Mothers Comments RE:Smiles High Clinic, Kool Smiles

"OnTipToe" from Colorado reported the following story:
January 2008

If you are relying on medicaid coverage and seeking dental care for your child, who is insured, watch out for this! One company, called "Small Smiles" and in our city they were called "Smile High" has been known to have this type of BAD practice!
(blogger note: Smile High's Lead Dentist was Dr. Tu Tran, the founder of Kool Smiles in Georgia.)

I took my twin daughters there for their first visit to the dentist when they were 18 months old. Main reason for going there was it's close proximity to my home. We are in a poor part of central Denver.
Strangely, and for the sake of my girls, I was involved in CNA clinicals at a local hospital at this time. The very day, I spent several hours in a class at the hospital discussing the federal laws governing restraint of patients in hospitals and LTC facilities. So, I was educated on this and it's ethical and moral issues.
When I got to the dentist, the first thing I had to do was read and sign a consent form for treatment which listed the 10 ways that the dentist might restrain my child for treatment. This threw me, given the class I'd just had. I was very surprised, this being my first experience taking kids to dentist, that this was a regular part of their practice. When the clinician came out to call one of my daughters back, I got up and started gathering everyone up. She said, "You can't go back." I was aghast! What do you mean? Don't you see this is just a baby? I will go with her, as well as her twin! Well, none of the dentists will treat the child with the parent present, I was told. I couldn't believe it!
So, I asked for the records that I filled out and signed, as well as that restrain form. I left. Not before hearing a young dentist tell me that ALL pediatric dentists were trained in this practice of restraint and disallowing parents into exams. He warned me that I would not another dentist in this city who would allow me to accompany my child into the exam. I told him that my child would just not have dental care then!
Next day, I took that form into class for my instructor to see. She told me that EVERY form listed there was patently illegal practice with ANY patient in the US, by FEDERAL law. So, my advice: if you or your child is subjected to this practice when going to the dentist, call them on it. Tell them you'll report them to the Dental licensing board for illegally using restraint.
Thankfully, we have found a great pediatric practice here in Denver which has wonderful doctors and staff. They always allow me to be present for exams and NEVER use restraint or scare tactics for treatment. They are clean, bright and have a great attitude. And all my children, the twins are 9 now, son 6 and daughter 3, enjoy their visits to the dentist without fear. It's called Primary Dental and they are located in Wheatridge, CO.
I have heard some horrible news reports about children subjected to numerous root canals on their baby teeth in one visit. These are primarily done on children who have medicaid coverage. And it's been found that these dental practices are using any way they can to overbill medicaid. Some ex employees interviewed told of promotions and expectations of employees to add services to pad the bills to the government. Adult practices won't even do more than two at a time! Another report about a 6 yr old boy who was so severely restrained that the dentist broke his leg! So, please, you owe it to your children to find another practice, if this is happening to them. LISTEN to them about their fears if they are distressed about visiting the dentist!
Good luck and take care.
_____________________________________________________________

Jen in Fairmount, GA says this about Kool Smiles
August 2007

I don't know the reason, but I am so happy to know no one else who has Wellcare will be fooled into going to Kool Smiles again! I wish they had pulled them a month ago so we would not have taken my grandson. I hope they do go out of business!!! I don't know what kind of dentists they are (we weren't allowed to know) but they did provide one of the most traumatic events of my daughter, grandson, and my lives. We had no plans to ever go back, anyway, but I wish it had not been an option in the first place!

______________________________________________
Frm Kool Smiles Employee, Virginia Beach, VA
August 2007

I believe your news station may want to look into this matter on a deeper level. I resigned my employment with Kool Smiles due to the type of care the children were receiving and the way in which the corporate leaders were managing/reporting the billing of such dental care to Peachtree/Medicaid.
Several months ago Medicaid entered many of the Kool Smiles offices, unannounced, and seized dental records - including x-rays. It is clear now what the audit revealed. The children's dental needs are the most important issue here and by Peachtree/Medicaid pulling their contract the results of the care the children were truly receiving had to have been clear in the records/x-rays.

_____________________________________________
Whib101, Roswell, GA.
August 2007

You folks do not have a clue.. I am very familer with the corp ops of Kool Smiles. They operate a medicaid mill. Those poor kids have multiple dental procedures performed at one visit. How may adults out ther get a extraction, root canal and crown work done at one sitting. For Dr Strange to say these 71,000 kids would be without a dental home is a joke. There is no continuity of care in this operation the kids do not even see the same dentist on follow-up visits. The dentists practicing at these locations are not even board certified pediatric dentists.
Its no wonder they only serve govt funded patients... private insured patients would not tolerate the substandard practices this operation conducts
Thank God those two managed care providers through clinical audits recognized what these profit maximizers were doing !
______________________________________________________
Sharon, Gainsville, GA
August 2007

I personally took my children to a Kool Smiles office where they were given a total of 6 crowns that their current dentist has now said were completely unnecessary. Also, I filed a lawsuit against Kool Smiles for damage and injuries that my the 3 year old daughter received during her treatment. In my opinion, no responsible parent should ever settle for the lack of care received at Kool Smiles. Many private offices accept Wellcare and provide much more personalized, quality service.
________________________________________________________

This blogger could just go on and on with these type of complaints, opinions and thoughts. This is just an example of the type of complaints out there about Kool Smiles, Smiles High, Small Smiles and the like.

Wrapped In A Rainbow

Telling a child he/she will be wrapped in a rainbow sounds wonderful doesn't it, but here is the real truth.

It's still a straightjacket, papoose board, pediwrap, no matter the pretty colors.

At Specializedcare.com here is the info on the "Rainbow Wrap". Note at the bottom it tell the dentist/user to check with their state laws on using one of these.

On the website this is the "fine print", I made it the Large Print.

The Rainbow® Stabilizing System is the most flexible and comfortable system available to prevent sudden and unsafe movements. The mesh wrap is breathable to reduce patient overheating and the soft padded board provides greater patient comfort.

The NEW Rainbow Wrap is made of "sport-mesh," which is strong, but less rigid, making it more comfortable for your patient.

The Rainbow Wrap is now 'coat-length,' meaning that it stops above the knee. A wide, 6-8" velcro strap is provided to stabilize the legs and knees and to prevent kicking. With this strong strap, the legs can be stabilized first, so the patient will be better controlled as the Wrap is secured.

The Rainbow Wrap can be used as a one-piece or a two-piece wrap. Velcro strips lock the top and bottom halves of the wrap together, for those who prefer a one-piece system. Just remove the Velcro strips to have the flexibility of two-section Wrap.

The Rainbow Stabilizing System now comes with a Laundry Panel. When this panel is placed over the 'hook' Velcro on your Rainbow Wrap prior to laundering, it will help prevent lint and other materials from sticking to the Velcro, thus extending the life of your Wrap.

Head stabilizers are sold separately.

Important: Consult the appropriate authority in your state for regulations on the use of stabilizing devices.

Interview with the Journalist Who Broke This Story in Washington DC Area

Interview with Reporter, Roberta Baskin from WJLA-TV, in Washington DC who brought the use of Papoose Boards to the attention of the public.

Thanks to Poynter's Online
An Investigation

WJLA-TV investigative reporter Roberta Baskin aired a story Monday night about the nation's largest chain of for-profit dental clinics. With 66 clinics nationwide, Small Smiles makes a good living off Medicaid. (Watch the story. Warning: It is hard to watch.)

WJLA said it found x-ray technicians who were not licensed to perform the work they were doing, and the station said young children were sometimes children-strapped to "papoose boards" that kept the kids immobile during uncomfortable procedures that their parents were not allowed to witness.
The station said the clinics also quoted former clinic workers who said they were pressured to push baby root canals as treatment because such treatments are lucrative.

I interviewed Baskin via e-mail to learn more about the investigation:

Roberta Baskin

Q. How did you find this story?

A. It began with picking up the phone and listening to a random caller. She was a dental assistant who said she'd been fired for complaining about how her clinic treated Medicaid kids. She went on to describe a bonus system, with daily financial goals, which she believed provided an incentive to do unnecessary procedures for more Medicaid money. At first she complained to the Maryland inspector general's office overseeing Medicaid. But they referred her to the Better Business Bureau. That riled her enough to call WJLA.

Q. What surprised you the most?

A. It surprised me most that the small policy clinics have a policy to separate children from their parents and say it's a privacy regulation under the Health Insurance Portability and Accountability Act (HIPAA). It surprised me even more that they let our cameras in the back, when they wouldn't allow parents in. It also surprised us how much access we got and how much video we were allowed to shoot of questionable practices. The dental staff is so used to doing what they're doing that they didn't seem to think there was anything unusual about their treatment of Medicaid families. It's just the way those Small Smiles clinics we videotaped do business.

Q. How did you get access to patients?

A. We brought patient consent forms in English and Spanish and asked for permission. Some families said yes, others declined.

Q. How were you able to prove the story to be true, given that you are dealing with HIPAA, Medicaid and medical board oversight?

A. It's a complex system. In addition, there are managed care agencies between the clinics and the state, each with their own rules of engagement. We interviewed more than 100 people: dentists, associations, dental boards, inspectors general, Medicaid, dental assistants, on and on. There are other former employees of Small Smiles we interviewed who were afraid to go on camera, but their stories laid out the same issues.

Q. Just the topic of dentistry, little kids getting root canals and being tied up in "papoose boards" all sounds disturbing. Did you have any concerns that people wouldn't watch it?

A. Yes. It's not a pretty subject. A newsroom employee outside editing was in tears just listening to the children cry. Another production staffer was sobbing after seeing it. We had an extraordinary response in e-mails and calls from viewers. Most were angry at the practices, some were upset by what they saw. And yes, a few were angry at me. We needed to show what we saw so people would see what they otherwise couldn't. We also made an effort not to show shots in the mouth or too many faces. The photojournalist purposefully shot Miguel's feet because that told a lot of the story.

Q. What did you learn when investigating this story that other journalists should know?

A. The most important stories are always the hardest. This one was a challenge on many levels. But tenacity and patience eventually pay off. Also, you don't have to shoot on hidden camera. Going through the front door is always best. A child had died in Maryland from a brain infection caused by untreated tooth decay. It highlighted the fact that four out of five dentists refuse to take Medicaid kids. Small Smiles has a business model that exclusively handles those kids. We just asked to see how they do it.

Dental Treatment Agreement-Papoose Board Used

WARNING-Carefully Read The Insurance and Consent Form Prior To Dental Care For Your Child.

You may be consenting to strapping down your child for minor dental care.

Here is a copy of the standard paper work filled out prior to treatment I located on the Net. Note the section in red below. After reading over the paper work and it mentioned using restraints, this is one dentist I would have serious reservation about taking my child for dental care. But of course that's just me. He may be a very well trained dentist, I don't know. All I know is in his consent forms, he wants you to sign a consent to strap down your child. This is typical for way too many dentists. What I'm saying is be very careful as to what you are agreeing to have done to your child.

Welcome to Larry Caldwell, DDS
Dentistry for Children
15200 Southwest Freeway, Suite 320
Sugar Land, Texas 77478
(281) 565-5437
Fax: (281) 565-6446

Be sure to complete front and back and bring with you on your first visit. You may mail
them if you like and we can get your insurance verified before your appointment. Please
call if you have any questions.

The packet includes the following:
Welcome Form
Office Policies
Behavior Management Policy
Dental Insurance Considerations Letter
Acknowledgement of Receipt of Notice of Privacy Practices

Tell Us About Your Child
Today’s Date_______________
Name_________________
Last First MI________________
Preferred Name
Male Female (Circle One_
Child’s Birth date ___/___/___ Child’s Age_______________
School Grade_______________
Child’s Home#___________________
Child’s Home Address____________________________________
Apt/Condo#____________
City State Zip________________________________________
Who is Accompanying the Child Today?___________________________
Name_________________________
Relationship_____________________________
Do you have legal custody of this child? Yes No
Is your child adopted? Yes No
How did you hear about our office?____________________
Other family member(s) seen by us___________________________________
Parent’s Marital Status Single Widowed Married Divorced Separated (Circle One)
Primary Dental Insurance_____________________
Insurance Co. Name___________________________
Insurance Co. Address________________________
Insurance Co. Phone__________________________
Group # (Plan, Local or Policy #)__________________________
Insured’s Name___________________________________
Relationship to Patient_________________________________
Insured’s Birth date ___/___/___ SS#___________________________
Insured’s Employer__________________________
Orthodontic Coverage? Yes No

So that we may better serve you, please provide us with an email address:____________
Person Responsible for Account________________________
Name_____________________________
Billing Address____________________________
Work# Ext Home#_________________________
Employer___________________________
DL# SS#_____________________________
Name of Nearest Relative___________________________

Work# Ext Home#________________________

Mother’s Information Step-Mother Guardian
Name__________________________
Work# ________________Ext Home#_______________
Employer___________________________
Cell#_____________________ SS#_____________________
Date of Birth_________________

Father’s Information Step-Father Guardian
Name___________________________
Work# _______________Ext Home#__________________
Employer______________________________
Cell# __________________SS#____________________
Date of Birth____________________________________

We would like to welcome you and your child to our office. Our goal is to make every child’s visit pleasant and educational. Our practice is based on preventive care. We strive to teach good oral care that will enable your child to have a beautiful smile that lasts a lifetime.

Welcome
Larry Caldwell, D.D.S.
& Associates
Medical History


Has the child ever had a bad experience with dental work? Yes No
Is the child Delayed Average Advanced in social development? Please circle one.
How would you describe the child’s personality/temperament? Circle all that apply:
Cooperative Uncooperative Sensitive Apprehensive Well-adjusted Aggressive Shy

Previous dentists’ name and phone number_____________________________
Last Date Seen____________________ X-rays_____________________
Is your child’s drinking water fluorinated? Yes No
Is your child taking vitamins with fluoride supplements? Yes No
How many times a day are your child’s teeth brushed?
Is the child currently using a bottle? Yes No How often?
Current dental habits. Please circle:
Thumb or Finger Sucking Use of Pacifier Lip or Cheek Biting Nail Biting
Previous or current TMJ (jaw) pain, tenderness or popping? Yes No
Does the child have or ever had recurring headaches? Yes No
Has the child ever had any of the following medical problems? Please circle all that apply.
Y N Cancer/Tumors Y N Hepatisis
Y N Tuberculosis
Y N Asthma
Y N Rheumatic Fever
Y N Sight Impairments
Y N Congenital Heart Defects
Y N Liver Or Kidney Disorder
Y N Lung or Respiratory Problems
Y N Gastro Intestinal Problems
Y N Convulsions/Epilepsy
Y N HIV/AIDS
Y N Diabetes Y N Endocrine System
Y N Hearing Impairments
Y N Frequent Infections
Y N Hemophilia
History of blood transfusions? Yes No
Date_______________________________
Does the child have a heart murmur or condition that requires Prophylactic Antibiotic coverage for dental work? Yes No
Please list any serious medical problems that the child has had:

Hospitalizations or injuries

Please list all drugs the child is allergic to Other allergies____________________
Please list all drugs the child is currently taking Dose___________________________
Does the child have seizures? Yes No Are the seizures related to high fever? Yes No
Does the child experience an aura before seizure? Yes No
Are the seizures related to high fever? Yes No

Does the child have any behavioral or learning disabilities?
Mental Retardation? Yes No Skill Level____
Handicaps/Physical Disabilities_____________
Any other significant problems or comments

Has the child had any recent infections of bacterial or viral origin? Yes No
Is your child currently under the care of a physician? Yes No
Child’s Physician___________________ Phone___________ Date Last Seen_______

Because your child is a minor, it is necessary that signed permission be obtained from a parent or guardian before any/or all necessary dental treatment is performed. Diagnosis of services needed and financial obligations will be discussed with you by the doctor and/or staff before treatment is rendered.

Your signature authorized Dr. Caldwell and/or his Pediatric Dentist Associate to render necessary dental treatment, to administer anesthetics, to administer medication, to take radiographs (X-rays), clinical photographs, study models and other records necessary for an accurate diagnosis, to utilize behavior management therapy as needed to provide safe dental care for your child and employ such assistance as is appropriate.


Signature of parent or guardian_______________________ Date____________

I verbally reviewed the medical/dental information above with the parent/guardian & patient named herein. Initials_________ Date__________

Doctor’s Comments:
_______________________________________________________

Our office is committed to meeting or exceeding the standards of infection control mandated by OSHA, the CEC and the ADA.

Larry Caldwell, D.D.S.
15200 Southwest Freeway, Suite 320
Sugar Land, Texas 77478

Office Policies
The person accompanying the patient is responsible for the account regardless of who carries the insurance on the patient.

We request that the person accompanying the child not leave the premises until the appointment is over, in the event a question arises regarding the child's appointment.

A broken appointment is a loss to everyone. As a courtesy, please allow a 24 hour notice for any schedule changes.

Dr. Caldwell, as a courtesy, will accept and file your insurance for you, HOWEVER, WE ARE NOT A PARTICIPATING PROVIDER ON ANY DENTAL PLANS, THIS MEANS YOU ARE RESPONSIBLE FOR THE DIFFERENCE BETWEEN OUR FEE AND THE INSURANCE ALLOWABLE FEE.

THE ONLY HMO/DMO WE ARE AFFILIATED WITH IS CIGNA (AGE LIMIT IS UNDER 7 YEARS OLD). IF YOU HAVE AN HMO/DMO, THEN YOUR INSURANCE WILL NOT PAY OUR OFFICE.

I am aware that insurance will cover an estimated percentage of most dental procedures and the portion that is not covered by insurance is due at the time services are rendered, unless other financial arrangements have been made prior to the dental appointment.

I am aware that some procedures are subject to a deductible and if it has not been met then I will pay this at the time services are rendered unless other financial arrangements have been made prior to the dental appointment.

If you have secondary insurance (two DENTAL plans), it does not necessarily mean that these combined insurances will cover your services 100%. It is up to you, the insured, to know how the two dental plans will coordinate benefits. We do not file secondary insurance.

I hereby agree to assign all insurance payments to Dr. Larry Caldwell. I am aware that my insurance company may not cover all of the professional fees. I hereby agree to pay, within 30 days, any outstanding balance following payment by the insurance company unless other financial arrangements have been made.

I agree that if the insurance fails to pay Dr. Larry Caldwell within (60) days of the rendering treatment all fees are due and payable at that time.
In the event the insurance company pays you the patient instead of Dr. Larry Caldwell, I agree to forward the payment to
Dr. Larry Caldwell.

In the event a check is returned from a financial institution, a return check fee of $20.00 will be applied.

In the event of default, I promise to pay legal interest on the indebtedness together with such collection costs as may be required to effect the collection of this note.

SIGNATURE:______________________________________ DATE:______________

Larry Caldwell, D.D.S.
15200 Southwest Freeway, Suite 320
Sugar Land, Texas 77478

Behavior Management Policy

Providing quality dental care for children requires expertise in directing child behavior. Our goal is to instill in the child, a positive attitude towards dentistry. Maintaining proper behavior of children while in the dental office demands skill of verbal guidance, prevention of inappropriate actions, and reinforcement of appropriate behavior. These techniques are used only for behavioral modification and not to reprimand or punish a child.

The following are various behavior management techniques used in this office.

•Positive Reinforcement: Social reinforcers such as verbal praise and non-social reinforcers such as rewards (toys, stickers).

•Tell-Show-Do: Explain procedures and instruments to the child with the use of modified terms such as “sleepy juice,” “water whistle,” and “wiggle tooth” rather than “shot,” “drill,” and “pull tooth.”

•Distraction: Use of distraction to divert the patients' attention from what he/she may perceive as unpleasantness.

•Voice Modification: Change of voice volume or tone to gain a child's attention and direct his/her behavior.

•Nitrous Oxide/Oxygen Sedation: This is a very safe and effective conscious sedation method which is easily monitored. The onset of this sedation is quick and recovery is fast and complete before the child leaves the office.

•Pediwrap or Papoose: Partial or complete immobilization with the use of a blanket type wrap, is sometimes necessary to protect the child from injury while using dental instruments. This technique is only used in cases when it has been determined that all other forms of behavior management have not or will not be effective.

It is our office policy to minimize the use of more extreme forms of behavior management techniques and to implement them only when necessary.

SIGNATURE:___________________________________ DATE:_____________

Larry Caldwell, D.D.S.
15200 Southwest Freeway, Suite 320
Sugar Land, Texas 77478
(281) 565-5437

Dear Parent,
We accept and file dental insurance as a courtesy to our patients. We try to know all aspects of your dental plan. Any treatment outline that we present to you is just an ESTIMATE and not a guarantee of benefits.

When we call to verify benefits, the insurance company informs us that, “this is not a guarantee of benefits until they actually receive the claim and process it.”

We file a pre-estimate to your insurance for some procedures such as orthodontic appliances, crowns, surgical procedures and large cases. We do not submit pre-estimates for every procedure but, at your request, we will gladly do so. It normally takes 3 to 4 weeks to receive an estimate back from an insurance company.

In-Network versus Out-of-Network PPO Insurance
When you have a PPO you can go Out-of-Network and the insurance will pay our office. What does this mean? In-Network means that we have a contract with your insurance company and we agree to accept their fees. Out-of-Network means we DO NOT have a contract with your insurance and we do not accept the fee that your insurance allows and you are responsible for the difference between our fee and the allowable fee from your insurance. We will not adjust off the difference between the two.

HMO/DMO Insurance
When you have an HMO/DMO, then you have to go to a doctor that accepts your insurance; you cannot go Out-of-Network. The only HMO/DMO that we are on is CIGNA (age limit is under 7 years).

It is very beneficial, as the insured, to know your dental plan.
Common questions to Ask Your Insurance Company
• What is the frequency of exams, cleanings and fluoride?
• Is there an age limit for fluoride treatments?
• Are sealants a covered benefit? If so, what is the age limit?
• Do I have orthodontic benefits?
• Do you have a waiting period with your insurance plan?
Most insurance companies will tell you how they will cover a procedure if you give them the ADA code, which is on the treatment outline.

SIGNATURE:_________________________________ DATE:___________

Larry Caldwell, D.D.S.
ACKNOWLEDGMENT OF RECEIPT OF
NOTICE OF PRIVACY PRACTICES

**You May Refuse to Sign This Acknowledgment**

I, _______________________________________, have received a copy of this office's Notice of Privacy
Practices
________________________________________
Please Print Name
________________________________________
Signature
________________________________________
Date

For Office Use Only
We attempted to obtain written Acknowledgment of receipt of our Notice of Privacy Practices, but Acknowledgment could not be obtained because:
Individual refused to sign
Communications barriers prohibited obtaining the acknowledgment
An emergency situation prevented us from obtaining acknowledgment
Other (Please Specify)

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

Study Related To Dental Anxiety In Disabled Children

In 2003 the European Journal of Dental Education did a focus study with dental students.
It's aim was to determine which method of behavioral management was most acceptable to the future dentists.

The results were analyzed using ANOVA models. There were significant main effects of intervention method and treatment outcome, indicating that less restrictive methods and good intervention outcome were rated as more acceptable.

Significant two- and three-way interactions were found, which suggested that the use of restrictive methods may be perceived as more acceptable for a child with learning disabilities even when the outcome was poor.

Sad, but true that it appears it is much more acceptable to restrain, restrict, tie down, strap, use papoose boards, or pediwraps in disabled children.

I would like to see a study on how acceptable it is to the same to completely healthy children and a follow up on what effects such trauma had on the child later in life.

This study highlights the importance of empirically (seeing is believing) evaluating outcome and treatment restrictiveness when engaging in behavior management during dental procedures.

Cited:
J. Timothy Newton, Peter Sturmey (2003)
Students' perceptions of the acceptability of behaviour management techniques
European Journal of Dental Education 7 (3), 97–102.
doi:10.1034/j.1600-0579.2003.00277.x

In another study in the UK revealed that female dentist was MUCH more reluctant to use restraining devices on children that their male counterparts.

Of course female adults are much less likely to abuse, beat, and otherwise display aggression to children as well. Our jails do prove that.

Georgia Also Investigating Over Use of Papoose Boards

The Georgia Department of Community Health (DCH) commented on a possible Class Action Law suit against Kool Smiles, P.C. and the care management organizations (CMO), Peach State Health Plan and WellCare of Georgia.

In a press release dated August 22, 2007 DCH said it was thoroughly investigating complaints by parents/guardians of patients as well as practicing dentists of Kool Smiles, P.C.

Allegations include but are not limited to:

— “Unusual patterns of patient restraint”(such as use of restraining boards for children) and sedation vs. Traditional Pain Management (usage of Nitrous Oxide or IV sedation) .

— “Over-utilization of stainless steel crowns” in children compared to other dentists and normal averages;

Irate Parents Discuss Papoose Boards Used By Ruthless Dentists

So many parents and grandparents are irate over the practice of using Papoose Boards for dental care in children.

Click the link below for a small discuss among some concerned parents.

Yahoo Discussion

Child Dead From Papoose Board and Sedation

SANTA ANA--Four-year-old Javier Villa, who died after having his teeth drilled, was treated by dentists "who were incompetent and grossly negligent in sedating or monitoring the boy," according to a dental expert cited in court documents.

In addition, Dr. Richard Mungo said, Javier may have died because the dentists and their assistants failed to do something as simple as place a towel behind his neck to keep his airway open.

Dr. Miguel Garcia, who supervised the Megdal Dental Care clinic where Javier was treated, also destroyed the boy's chart, altered records, withheld evidence and concealed the amount of drugs given the boy, according to witnesses quoted in a search warrant affidavit filed in Municipal Court.

Separately, the state attorney general's Bureau of Medi-Cal fraud said Thursday that it is investigating the Megdal Dental Care chain for possible criminal fraud, but it would not provide details.

"We cannot comment on an ongoing investigation," Hardy Gold, supervising deputy attorney general, said in a statement.

The Board of Dental Examiners also is investigating a possible licensing violation by the Megdal clinics. State law requires that a dentist who owns two or more offices must be in each office at least 50% of the time.

Dr. Philip Megdal owns nine clinics in Southern California, said Jeff Wall, chief of enforcement for the dental board. Given the nearly full-time hours these offices keep, "I can't imagine" how he can be in compliance, Wall said.

Neither Megdal nor his attorney William Kent could be reached for comment Thursday. Both denied last week that there had been any fraud regarding Medi-Cal, the federally funded program of medical and dental care for the poor. They also said Megdal was the owner of the buildings where the dental clinics are, not the clinics themselves.

The Santa Ana police and the dental board are investigating Javier's death.
Javier, who stopped breathing in a dentist's chair Aug. 4 and died at a hospital a few hours later, had been taken to the Megdal Dental Care office in Santa Ana to have half a dozen cavities treated. He was given an oral sedative and an injection of painkiller.

An attorney for Garcia denied wrongdoing on his client's part, as did an attorney for the second dentist involved.

Mungo told state dental board investigators "Javier was not properly sedated or monitored" by Garcia, who prescribed the oral sedative chloral hydrate, or Dr. Gabriella Pham, who did the actual dental work.

Mungo also said improper positioning of Javier on a restraint board could have been a major factor in the boy's death and that numerous routine safety procedures were not followed.

Javier was strapped to a papoose board, used to immobilize young patients. Mungo said it was vital that the heavily sedated patient's airway remain open. That could be done by placing a rolled towel or pillow under the patient's neck and shoulders, he said.

That was not done, according to statements made to investigators. Nor was the patient's blood pressure, pulse or breathing monitored with standard equipment, according to the affidavit.

"I'm not sure chloral hydrate is the culprit," Mungo said in an interview Thursday. "My concern is the monitoring and positioning of the child. The papoose board is fine, but you need to know how to use it."

Mungo and other pediatric specialists said it was crucial to give the proper dosage of choral hydrate, based on the child's weight, and to have constant, mechanical monitoring of the child's heart rate and amount of oxygen in his blood.

"In the wrong hands it's [chloral hydrate] not so wonderful, it's potentially deadly," said Mungo, a Huntington Beach pediatric dentist who teaches at USC Dental School.

The case highlights a problem involving the sedation of dental patients, experts said. The state requires dentists administering general anesthesia or conscious sedation drugs intravenously to undergo special training and licensing and have equipment to handle emergencies. However, no such rules apply to dentists who sedate patients with oral doses.

Dr. Ray Stewart, president of the California Society of Pediatric Dentists, said Javier's death might put needed pressure on the state to regulate oral sedation.

"There's been resistance on some people's part to have any more governance, but it's just exactly situations like this here that force the governing bodies to say OK, something has to be done," Stewart said.

Neither Garcia nor Pham had been issued general anesthesia or conscious sedation permits, said officials at the state dental board.

A dental assistant gave Javier chloral hydrate at Garcia's direction, according to the affidavit, and injected Lidocaine in his gums to deaden feeling in his mouth. But the affidavit shows a sharp dispute about the amount of drugs the boy received and also alleges Garcia tried to conceal what happened from investigators.

Pham and dental assistant Alejandra Juarez told investigators that Garcia ordered Juarez to destroy Javier's dental chart, which included the notation that the boy had received 16ccs of chloral hydrate. He began a new chart, the affidavit says, showing the boy received 6ccs.

"That is the story," Garcia said to Pham and Juarez when they met shortly after paramedics took Javier to the hospital, according to the affidavit.

Garcia told investigators he ordered a 6cc dose of chloral hydrate and "does not recall" if he was in the room when Juarez administered it, according to the affidavit.
The manufacturer's maximum suggested dose for a child of Javier's size is 9ccs, according to the affidavit.

Garcia declined to discuss those allegations Thursday. "I wasn't the treating dentist," he said. "Even I don't know all the things that went on."

Juarez also said that on the day of Javier's death, Garcia apparently concealed from a coroner's investigator the amount of Lidocaine administered to Javier. Juarez told dental investigators she "retrieved the [Lidocaine capsules] from the trash and handed both of them to Dr. Garcia, and Dr. Garcia gave only one to the coroner," according to the affidavit.

Mungo was critical of the office procedures, training and the fact that one dentist administered the oral sedation while another treated the patient.

Pham told investigators it was "standard procedure" not to place anything under the necks of papoose children, according to the affidavit. During a demonstration with investigators of the technique the office used on Javier, Pham gave no indication that either dental assistant was instructed to keep Javier's airway open, according to the court document.

In addition, dental assistant Claudia Briseno told investigators she understood that her job was to hold the boy's head so that he did not move side to side and he did not cut himself.

Click here for another investigative report from Colorado as far back as 2004 and still there are no national laws saving out children.
My word on this: A little patiences would have saved this child's life!

Papoose Board Used On Child At Dentist

I recently discovered that these pictures show the latest attire a child needs to wear to the dentist.

There's just something about the Papoose Board that seems ... unfair, really really sneaky, a betrayal, and a ruthless display of dominance don't you think.

From reading the reports all over the web, I'm not the only one to feel this way. 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 combination of behavior control.

Caution This Video May Be Very Distrubing:



On January 2, 2008, this particular Dental Office, Small Smiles, has now changed it's policies but basically denies they use them as much as they really do. See more here.

Even companies selling this things clearly state they are for use as a "Last Resort" and modifications are highly recommended prior to their use on a child at a dentist office according to the American Academy of Pediatric Dentistry.



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 is what I'm asking, and so far I've not gotten any answers.

"Imagine a visit to a dentist office where you walk back to your room 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. You really have to put the whole picture together to understand the trauma of it all.



Now we adults can manage that, but a child has a bit more trouble. Especially when they have been thrown in the natures 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 arm 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.


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!


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.

• How did this restraint mechanism come to be called a Papoose Board?
  

• How is it still acceptable for it to be called a Papoose Board?
  

• Native American's are insulted at the use of this name offended by the idea that this restraint technique be associated with a cultural tool used for swaddling Native American babies.
  

• I’m sure this is not what their elders intended it to be used for.
• 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.
  

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

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. Sorry, it's not working. It's a straight jacket for a child, period!

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.”

That's where I am. I never treated my children this way and would never allow anyone to tie up my child for dental care. The idea that I have a son and daughter in law, who are supposed to be well educated, would allow this to be done to my 5 year old grandchild has infuriated me.

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. I started my children early going to a dentist and not once, not one time did any dentist ever mention using any kind of restraint.

• 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. In summary 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" as an excuse to exspediate the procedure. 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 or child's parents and the child or child's parent/parents agreed to putting on the restraint. Come on, No child thought they would be tied up and tortured when they agreed to this!

• Parents who agree to this all I can ask is: Where is your damn brain!

Filling 4 year molars on a 5 year old child does not constitute Extreme Case, as in my case.

The only extreme case here is the mental status of a parent who would allow this.

Long Term Damage:

Deaths:

• 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, mame and mentally damage your child over a filling, cap or other nonemergency 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 Supports even considered the
psychological safety of the patient!

Another recount from a mom: (DS=Dear Son)

I'd only been that dentist once before. DS has Medicaid and I thought it seemed like a lot of work, too, but I told them to do whatever was needed right then so he wouldn't have to go through it again. He also didn't give DS any sedation other than the shot in his gums and he cried so hard he threw up blood. I was crying too, and the dentist said, "This is typical of a child his age to cry, he can't feel anything, he's just afraid of the noises." Uh, hello? DS was afraid because he was strapped down, had a drill in his mouth, blood going down his throat, and some stranger telling him not to cry. I was so mad at myself for letting this happen, and even madder at the dentist. I had called all the dentists who accept Medicaid in my area and none offered anesthesia/sedation. I thought he'd be drowsy from the shot (he wasn't) and I wasn't expecting all that to happen - torture! Argh! Sorry, this turned into a long rant here....

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

Dr. Penelope Dunlap - Angola Indiana Dentist–11 Felonies

An Angola dentist accused of diagnosing fictitious cavities lost her bid Friday to regain her license to practice when the Indiana Board of Dentistry voted 6-0 to continue Dr. Penelope Dunlap’s suspension.

Five members of the board abstained but did not give a reason.

Dunlap was initially given a 90-day suspension in November that was expected to run out in February, before the board was scheduled to meet again.

The latest 90-day suspension will last until May 4, just past an April trial date that has been set on 11 felonies Dunlap has been charged with in Steuben County. * * *

In November, the state Attorney General’s Office filed a complaint with the Indiana Board of Dentistry seeking an emergency suspension in reference to questionable cavities in three patients.

In December, local prosecutors filed six counts of Medicaid fraud and five counts of attempted theft, all Class D felonies.

Dentist Allegedly Caused a Child's Death

October 27, 2004

WTAP News
Denise Alex
The Ohio State Dental Board has ruled that the actions of a Belpre dentist who administered a lethal dose of local anesthetic to a two-year-old West Virginia boy constituted malpractice.

Doctor James E. Kirkpatrick injected what experts testified was three times the manufacturer's maximum recommended dose of Prilocaine into Hunter Owens.

The boy died less than 90 minutes later on October 27th, 2004 at Camden Clark Memorial Hospital in Parkersburg. Kirkpatrick was attempting to extract eleven rotted teeth from the boy.

The board Wednesday ordered Kirkpatrick's practice closed after ruling that his intentional decision to push the limit of the anesthetic was egregious malpractice.
Kirkpatrick's lawyer says he will appeal the ruling in Washington County, Ohio, where Kirkpatrick lives.

WTAP called Kirkpatrick's office Thursday and a recored message says his office will be closed until Monday, November 7th, 2004