Friday, August 27, 2010

Corporate Dental A Good Investment? Not for the patients!

I hope you don't want your dentist to have your best interest in mind, those who work for these places only need answer to shareholders and keep the bottom line in the black.  Know what that means, swift, cheap and low quality care and being sold crap you don't need. 
The New York Post

The private-equity barbarians may soon be running a dental office near you.
In recent weeks private-equity firms have been bidding for two of the largest national chains of dentists' offices as they drill further into the space.

In fact, a PE firm is close to winning the auction for Syracuse-based Aspen Dental with a winning bid likely to stretch past $500 million. A separate auction for the slightly larger Kool Smiles chain is well underway, sources said.

Aspen, with its nearly 300 branches, is working with investment bank Moelis & Co. to sell itself. Kool Smiles, which generates $80 million in EBITDA (earnings before interest, taxes, depreciation and amortization), has hired investment bank Harris Williams, The Post has learned.


Financially, dental is the old-fashioned piece of the healthcare industry. Most practitioners still work outside a management practice and more than 80 percent work with, at most, one other dentist. Most importantly to private-equity firms, it is one of healthcare's last bastions of fee-based services, according to the American Dental Association.
 Financial consultant Tom Climo said 89 percent of dental services, including preventative care, are covered by insurance, with patients only paying for oral and cosmetic surgery. Healthcare reform that is cutting into reimbursement for medical doctors is not affecting dentists, he said.
An investment banker said private-equity firms like dental offices because they sell for low valuations and one can borrow a fair amount of money against them because of reliable cash flow.

The downside, Climo said, is private-equity firms are likely to work dentists longer once they take over practices to boost profits and that could lead to worse service.
[COULD!?  It has! They also failed to mention in most states they operate Illegally!]
Private equity firms already own the Forba and Bright Now! dental chains. Kool Smiles did not return calls for comment.
[Kool Smiles didn't return phone calls, well hell no, they didn't!]

Tuesday, August 24, 2010

Things FORBA Small Smiles Don't Want You To Know

In the past two weeks FORBA, for some reason,  after 2 years has decided they don't want anyone to see information or opinions of two subjects.  I received a letter last week asking two be removed and this week they've added a new one to the list.  Until it can be further investigated I will remove them, in accordance to the consent injunction I signed.  However, 2 years ago, I filed a Compliance agreement saying I had removed reference to documents they were stupid enough to post openly on the Internet.  Being they accepted that Compliance statement with no objections, seems to me I had satisfied their request, right?
However, they have decided to pick on me again, I guess I'm the only case in the courts they feel they can truly get a bit of satisfaction beating upon.  I find it amazing in so many ways. 
Here is a quote from their Cease and Desist Letter:

"…a review of recent postings on your website dentistthemenace.com which is directed to debbiehagan.blogspot.com, reveals that you are engaging in clear contempt of the Court's permanent injunction by publishing confidential and internal information about FORBA's contracts with its dentists.  Without limitations, we direct you to your entries dated July 13 … and 20… 2010…" 
I'm not sure how they consider their new deals with the dentists "confidential and internal" since there are ads out the waazoo on the Internet advertising they are hiring and dentists will be paid a commission.  But we know how they operate, put it on the Internet, and cry like a baby if someone who does not like them reads it!
Clearly their standard of "Confidential and Internal" differs greatly from what is normal, instead meaning anything they themselves post on the Internet.  With that being the stick by which they measure, how in the hell would anyone know what they consider "Confidential and Internal"!!??
As for all other lawsuits involving them, I actually have lost count! 
Ohio – 2, or three I think
Virginia – 3, I believe
Tennessee- 1
Oklahoma – 1
New York – Hundreds maybe, who knows
Colorado – untold number but at least 1 or 2 this year
South Carolina – 1, but I think it's settled
Anyway, you get the point…they have mucho legal proceedings going on and mucho legal fees.
Here is the response received from them yesterday.  Yesterday they added a new post they want removed.  I guess I could get one of their letters everyday seeing how they gauge "Confidential and Internal".  Looks like someone has a full time job and the postal service is going to love them!  However, I highly doubt they get another wish list filled.
Back to what they don't want you to know:
1.  Warnings and Pitfalls For Dentists - A post about problems working strictly on commission – After I reviewed this post in full I remembered this wasn't written by me but someone who saw several problems.  So I highly disagree that this information/opinion is or was "Confidential and Internal" to FORBA's business operations. 

2.  Small Smiles Dentists Pay To Be Production Based Only By January 2011-No Vacation-No Holidays-No Paid Time Off – Since this information are in ads Jenna Kochenberger has posted on the Internet, I highly disagree that this is "Confidential and Internal" either and believe they would have a hard time holding this argument. 

Anyway, we all know FORBA by now, whether it's being run by the DeRose bunch or the Arab bunch and their cronies they try to bully their way through, so bully it is.
They manhandle and bully the innocent children, they bully and imprison their employees, in my opinion of course,  so what else does one expect from the famous Bully Dental Company.
And by doing this, they just keep stuff that would have gotten lost in the mix, back to the top. 
GO FORBA! 

Saturday, August 21, 2010

4 Year Old Tulsa Child Dead After Sedation At Pediatric Dental Group, Tulsa, Oklahoma – Charles Keithline, DDS! 4 Dead Children In 4 Months!

Is anyone paying attention to this issue. 
I'm thinking no. 
I hope someone takes this up and does NOT leave it to the Oklahoma Board of Dentistry,  they let citizens down every day!  Dental Boards fall far short on protecting the citizens of Oklahoma, but it's not just Oklahoma!

Dr. Charles Russell Keithline III's dental licenses ( # 3942) shows he has been disciplined before!  Why is that not in the report?  Call the  Board of Dentistry (405) 524-9037 for more information.

Here is what I found:

Dr. Charles Keithline # 3942
Charges:
practiced dentistry in an incompetent and/or negligent manner.
Action:
6 month suspension  and 5 yrs. probation. 
(I'm told it was due to drug addiction, but can not verify)
 

This death happened on August 14, 2010.  The earliest reports I can find are from yesterday, August 20, 2010, and  only from one source.  Why?

***********

Tulsa, OK
By KIM ARCHER World Staff Writer
Published: 8/20/2010  11:00 PM
Last Modified: 8/20/2010  11:00 PM
The Tulsa Police Department and the Oklahoma Dentistry Board are investigating the death of a 4-year-old girl who had been put under sedation for a dental procedure at a Tulsa pediatric dental clinic.
Akasmse Rose Tecumseh of Morris died Aug. 14 after leaving Pediatric Dental Group, 602 S. Utica Ave.

“I can tell you we are working constantly on this,” said Linda Campbell, executive director of the Oklahoma Board of Dentistry. “We are working on the timeline.”
She said investigators have been at the clinic going through records this week to find out how long the sedative was administered and whether proper protocol was followed.
Campbell said the Tulsa Police Department is working with the board’s investigators on the case.
“Certainly one death is too many, but we are looking at this to ensure there is clear and convincing evidence” regarding any potential wrongdoing, she said.
The primary dentist at the clinic is listed on the group’s website as Dr. Charles Keithline, a fellow of the American Academy of Pediatric Dentistry and a diplomate of the board.
Keithline’s attorney, Keith Sweet of Oklahoma City, said the dentist could not comment about the patient, citing patient privacy laws. Campbell said an associate of Keithline’s performed the procedure.
Only seven people in Oklahoma are known to have died after being sedated at a dentist’s office, she said. Many were ruled natural deaths after investigations because the patients were found to have had pre-existing medical conditions, such as heart disease or asthma.

Before Akasmse’s death, the last death linked to sedation at a dental office was that of a 6-year-old boy in Muskogee six years ago, Campbell said.

In that case, the investigation found that a pharmacy erred by providing the patient a lethal dose of methadone instead of the prescribed sedative, she said. The dentist was exonerated.
According to the American Dental Association, the use of sedation and general anesthesia has been an integral part of dental practice since the 1840s.

If properly administered by trained personnel, sedation and general anesthesia are safe and effective, allowing millions of people access to comprehensive dental care who otherwise would not get it, the ADA says.

The ADA sets guidelines for the industry regarding the use of sedation and offers continuing education on proper monitoring and airway management during the use of general anesthesia.
Officials with the Oklahoma Dental Association would not comment.

Read more from this Tulsa World article at http://www.tulsaworld.com/news/article.aspx?subjectid=17&articleid=20100820_11_0_TheTul956938

The child was having some restorations done and crowns put on her deciduous teeth, according to Linda Campbell, executive director of the Oklahoma Board of Dentistry.
**********

Update Sept. 2, 2010

One story coming from the community is that Dr. Charles Keithline is charging the child's stepmother with causing the death of this child.  He is saying she left his office and drove the child around in a hot car for three house.  Of course Dr. Charles Keithline isn't planning on taking any responsibility. 
Just because a child has an underlying medical condition does NOT mean the child died of "Natural Causes" and the dentist is off the hook.

It's clear this is what has happened as the article mentions the number of deaths in Oklahoma and all were ruled "natural deaths" because of other health issues. How in the hell does this let the dentist off the hook?

And screw the AAPD or ADA guidelines and comments.  Remember they are the ones who sent out the "talking points" memo after deaths earlier this year to cover their (and their colleagues) asses!

I'm having big issues with this DOCS (Dental Organization For Conscious Sedation) Company, based in Seattle who delivering these "drive-thru" classes for dentists.  They advertise and have testimonials from dentists who talk about how offering Conscious Sedation is another tool to increase their profits! 

Related Articles:

Five Year Old David Liddell Death July 12, 2010

Deaths In Dental Chair On The Rise

Thursday, August 19, 2010

Hey Kool Smiles - Time For The Assistant With The Long Green Fingernails To Go! YUK!

Hopewell, VA 

Kool Smiles Complaint:

Me and my 6 yr old went to Kool Smiles because i was looking for a place to take us both for the convience. It was horrible for me and her. She had a dental assistant with 2+ inch fake green nails that she kept stabbing into my daughters mouth.
My experience left me with a sore mouth and a assembly line experience. Now I can't get them to stop calling me to schedule another appointment and sending me post cards. I have called and called and requested they remove all my information and told them the unpleasant experience we had and they are still calling my work and sending things.

 ATTN:  NCDR, LLC (Kool Smiles)

Clean Up Your Act! 
(I know, a pipe dream) 
Stop Calling People At Their Place of Employment! 
(I get this complaint a lot!)

Tuesday, August 17, 2010

New York Ocean Dental Complaint

This was posted in the comment section but thought it deserved some front page space.  Mr. Hoecker, do you have an comments on this! 


I took my daughter to Ocean Dental as it was difficult to find someone close to where I live that would accept medicaid.  They wanted me to watch through a window while they cleaned her teeth and did not let me go back for X-rays or the exam....then I was told after not being explained anything, showed x-rays, etc, that my daughter needed two fillings and a cap, she is 3 and a half, so I made an appt for the first filling, they kept pushing me to sign a waiver for laughing gas but didn't even give me time to read what I was signing, as there were so many people there I just did and that was a mistake, then I wasn't even allowed to stand in the hallway while they filled the cavity, after that someone did talk to me for about two minutes and said that I needed to make sure she brushed I said she does brush and I supervise, then the person said, "well you wouldn't let your three year old wash your dishes so why would you let her brush her own teeth," when that was over I took her out to the car where she proceeded to barf in the backseat and lean her whole body over to the side and said she didn't feel good.  I was so mad that I called there and complained, and decided not to go back, I took her to a far away dentist from my house and to my surprise they went over x-rays and showed me her teeth and proceeded to tell me that she had no cavities, I said well they said she needed another filling and cap and they looked again...same results....I am furious that this is how people are being treated just because they have medicaid..your not entitled a decent dentist unless you drive for at least 45 minutes?  These people need to be investigated in my opinion.....

OMG!

Ya Gotta See It

 

A Look At FORBA's Dental Lobbying In Massachusetts

FORBA Holding, LLC
Johnson Haley, LLP
51 Franklin St. Boston, MA  02110
617-778-1200     
                                                                              
Date
Amount
Expenses
1-1 to 6-30-2010 $54,469.00 No Exp.
$750.00 To Todd R. Cruse
Expenses were only $1500.00, that's pretty darn good net income for the first 6 months from one client.  Todd spent that on May 4, 2010 for a Delta Airline ticket ($1,500 and $400 for the Taj Hotel)
1-1 to 12-31-2009 $124,500.00 $818.70 expenses listed.  Another Todd trip in Aug. 2009.  $318.70 for same hotel and $506.20 for air.
1-1 to 12-31-2008     $112,500.00 No Exp.
1-1 to 12-31-2007 $ 96,000.00 No Exp.
1-1 to 12-31-2006 $120,000.00 No Exp.
1-1 to 12-31-2005 $65.000.00 Contact -Todd Cruse, 415 N. Grand Ave, Pueblo, CO  81003 tcruse@ddmktg.com
Total
$573,219.00

Monday, August 16, 2010

FORBA/Small Smiles Job Ad - Advertising New Contract Policy

Dentist

Forba - Washington, DC 20001




Forba Dental Network is currently searching for a skilled and compassionate Dentist to join our stable and successful offices in Washington DC and Oxon Hill, MD. For years, the primary mission of our offices has been to meet the dental needs of underserved children and young adults.  Dentists on staff enjoy a rewarding work environment without the administrative burdens of operating a practice.  You will have the opportunity to focus on quality care, while we handle the administration responsibilities.  You'll find a rewarding career with purpose, pride and passion when you join the team! 
We provide a competitive compensation and benefits package including Excellent Salary based on a percentage of your production,100% Health Insurance Premium Coverage (Employee & Family), 100% Malpractice Insurance Coverage, 100% Long-Term Disability Insurance Coverage, 100% Reimbursement for Continuing Education, Dues and Licensing Fees, 401(k) Plan with Match, Licensing & Credentialing Support & Relocation Reimbursement.

General Dentists & Pediatric Dentists are encouraged to apply. Please call Jenna direct at 719-562-4462, email jlkochenberger@forba.com, fax 719-584-7696 or visit our website at www.forba.com.


DDS or DMD
EOE

Friday, August 13, 2010

A Great Way To End The Week

Kool Smiles South Side Of Tuscon Tries To Stop Mom From Accompaning Children To No Avail


Friday, August 13, 2010

I should've known at "Kool".

I should've known. When I chose a kids' dentist office whose very name is misspelled (albeit on purpose, in an attempt at being clever I suppose) Kool Smiles. I should've known. When I chose a dentist that was sandwiched between a carniceria and a check cashing/loan shark business. I should've known. When I chose a kids' dentist who strangely decided that rap and an unusual (not in a good way) hybrid of Mariachi and Tejano music would be a nice mix for their patients (who are 10 and under). I should've known. When I chose a dentist that close to the Air Force base. The South side of Tucson is in some ways similar to the South side of Chicago, except that it has better Mexican food and fewer crooked politicians. I should've known. When we go inside and the really great jungle gym, slide, rock climbing, play area thingy appears to have been dipped into a Rotavirus/H1N1 cocktail, followed by a layer of melted popsicle and then topped off by a light coating of dirt and granulated sugar. Yuck. I should've known. When they call the 3 and 4 year-old patients to come back and insist that I wait in the lobby. A part of me thought, "You're crazy if you think I'm going to let my 3 and 4 year-old go back there by themselves. That will be mayhem for them AND you." The other part of me (the more sarcastic one that lives her life with tongue-in-cheek) thought, "You're crazy if you think I'm NOT going to let my 3 and 4 year-old go back by themselves. That will be mayhem for them AND you. Good luck with that..." In the end, the sensible me won (in addition to being sarcastic, the other one tends to throw in the towel way too soon in my opinion) and I did accompany the girls back. However, this was not before they insisted that I NOT accompany them, but rather peer through a two-way "interrogation mirror" while they were being seen. I should've known. When I chose a dentist for my children that uses two-way mirrors....

I will be returning to our previous dentist who sports the lime green Easy Tone Reeboks and Lily the lovely hygienist who was born to work with kids. There is no playland and the music is unremarkable, but I don't feel like I need a shower when I leave. I will however, be returning to that carniceria for their specials on chorizo and queso fresca.

Thursday, August 12, 2010

FORBA Small Smiles - Public Health Hazard? Yes, I sure think so, what about you

FORBA Holding-Small Smiles Dental Center  Better Business Bureau Rating
Public Health Hazard?  Yes, I sure think so, what about you?






Wednesday, August 11, 2010

National Union Fire Insurance Company Files Suit Number Two in Tennessee

The latest suit between National Union Fire Insurance Company (NUFI) and FORBA Holding/Small Smiles Holding (New FORBA) was filed August 8, 2010 in Middle Tennessee Federal District Court.

In short, NUFI says FORBA failed to disclose the fraud investigation by the DOJ, HHS and several state Attorney Generals.  Nor did FORBA disclose that American Insurance, the insurance company that previously had them covered, cancelled their coverage due to "claims experience".

This took place through an insurance broker-Affinity Insurance d/b/a Dentist's Advantage.  Affinity secured the policies for FORBA/Small Smiles in the beginning.

Then Affinity told FORBA American Insurance was not renewing their policies due to "claims experience"  At that point FORBA asked Affinity to get them other insurance.  Affinity was an "authorized dealer" so to speak for NUFI.  So, Affinity secured insurance for FORBA, selling them a NUFI policy.  (Affinity knew why FORBA had their insurance canceled, didn't they?)

Affinity wrote the insurance policies in August 2009 and onward they marched, according to the Complaint.

Then, came the investigations results and a multi million dollar settlement with the government.  As well, a Corporate Integrity Agreement with Health and Human Services was made.

When FORBA Holding/Small Smiles Holding (New FORBA) filed suit against "Old FORBA" (The DeRose-Padula-Roump Bunch) crying foul, saying didn't know how bad Old FORBA really was, they ended up spilling the beans on how much they really knew and when they really knew it.  Being Gypsies, Tramps and Thieves, it's hard to keep all the deception in order. 

The Complaint against Old FORBA revealed facts that made it clear, the information New FORBA gave NUFI was, at worse, fraudulent and certainly misleading. (surprise surprise)

Basically NUFI is saying they didn't know what dirty rotten scoundrels New FORBA really was either.  Just as New FORBA claimed against Old FORBA.  In the suit New FORBA v Old FORBA, New FORBA admitting knowing in late 2007 they were being investigated.

Wouldn't it be funny if I had evidence NUFI knew or should have known all about the various investigations.  Let's just say for example website visitor logs.  Not saying I do, just saying it would be funny.

New FORBA filed suit against Old FORBA for the same reasons NUFI is filing suit against New FORBA.  Pot, meet Kettle.

NUFI is asking the court to rescind the last two years of liability insurance coverage they had on New FORBA and all of its employees.  Basically they are wanting to not have to pay up on any claims that will arise for the period 8-2008 through 9-26-2010.

Just as New FORBA is wanting to rewrite dentists employment contracts - in case the courts do not rescind and make void the NUFI insurance policies, they want the court to rewrite the policies on what is/was covered would be minimized.

Wonder if FORBA is looking for new insurance?

Good luck with that.

Click here to read the complaint.
The Policies/Exhibits are here;
No. 1 ; No. 2 ; No. 3 ; No. 4

Update:
The Tucson Inspection a few weeks ago, did NOT go well.  After all this time, they still can't get it together.  In the suit above, NUFI called it a "Raid"!

Lawsuits Against Kool Smiles Filed In Kentucky

I've found reference to two suits, but I can only locate the actual complaints on one.  Not sure what is going on with that.

One is Taylor vs. Kool Smiles in Lexington, this on is on file with the courts.

The second on was referred to in an online news papers:

Jerrisha Coomer v Kool Smiles, see it listed here.  This one I've not located just yet and found no other mention to it other than in the online paper.

If anyone has info, please email me with the info.

Tuesday, August 10, 2010

South Texas Dental -Dr. Kapadia


by BYRON HARRIS

Bio | Email

WFAA

Posted on August 10, 2010 at 9:10 PM

Updated Thursday, Aug 12 at 2:02 PM

NEWS 8 INVESTIGATES - South Texas Dental

Taking your child to the dentist can always be tricky. But what if you think a dentist is going do one thing to your child but then he does a lot more?

And what if your son comes out of the office black-and-blue and crying?

Hundreds of times a day, all across Texas, moms and dads take their kids into South Texas Dental to have their teeth worked on. It's a major corporation, employing dozens of dentists in four cities.

The company's long-term success indicates it is providing a valuable service.

But not for Nichole Villareal of Keller, who took her son to a South Texas Dental office in Fort Worth.

Anthony Martinez was left with a welt on his face.

"When I found out this was all done without my consent, and that he was in pain and he was hurt and he was bruised, I was furious," Villareal said. "I knew it was wrong because I work in a medical office, and I know."

The Fort Worth location of South Texas Dental is part of a chain of 23 clinics statewide. The company aims its practice at children.

Nichole Villareal took her son Anthony there because her husband was changing jobs. His company insurance hadn't kicked in yet, and she had to use a dentist who would accept CHIPS state insurance.

Anthony's previous dentist, Dr. Bridget McAnthony, said he did need treatment.

"When I saw him, he only had one cavity. It was on the outside surface of his tooth," McAnthony said.

T0810_south_texas_dentalhe dentist at South Texas Dental, however, said the eight-year-old had two cavities and needed sealant on two more teeth.

Villareal signed a consent form for that work to be done. When she took Anthony in, the dentist would not permit her to be in the room with her son.

When he came out? "It looks like he got punched in the jaw," Villareal said. "He has a bruise on the outside of his face that wasn't even supposed to be done."

Anthony said he was held down in the chair. It turns out that four of his teeth had been drilled.

Villareal said that work was done without her consent.

"And they didn't numb Anthony for the bottom procedure, so two fillings were done on the bottom and he wasn't numbed," she said.

When Villareal went back to complain, the dentist wrote Anthony a prescription for pain medication.

Dr. Kapadia did not respond to three phone calls from News 8 seeking comment.

His notes indicate Anthony was "very uncooperative" in the chair. The child's mom took him back to Dr. McAnthony to examine his mouth.

"It looks like they might have put some kind of intra-oral device in, and maybe they mashed down with their thumb on the inside to bruise him," McAnthony said. "It would have to be something that went from the inside to the outside, because he was bruised on the outside, too."

After we got no response from the dentist at the South Texas Dental office, we called Dr. Chad Park, who supervises three clinics in Fort Worth for the company. He said he is still investigating the matter.

The Texas Administrative Code says a dentist should maintain a consent form signed by a patient, or in the case of a minor, a form signed by his parent.

Villareal said no parent would give a dentist consent to do what was done to her son.

Friday, August 06, 2010

DeRose Buddy Could Be Lt. Governor of Colorado

This is just fantastic news!  (sarcasm)  Colorado State University-Pueblo President Joseph Garcia will be the running mate of John Hickenlooper in the Colorado's race.
Ya know, CSU…  Where the DeRose family plants football stadiums and millions more in various contributions.  It is where Dan DeRose is the football hero.
Here is a glowing blog post devoted to Dan. 
Puke and Gag. 
One comment actually congratulated Dan and his brother Mike calling them "class acts" and "crusaders". 
OMG!

update:
See

National Union Fire Insurance files suit against Small Smiles Holding in Tennessee District Court Friday Aug 6, 2010

National Union Fire Insurance files suit against Small Smiles Holding in Tennessee District Court Friday Aug 6, 2010.  Small Smiles Holding is getting the suit since it is the first named in on the policies.  If I were a dentist working for Small Smiles, I would be extremely concerned, that liability insurance you thought would CYA, just may not. 

Seems most of the evidence being cited in the TN suit comes from the New FORBA v Old FORBA case brought back in January, where they were fighting among themselves.  That case was quickly dismissed at the request of the parties.  That lawsuit let a whole lot of worms out of the can that will haunt All FORBA's for years to come.  Wonder what stupid attorney advised that lawsuit.

I'll post more later, I'm only on page 5, and there is 142! 

Oh, and in case you did not know, as I didn't, there was a suit filed against FORBA Holding, who is wholly  owned by Small Smiles Holding in Oklahoma on June 7, 2010 - Hernandez v FORBA (CJ-2010-1632)

Thursday, August 05, 2010

Inlaws of Small Smiles Regional Director, Jason Owen, Issues Threat?

I believe I have been threatened by relatives of Debby Owen, Jason Owen's wife.  This comment was posted on the entry about Jason and whether he's quit or not.  The IP is from East Hampton, New York, 13 miles from Shelter Island, New York-home of Debby's family. Read it and you decide.
  
Mike Lindley, what do you think?  Al Green, how about you?  Dangerous bunch or no?
Nothing but class for FORBA, right?
 
Brandon <chiefgabbard@optonline.net> (unregistered) wrote:
you are such a loser! since you don't have the balls to take on the government, who runs the medicaid program, you attack private citizens and blast their personal info on the internet. If your problem is with the dentistry, that is one thing. But to blather on pointlessly, about a man doing his job is absurd! If you think these kids are treated "unfairly" get used to it, it's called Obamacare and we all HAVE to have it, as far as I know, no one is ordering you under IRS penalty to take your kids here. It's just like any other government program, best service at the cheapest price. What next, are you going to bitch about no Swiss or Gouda Government Cheese and how the farmers are to blame? I appreciate you are trying to make things better, but picking on the underlings is cheap and petty, call Washington, call your politician, talk to them about your demands, but infiltrating someone's personal life to show what a dirt-bag you can be is very unbecoming. 
It won't be so cool when maybe someone who doens't agree with you or your beliefs, finds your info and shows up on your front porch one dark dreary night to discuss their disapproval of your life choices. Do unto others... Karma's a BITCH!  [
IP address: 24.189.127.31
Link to comment: http://disq.us/jleyx

I'm guessing Jason will be called on the carpet tomorrow...

That Karma thing is something I'm counting on.   Hook 'em and Cook 'em.

Update: 

From: Disqus
Date: 08/06/10 15:57:26
Subject: [dentistthemenace] Re: Inlaws of Small Smiles Regional Director, Jason Owen, Issues Threat?
======
Brandon <chiefgabbard@optonline.net> (unregistered) wrote:
I don't care about your bullshit blog, or anything you have against any company. I have a problem with YOU putting MY name out there. I feel THAT is a DIRECT THREAT to me and my families safety and security you self-righteous bitch! I assure you that all your complaints bother me, not until YOU put MY NAME on your blog did i even know what FORBA was, so don't tie my comments into some way to try and get another man fired. I'm a big boy and I stand behind my words! This is between you and the medicaid dentistry program... KEEP MY NAME OUT OF YOUR MOUTH AND OFF YOUR BLOG AND WE WON'T HAVE PROBLEMS!
IP address: 24.189.127.31
Link to comment: http://disq.us/jodpl

One thing for sure, the author what's this to be seen so that is what I've done.  If they wanted it private and didn't want everyone to see it, they would have sent an email.

 Just call me, Karma. 













I want to say here it was apparent that Jason and Debby wanted anyone in the world to read their lovely family blog.  Everyone, but me that is...  

Let this be a warning to all.  Not everyone likes you!

Kool Smiles Employee Warns Of Orange Jumpsuits; Wants Parents

Abileen Texas
Former Kool Smiles Employee

 

This dental clinic runs a very disorganized child factory. They truly only care to see "NEW" kids ages 4 and up that are well behaved as this is the age group that makes them the most revenue.

If your child is scheduled for a six mo cleaning expect to be rescheduled multiple times. Where is the continuance and quality of care? They rarely follow proper protocols on First Dental Home exams provided by the Medicaid program for babies age 6 mo to 36 mo.

The billing fraud that occurs throughout this company should be grounds for imprisonment or at the very least a through investigation by the OIG. I would high discourage anyone from taking their children to Kool Smiles, and find another employer unless you look good in orange jumpsuits. Not a good company to work for or take your precious kids to.

Wednesday, August 04, 2010

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

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

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



Before














After















After
















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

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

Mom Tells Of Recent Kool Smiles Experience In Massachusetts

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

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

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

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

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

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

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

GRRR....Okay vent over! LOL!

UPDATE:

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

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

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

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

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

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

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

Tuesday, August 03, 2010

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

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

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


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


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


He should hang around for their time in the operatory!  


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


Jason Owen -
DOB - May 16

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



Monday, August 02, 2010

Ohio Regional Manager Needed At FORBA - July 2010

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

Regional Manager, OH


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

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

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

Related Atricle
Attn: FORBA Small Smiles Employees

Sunday, August 01, 2010

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

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

Pueblo Chieftain, July 31, 2010

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

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


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



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

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

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

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

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

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

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

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

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

   Why not just have your family doctor do that?

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

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

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

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

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

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

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

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

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

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

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

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

Thursday, July 29, 2010

CanHouse Studios and Ballancing Act

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

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

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

Wednesday, July 28, 2010

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

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

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

Monday, July 26, 2010

Up A Creekview - William Nash, DDS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Sunday, July 25, 2010

Inside The Mind Of A 4th Year Dental Student

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

Sunday, July 25, 2010


Profiling the Pediatric Patient

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

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

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

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

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

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

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

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


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

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

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

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

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

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

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



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