Campaign Desk — April 13, 2012 06:15 AM Every once in a while an interesting, well-done piece from public radio comes along that makes you think. This week came a story about a new war in the Great Plains region. You might call it The War of the Dentists and their Competitors. Kansas Public Radio health reporter Bryan Thompson examined a simmering dispute between traditional dentists—the ones who like to treat well-heeled patients in big city suburbs—and those professionals who want to become licensed as Registered Dental Practitioners (RDPs). These practitioners’ training places them somewhere between a regular dentist and a dental hygienist, and they would be able to fill cavities and perform simple extractions of children’s teeth.
A Sumter dentist convicted of child molestation and found to have possessed child pornography 12 years ago is trying to regain the privilege he once enjoyed of practicing dentistry without restrictions or reduced restrictions, including treating children as patients.
The case of Russell Hurst Jr. is now playing out in the S.C. Court of Appeals, where his lawyer is arguing in a legal brief that Hurst has in effect been pronounced rehabilitated by a behavioral expert and should be free of all restrictions placed upon him by the S.C. Board of Dentistry – restrictions that currently allow him freedom to oversee a Sumter dental practice but only see adult patients.
Just a reminder today is the day of the big Texas Dental Board Meeting, the one where the Dental Board Executive Director didn’t want to attend, so she resigned.
Since there seems to be confusion in the world of prosecution and regulation as to whether these corporate dental companies, such as Kool Smiles, Aspen, Heartland and now Wal-Mart, are legal or illegal there is a comprehensive review of all 50 states ready, just for the clicking. Go ahead, try it. CLICK HERE
Dental boards say they don’t regulate the corporate mills in any way, however, North Carolina is proving that not to be true. So far, it’s the only state taking the initiative but it’s unclear as to whether they are only targeting Heartland Dental or all, and I mean, ALL corporate dental practices. [I say this since I know there are some regional clinics operating at full speed down there with dollars headed directly to Colorado’s Michael DeRose’s pockets. By the way, he’s on the List of Excluded Individuals and Entities, where he’s not to profit from Medicaid in any way. But, heck, I know that’s small potatoes, right?]
Persecutors, on every level, from the local city or county prosecutors all the way to “The” Attorney General of the United States, seem to ignore the fact that the corporate dental mills are just flat out illegal operations. Every bill they send the US taxpayer is a fraudulent bill! Every one of them!! Every treatment they deliver within their walls is illegal to do! Every x-ray taken, is being done so, illegally. What is not to understand and what are they failing to “get”? Anything?
The corporations should not be ripping the taxpayer from stem to stern, using taxpayer dollars as toilet paper on their $10 million jets and authorities should be lined up outside these place with warrants and handcuffs.
This dragon has been slayed and quartered on this website, time after time, after time, after time, for well over 4 years now and Medicaid fraud is still a run away train when it comes to dentistry.
Since December there has been a noticed increase in individual dentists getting nailed for Medicaid fraud, with most of them getting some jail time along with their fine and repayment. Remember, the Medicaid fraud in dentistry is mostly treatment on children in case anyone has forgotten that!
So for any prosecutor with a set of balls out there, even if you have a teeny weeny set, that just might want actually bring criminals to justice-criminals who are not only stealing from the taxpayer, but physically hurting children-click here and check your state laws. It’s all laid out for you, it just cant’ get any easier, truly. Then get a warrant and shut these places down. If you need assistance, call me. Hell, I work for free!
I don’t know a thing about it, but thought this should be kept around for those “eat your words” moments that usually come up at a later date. lol
Yesterday the Kellogg Foundation issued a report about using mid-level providers for dental treatment and the American Academy of Pediatric Dentistry responded. Both are below. I’m not exactly sure what the issue is with “mid-level” providers. A whole heck of a lot of the Medicaid dentists are barely “mid-level” in training, so that can’t be the issue. (sorry, I couldn’t help myself)
BATTLE CREEK, Mich. – An extensive review of the literature documenting care provided by dental therapists and clinical outcomes worldwide indicates that they offer safe, effective dental care to children. Released today by the W.K. Kellogg Foundation, the study reviews more than 1,100 reports regarding dental therapists and their work in various countries. The report documents evidence that dental therapists can effectively expand access to dental care, especially for children, and that the care they provide is technically competent, safe and effective. In addition, the review also showed that the public values the role of dental therapists and there is strong patient and parental support for their work.
Disclaimer - I am no dentist. I am no Chemist. I am no Writer. Yesterday there was a report about the direct relationship between low-level radiation exposure from dental x-rays and brain tumors. The article tried to reassure us that the tumor were “usually” benign, though, so don’t worry.
It’s starting to look like the children that can’t be maimed with brain tumors, may well be killed off with cancer.
What am I talking about?
“Formecresol”, sold under the brand name Formo Cresol.
I mention the rat poison because of the fluoride controversy, since rat poison is all but 100% fluoride, at least one state has out lawed it’s use in drinking water! More on Fluoride here. Hawaii addressed this back in 2003.
But back to the Formacresol. Formacresol is a mixture of Formaldehyde (embalming fluid) Cresole (used in Sharpie markers) and glycerin. (Formocresol: 48.5% formaldehyde, 48.5% cresol, 3% glycerin.) Buckley's Formocresol: 19% formaldehyde, 35% cresol, 17.5% glycerin. It is used as a “medicated dressing” within the tooth chamber after the pulp has been removed.
In 2011 Formaldehyde was listed as a “known human carcinogen- i.e. it’s known to cause cancer in humans.
The National Institute of Health says this drug has NOT been found to be safe and effective by the FDA, nor has it’s labeling been approved. Link here
In January 2010 the FDA issued a recall on several lots of Formo Cresol manufactured by DSHealthcare, Inc. d/b/a as Sultan Health Care, Hackensack, NJ. The lots were sold by Henry Schien and Super Dent.
There are other bactricides to use inside the tooth that do the exact same thing as formacresol, only safer and better, but guess what? Formacresol is cheaper! Guess what the dental mills who are supposedly saving the teeth of the poor children are using? Here is a search for substitutes.
Although Formacresol remains within the standard of care, it has been debated about its safety for years, and each year that passes, more and more are calling for its ban, kind of like the amalgam fillings thing.
During the recent media blitz on sedation dentistry for children, namely the one on March 12, 2012 on The Denver Channel. Dr. Mark Koch said he was about to treating 16 out of 20 baby teeth on a patient. Janine Consantini said that the day before they had a child who had something done to every tooth in his head.
I’m wondering if anyone is assessing or tracking the children who have been treated by the mass treating Medicaid dental mills and their patients increase in cancer? This formacresol is being place on an open blood source, via a soaked cotton pellet and left there, then a crown placed on top of it and there until the it’s absorbed into the child’s body and/or the tooth falls out. If no one is looking at this, I ask why not!
Is it the same reason no one is tracking these sedation deaths?
I’m highly suspicious about articles like the one below or the latest sedation dentistry media blitz. I have to wonder if these are meant to drive home the request the ADA and the AAPD made to Centers for Medicare and Medicaid dated July 12, 2011 where they were crying and whining about the audits being “too aggressive”. Evidently they made a home run in NY since it was recently announced NY relaxing it’s audit.
(NEW YORK) -- “It’s time for your annual X-rays.” This is what millions of Americans are told when they visit the dentist. But new research out of Yale finds dental X-rays may be linked to increased rates of brain tumors.
Meningioma is the most common type of brain tumors that originate in the brain and spinal cord, making up one third of these. People who were diagnosed with meningioma were compared with healthy individuals. They were asked how often they had the most common type of dental X-ray, called a bitewing, which involves placing an X-ray film between the teeth and shooting the film from outside of your cheek. In those who reported having this type of X-ray once a year or more the risk for meningioma was 1.4-1.9 times increased depending on their age.
Another type of dental X-ray, called the Panorex, that rotates around your head taking a picture of all of your teeth from outside your mouth was associated with an almost five-fold increase in rates of meningioma when the X-ray was performed before age 10. For those older than 10 there was a 2.7 to 3 fold increased risk when this X-ray was performed once a year or more.
Current recommendations by the American Dental Association do admit that there is little use for dental X-rays in healthy people without any symptoms, but still recommends X-rays of healthy children be taken every 1-2 years and every 2-3 years for healthy adults. The authors think these guidelines may need to be reevaluated in the wake of their findings.
Reactions to the study have been mixed. For critics, the design of the study has some serious flaws. The main weakness is the failure of the researchers to obtain any of the patient’s dental records to verify that the number of X-rays they reported having was true, says Dr. Richard Besser, ABC News' chief health and medical editor.
“People with cancer are more likely to remember having dental X-rays,” explains Besser. “They are searching for some cause of their cancer and may incorrectly attribute it to any number of factors.” Dr. Besser also points out that the study failed to find any connection between having braces and risk for meningioma. “When you have braces you remember that clearly, and people who have braces on average undergo more x-rays than people without braces,” says Besser.
Dr. Alan G. Lurie, a Ph.D. radiation biologist who specializes in cancer induction and is president of the American Academy of Oral and Maxillofacial Radiology, agrees with Dr. Besser that the study has a serious flaw.
“They’re asking people to remember (in some cases) a couple of radiographs they had 30 years earlier when they were kids. They’re not going to be able to tell you what kind of X-ray machine was used…what kind of film, were there any retakes?" Lurie says.
Other doctors see this as a strong study and think that it raises valid concerns. “The current study is well-done and confirms that even in the ‘modern era’ radiation exposure from repeated dental X-rays conveys an increased risk of these tumors,” says Dr. David Schiff of the Neuro-Oncology Center at the University of Virginia.
Overall, doctors are not surprised that dental X-rays could cause this type of tumor because the type of radiation that X-rays give off is known to be associated with brain tumors. “Ionizing radiation is the only well-accepted environmental risk factor for development of meningiomas," says Dr. Schiff.
However they warn that this study cannot prove that dental X-rays cause brain tumors. It can only reveal a possible association between dental X-rays and tumors.
Still, there are some important things people can do to minimize their exposure to dental X-rays. For example, patients can ask their doctors whether X-rays are completely necessary, or how much radiation will be delivered by the various options available.
“All health professionals should be thinking that for our patients, each exposure must be beneficial and we should be of a mindset to do the fewest exposures possible to obtain needed diagnostic information," explains Paul Casamassimo DDS, professor and chair of pediatric dentistry at the Ohio State University College of Dentistry and chief of dentistry at Nationwide Children's.
Overall, experts hope that as a result of this study the public gains new awareness of a potential risk and will take their concerns to their dentist.
Dr. Paul Casamassimo is on the Advisory board of one of the nations worst offenders- Small Smiles Dental Centers, owned and operated by the bankrupt Church Street Health Management. Dr. Casamassimo should heed his own warnings!
He should be asking his colleague, Dr. Steven Adair about the unnecessary x-rays taken at the Small Smiles Dental centers, and the fraud involved in said unnecessary x-rays, especially at the Denver dental centers with Dr. Minh Tia and his office manager! I believe that amounted to some $200k between June 2010 and June 2011! Just saying….
In an article about “Dental Therapist” dated April 10, 2012, it mentions Dr. Paul Casamassimo is the AAPD Pediatric Oral Health Research and Policy Center Director.
Academy of General Dentistry Responds to Dental X-Ray Warning: Thursday April 12, 2012
CHICAGO, April 12, 2012 /PRNewswire-USNewswire/ -- On Tuesday, April 10, 2012, in the journal Cancer, the American Cancer Society published an article entitled "Dental X-Rays and Risk of Meningioma," which summarized a study that sought to develop a correlation between dental radiographs and brain cancer.
According to the Academy of General Dentistry (AGD), a professional association of more than 37,000 general dentists dedicated to providing quality dental care and oral health information to the public, the study's findings are not applicable to modern dentistry because the study was based upon an examination of outdated radiographic techniques, which produced considerably more radiation than patients would be exposed to today.
"Modern radiographic techniques and equipment provide the narrowest beam and shortest exposure, thereby limiting the area and time of exposure and reducing any possible risks while providing the highest level of diagnostic benefits," said AGD President Howard Gamble, DMD, FAGD. "Today, patient safety is always maintained with the recommended use of thyroid collars and aprons."
The article from the American Cancer Society, which received attention from many reputable news outlets, could cause the public to decide to limit or even refuse X-rays in an effort to keep their families safe.
"It is regrettable to think that an article based on outdated technology could scare the public and cause them to avoid needed treatment," said Dr. Gamble. "With the radiography techniques in use today, the amount of radiation exposure is reduced and more controlled than it was in years past."
The AGD supports radiographic guidelines provided by the American Dental Association (ADA) and the U.S. Food & Drug Administration, and concurs with the ADA that dentists should order dental radiographs for patients only when necessary for diagnosis and treatment.
The AGD encourages patients to discuss their concerns with their dentists in order to determine what's best for them. The AGD also encourages dentists to communicate with their patients and address any unexpressed concerns of radiographic risks in order to reduce fear and promote a better understanding of the benefits and the risks associated with the specific needs of each patient.
"Neglecting one's oral health has serious oral and systemic risks," said Dr. Gamble. "Radiographs play an important role in improving the oral health of the public, and patients should not be deterred from seeking oral health care due to misperceptions from this study."
The Cancer study contained many inconsistencies and possibilities for error, including the fact that its findings were based upon a population-based case-control study. This means that it relied upon the patients themselves to recall and self-report past events, many of which were from decades earlier.
The AGD supports ongoing scientific research on any correlations between dental radiographs and incidents of disease in an effort to provide the most accurate information to the public and to correct any misperceptions created by the Cancer study.
About the Academy of General Dentistry The Academy of General Dentistry (AGD) is a professional association of more than 37,000 general dentists dedicated to providing quality dental care and oral health education to the public. AGD members stay up-to-date in their profession through a commitment to continuing education. Founded in 1952, the AGD is the second largest dental association in the United States, and it is the only association that exclusively represents the needs and interests of general dentists. A general dentist is the primary care provider for patients of all ages and is responsible for the diagnosis, treatment, management, and overall coordination of services related to patients' oral health needs. For more information about the AGD, visit www.agd.org.
SOURCE Academy of General Dentistry
All I have to say here is that the AGD or any other of the D’s are not to quick to come out against reports that are loaded to the brim with “old” and “outdated” studies if it could possibly generate revenue.
Rob Walton, and Wal-Mart version of “owner dentists”, Dr. Andre Bruini and Dr. Chris Comfort, should read these before they delve much further into the abyss and Land of Oz.
BTW, this Wal-Mart thing might get a bit “sticky” besides being “shady”. I’m seeing Stark Law issues-if they take Mediciad-Medicaid, or Anti-Kickback issues, IRS issues on “employee vs. contractor”. Lots of stuff on this to come.
I decided to read over some more of the thousands of pages filed on the Church Street Health Management/Small Smiles dental bankruptcy filings as we did our family travels this weekend. What caught my eye was a 140 page Affidavit of Service. The list was very interesting, and what,or should I say who, was on this listed was what really made an impression.
First, in my loose estimate there are some 800 to 1000 minor children who have lawsuits pending against this criminal enterprise for abuse, mistreatment or overtreatment and blatant malpractice.
Second, you know those whistleblowers who blew the lid off this particular criminal enterprise back in 2007 The one that finally reached a settlement in January 2010. Well, they are on the “notify” list, meaning they are to be “served” copies of all these documents, or most of them anyway.
Now, that means not only did Church Street Health Management and their host of Small Smiles dental centers fail to pay the fines (they call it a settlement) imposed by several states-some states have been paid more than others-but the whisleblowers have not received their full rewar$ for the hell they went through, filing lawsuits and turning these bastards into the Department of Justice.
There were two or three in the Virginia and DC area as well as Mr. Haney in South Carolina.
I think this issue on Whistleblowing needs some tweaking! One thing for sure, is criminals aren’t good credit risks.
Speaking of credit, Church Street Health Management and their Small Smiles centers sure have a lot of people to whom they owe a shit load of money. For a criminal enterprise to go belly up just over a year after the Feds begin keeping a much closer eye on their operations, by way of that Corporate Integrity Agreement, the CEO Michael Lindley signed, says a lot. A WHOLE LOT!
To me it says, unless we break the law, and commit malpractice on most of the children we profess to care so much about, to rip off Medicaid this business model is not for the profit minded.
I’ve not downloaded and read all the documents of the bankruptcy yet, but, I certainly will. I’ve not found their detailed list of Assets and Liabilities just yet. Last I read said basically they were working on it. I’m just guessing, but I bet this one has to be the one of the most creative “assets” lists the Federal Court system has ever seen.
I’m sure there will be some sort of “pecking” order to settle up these debts, whether there is some fool ass Wall Street firm or Private Equity scumbags to snatch up this hot mess company, which I doubt, by the way.
But the children they have abused and the ones still waiting out there to be compensated for their pain and suffering should be number one, the taxpayers number two and the whistleblowers number three and it would be a tie between, Al Smith, Michael Lindley or Steve Adair down there in Hilton Head last, and should be barred from any claim whatsoever!
Some other notables on the list are:
Lisa DeRose; Ameris – Lindley’s other business and the one that owns the plane and the condo in Florida; and, Jake and Jenna Kochenberger
On the one year anniversary of Jenny Olenick’s death, Medscape posted, what I refer to as “Anesthesia Media Blitz II”. Since early March, the AAPD and other associations have released various press releases promoting putting children to sleep to perform dental procedures. The Medscape article is the second round. Medscape could have posted a story on the hazards of such practices, but didn’t. I’m not saying it was on purposely, however, I’ve learned seldom are stories published without reason.
April 6, 2012 — Pediatric dentists cannot find enough dentist anesthesiologists to meet the needs of their patients, according to a survey of pediatric dentists published in the spring 2012 issue of Anesthesia Progress.
The survey responses differed somewhat by region, sex, and years in the specialty, with 20% to 40% of participants saying they currently use a dental anesthesiologist and 60% to 70% saying they would use one if one were available.
The demand for dentist anesthesiologists has been increasing in recent years in pediatric dentistry, according to a separate survey of dental anesthesiology program directors published in the same journal.
"The trend in the past has been that many dentists provided [both] anesthesia and dental care," coauthor James Jones, DDS, chair of pediatric dentistry at Indiana University in Indianapolis, told Medscape Medical News.
Now, many pediatric dentists would prefer to concentrate on the dentistry while someone else focuses on anesthesia, he said. "We're realizing that it's a safety issue."
Dr. Jones said researchers at the university had become aware of the need for anesthesia in their patients because they provide service to a lot of low-income patients who need extensive dental work of the type that often requires general anesthesia.
To see what other pedodontists were experiencing, they sent out emails to all 2586 active board-certified pediatric dentists who are members of the American Academy of Pediatric Dentistry and who made their email addresses available, asking them to participate in an online survey.
The messages bounced back from 659 of these, leaving 1927, of whom 494 completed the survey.
Participants disclosed their sex, age, years in practice, region, number of years as a diplomate of the American Board of Pediatric Dentistry, use of in-office sedation, and use of intravenous (IV) sedation. They also commented on their use of a dentist anesthesiologist.
The respondents differed in their use of anesthesiology by demographics. Thirty-nine percent of women answered "yes" to the question, "Do you use the services of a dentist anesthesiologist?" compared with 23% of men, which is a statistically significant difference (P < .01).
Only 12% of those in practice for longer than 21 years used IV sedation in their office, and only 25% of this group used dentist anesthesiologists (P < .01). Although only 53% of this group answered "yes" to the question, "Would you use the services of a dentist anesthesiologist, if available?" this percentage was not statistically significant compared with dentists who have been in practice for fewer years.
In contrast, 30% of those in practice for 5 years or fewer used in-office IV sedation, 38% used dentist anesthesiologists, and 74% would use dentist anesthesiologists if they could (P < .01).
Group practices were least likely to administer in-office sedation; solo practices were the most likely.
Practices in the Southwest were most likely to use in-office sedation. Westerners were most likely to administer in-office IV, employ dentist anesthesiologists, and use dentist anesthesiologists if they could.
Dental Anesthesiologists Address Many Needs
Dr. Jones said the finding points to a need for more training programs for dentist anesthesiologists. "I think the demand is going to increase over time," he said.
He pointed out that bringing an anesthesiologist into the office is half as expensive as taking the patient to a hospital or day-surgery center for anesthesia.
American Academy of Pediatric Dentistry Spokesman John Liu, DDS, agreed, noting that hospitals and surgery centers charge for the use of their facilities.
Dr. Liu, a clinical assistant professor of dentistry at the University of Washington in Seattle, told Medscape Medical News that pediatric dentists are in greater need of help from dentist anesthesiologists for several reasons.
First, more children are being diagnosed with behavior-related conditions such as autism and attention deficit disorder, he said.
Second, fewer parents are comfortable with having their children physically restrained through frightening and sometimes painful treatments. "The reality is that it's not an easy thing to sit through something like that," Dr. Liu, who has a private practice in Issaquah, Washington, told Medscape Medical News.
Dr. Liu also said that some state dental boards prohibit dentists from providing general anesthesia or deep sedation, even if they have completed residency programs in anesthesiology, and he thinks these regulations should be changed.
"I find it tremendously helpful to have a dental anesthesiologist, as opposed to an MD anesthesiologist, because he knows exactly what I'm doing and when I'm going to be done," said Dr. Liu. "I have used a dental anesthesiologist for more than 20 years, and I don't know how anybody manages without one."
Dr. Liu and Dr. Jones have disclosed no relevant financial relationships.
Current recommendations by the American Dental Association do admit that there is little use for dental X-rays in healthy people without any symptoms, but still recommends X-rays of healthy children be taken every 1-2 years and every 2-3 years for healthy adults. The authors think these guidelines may need to be reevaluated in the wake of their findings.