
Difficulty – 3/5

The Negotiator:
This patient will do anything to get out of the chair. They will bargain with you. For example, "please don't put that in my mouth (bite block), I promise I'll keep my mouth open." You may fall for the negotiator at first, that is until they bite down on the running bur and change that small occlusal composite into a pulp/crown. I usually just re-negotiate. "Be good and you get a shiny toy." If this doesn't work - proceed to manhandling.
TSD - slightly effective
N20 - slightly effective
Manhandling - effective if necessary
Difficulty - 2-3/5

The Mongolian Warlord:
Containing attributes of both “The Vomiter” and “The Screamer,” this breed is the absolute worst. They are combative, spit at you, vomit on you, scream at you, and essentially struggle the entire time. Unlike other difficult patients, they don’t get tired. These patients unfortunately seem to have the most neglect as well in terms of oral hygiene. If they require multiple pulps/crowns – they are best referred to a hospital for general anesthesia, there is no way you can get it done acceptably otherwise.
TSD – ineffective
N2O – ineffective
Manhandling – ineffective
Difficulty – 5/5

The Angel:
This is the type of patient that makes you happy to be a dentist. They are cooperative, exhibit very little apprehension, and are just cute as the dickens. TSD and N2O are always effective but are often not necessary as the patient will be compliant regardless.
TSD – often unnecessary
N2O – often unnecessary
Manhandling – unnecessary
Difficulty – 1/5

I may add or edit this post as the year goes on.   I haven’t covered all the types – just the most common run-ins for me so far.
PS. sorry for the lack of spacing after periods. I swear I didn't type it up like that... but the mystery makes it even more exciting right?



 From The Blog of 4th Year Dental Student - Skeletor, DDS