Awful story on 20/20 about Small Smiles - torturing children

Anonymous
Anonymous wrote:I am in health care and I find this report to be a bit distorted.
First, the unnecessary filling of teeth is always unacceptable. That could cause permanent damage. All parents should try to take a look themselves before anyone drills a permanent tooth.
The fact that medicare pays so little for these children to receive care, must be very frustrating to the dentists. They often average less than $10 an hour when you consider all the work that goes into it. That is why these cases should be spread out. No one dentists should try to care for all of these kids.
The boards that they use to strap the children down are not unreasonable. They are used to circumcise babies, and anesthesia has its own risks. I hold my child down in a wrestler's grip to get him trough a dental visit. I will not allow use of drugs and he will outgrow his fear, but we need to get through the appointment. We could be there all day talking, and it will not make a difference. When it is over, he is cool since nothing really hurt. I am not suggesting that adults not try to talk the child through it, but sometimes it does not work. That said, they should have allowed the parents to be with the children to help allay anxiety.
The case with the child crying while receiving an anesthetic gas was complex. The child might have been disinhibited by the gas, so the screams are difficult to judge. He might be completely amnestic, in those cases, it is best not to have the parents around, since they might not understand the situation.
Dental care in this demographic is problematic, but the parents need to take some blame. Yes, blame. Many of these children never brush their teeth and eat a ton of sugar. It seems like the poorer the child, the more candy! That has to do with ignorance rather than money. Parents need to educate themselves about caring for their own children. If they can't afford the care, then they should take measures to prevent the problems. Harsh I know.
It is a messy viscous cycle.
Medicare should pay dentists more so that these kids can go to regular dental offices and avoid these mills. Parents should be educated, and stop believing that they have no power to keep their children healthy.


Good lord. Tell me where you work so I can avoid your practice.
Anonymous
As a child I had a dentist that didn't believe in novocaine. He did all the work, and not good work, without any kind of pain management and I don't remember my mother going back with me. He was highly recommended by everyone in the community and his BIL was THE orthodontist around so everyone saw him. Turns out he targeted some of the families that didn't have high standing in the community to do shoddy work on. My parents are highly educated and my dad's job was one of the best paying in town but he was busy volunteering his time at Affordable Housing and at Centro Civico than golfing at the country club. So he targeted us. He started a root canal on me and did it in numerous sittings and during that time my dad lost his job, and his insurance, and I was kicked out of the practice. With a huge hole in my tooth. Once my dad had another job and insurance that tooth was pulled along with other teeth that he filled without cleaning first. Two of my molars permanent teeth are gone and I am so thankful they are in the back.

This has made me worry about bringing my children to the dentist and finding a good one. I am the same poster with the little boy that had unnecessary work done. I thought my gut feeling that it was a bad practice was because of my own past. I must admit though that if it wasn't for my past I may not have questioned their treatment when I did, nor would I be as angry with myself for allowing this all to happen. I question the new dentist I am bringing my son to even though his treatment plan is a little less aggressive than the one my own dentist came up with. My son now has holes in his teeth that need to be fixed. Holes that wouldn't be there if I had any idea that the dentist I was taking him to was an unethical bitch who had no second thoughts when it came to exploiting children. Despite her having children of her own.
Anonymous
My daughter works as a dental assistant and Thank God its not at this place...she was so appalled by what she saw..
Anonymous
23:37, what in the hell is wrong with you?? This is like blaming a rape victim because she wore a short skirt. Something is very, very wrong with you to try to defend this unethical behavior.
Anonymous
Anonymous wrote:
Anonymous wrote:I am in health care and I find this report to be a bit distorted.
First, the unnecessary filling of teeth is always unacceptable. That could cause permanent damage. All parents should try to take a look themselves before anyone drills a permanent tooth.
The fact that medicare pays so little for these children to receive care, must be very frustrating to the dentists. They often average less than $10 an hour when you consider all the work that goes into it. That is why these cases should be spread out. No one dentists should try to care for all of these kids.
The boards that they use to strap the children down are not unreasonable. They are used to circumcise babies, and anesthesia has its own risks. I hold my child down in a wrestler's grip to get him trough a dental visit. I will not allow use of drugs and he will outgrow his fear, but we need to get through the appointment. We could be there all day talking, and it will not make a difference. When it is over, he is cool since nothing really hurt. I am not suggesting that adults not try to talk the child through it, but sometimes it does not work. That said, they should have allowed the parents to be with the children to help allay anxiety.
The case with the child crying while receiving an anesthetic gas was complex. The child might have been disinhibited by the gas, so the screams are difficult to judge. He might be completely amnestic, in those cases, it is best not to have the parents around, since they might not understand the situation.
Dental care in this demographic is problematic, but the parents need to take some blame. Yes, blame. Many of these children never brush their teeth and eat a ton of sugar. It seems like the poorer the child, the more candy! That has to do with ignorance rather than money. Parents need to educate themselves about caring for their own children. If they can't afford the care, then they should take measures to prevent the problems. Harsh I know.
It is a messy viscous cycle.
Medicare should pay dentists more so that these kids can go to regular dental offices and avoid these mills. Parents should be educated, and stop believing that they have no power to keep their children healthy.


Listen, everyone knows that children cry when stuff hurts. The things you are defending aren't what are so shocking, if they're done infrequently and with the knowledge and compassion of a parent or other loving adult being in the room with the child. All the things you say are insufficient for justifying the myriad unethical practices that "Small Smiles" appears to exercise quite intentionally and regularly.

I surely hope you are not defending this particular clilnic.

And, yes, I agree that dental care insurance -- preventative and reactive -- needs to change. The incentive structure that helped motivate this particular clinic are exceptionally problematic.
Anonymous
23:27 makes some very valid points. Parents are 100% responsible for the condition of their children's teeth, period. And papoose boards are common in pediatric dentist offices. You either take care of the tooth decay, or you don't and let it lead to a serious infection.

I a not defending the practice in the article. I haven't even viewed it, so my comments have nothing to do with this particular practice.
Anonymous
14:37, you are missing the entire point of the discussion. No one is claiming that dentists are somehow responsible for cavities. People are upset that unethical dentists are doing unncessary work on infants, toddlers, and young children without the appropriate pain management. 14 root canals on a toddler? If you think that is reasonable, then I have a bridge I'd like to sell you.
Anonymous
Anonymous wrote:14:37, you are missing the entire point of the discussion. No one is claiming that dentists are somehow responsible for cavities. People are upset that unethical dentists are doing unncessary work on infants, toddlers, and young children without the appropriate pain management. 14 root canals on a toddler? If you think that is reasonable, then I have a bridge I'd like to sell you.


The 14 root canals is probably excessive, but the history of these kids is that when they have one cavity it seems that all the teeth have them. I have seen this in the hospitals when they come in for a full mouth of fillings. Admittedly, I have never seen them getting the root canals.
Anonymous
Again . . . I don't think anyone has a problem with children needing fillings. Even if they need a full mouth of them. But multiple root canals on baby teeth? That is pure torture, and it should be illegal.

Anyone in the medical profession who watches this video and thinks the PARENTS are to blame for what the doctors are doing to these children is probably either just as unethical or at risk of being just as unethical.
Anonymous
Is this video really surprising? If there is a profit to be made, some people will do so unethically.

There is so much Medicaid fraud in this country.

And, I agree with the PPs who say that it is your child, so it is your responsibility to advocate for his/her care.
Anonymous
Anonymous wrote:Again . . . I don't think anyone has a problem with children needing fillings. Even if they need a full mouth of them. But multiple root canals on baby teeth? That is pure torture, and it should be illegal.

Anyone in the medical profession who watches this video and thinks the PARENTS are to blame for what the doctors are doing to these children is probably either just as unethical or at risk of being just as unethical.


I am not sure why multiple root canals should be illegal if they are necessary. The point that you might be trying to make is that doing unnecessary root canals should be illegal.

No one said that parents are to blame for what the dentists are doing, but the parents are to blame if a child has a mouthful of cavities. After they send the feds to nail the dentists, they should send a social worker to the family's home.
Anonymous
21:13, you are a complete and total nut job. You seem to be defending dentists who were forced to pay upwards of $24 million in restitution for TORTURING children and defrauding the federal government. Do you work for Small Smiles?

You are trying to somehow blame the parents in this scenario. Something is wrong with you. Yes . . . we should be more lenient on the dentists who are providing unnecessary, PAINFUL procedures on toddlers and more strict on parents who feed their children candy. You should run for President so we can adopt such a reasonable, ethical social sytem and health care program.
Anonymous
Not the 21:13 poster, but, yes, if the treatment is necessary, how is it torture?

My child screams bloody murder every time she gets a shot. She screams if we need to instill eye drops. Heck, sometimes she screams if I try to pick her nose.

Are shots considered torture?

Parents have choices. If you aren't comfortable with leaving your child alone with a dentist, or if the dentist wants to do 28 root canals on your child (who only has 20 teeth) then you should choose another dentist.
Anonymous
Anonymous wrote:I am in health care and I find this report to be a bit distorted.
First, the unnecessary filling of teeth is always unacceptable. That could cause permanent damage. All parents should try to take a look themselves before anyone drills a permanent tooth.
The fact that medicare pays so little for these children to receive care, must be very frustrating to the dentists. They often average less than $10 an hour when you consider all the work that goes into it. That is why these cases should be spread out. No one dentists should try to care for all of these kids.
The boards that they use to strap the children down are not unreasonable. They are used to circumcise babies, and anesthesia has its own risks. I hold my child down in a wrestler's grip to get him trough a dental visit. I will not allow use of drugs and he will outgrow his fear, but we need to get through the appointment. We could be there all day talking, and it will not make a difference. When it is over, he is cool since nothing really hurt. I am not suggesting that adults not try to talk the child through it, but sometimes it does not work. That said, they should have allowed the parents to be with the children to help allay anxiety.
The case with the child crying while receiving an anesthetic gas was complex. The child might have been disinhibited by the gas, so the screams are difficult to judge. He might be completely amnestic, in those cases, it is best not to have the parents around, since they might not understand the situation.
Dental care in this demographic is problematic, but the parents need to take some blame. Yes, blame. Many of these children never brush their teeth and eat a ton of sugar. It seems like the poorer the child, the more candy! That has to do with ignorance rather than money. Parents need to educate themselves about caring for their own children. If they can't afford the care, then they should take measures to prevent the problems. Harsh I know.
It is a messy viscous cycle.
Medicare should pay dentists more so that these kids can go to regular dental offices and avoid these mills. Parents should be educated, and stop believing that they have no power to keep their children healthy.


You make some valid points.

I've worked in medical clinics also, that cater to Medicaid patients. Parents in this demographic often do not want to take any responsibility.

We've had patients come in on Medicaid with their nails perfectly manicured with little tiny rhinestones and the latest and greatest cell phones. Sorry, but if you can afford that, you can afford to buy your child toothpaste.

Medicaid is being taken advantage of by the general public and by the doctors who see these patients. Only a small percentage of patients on Medicaid actually deserve to be on it. The rest is a huge, expensive, taxpayer funded sham.
Anonymous
Anonymous wrote:21:13, you are a complete and total nut job. You seem to be defending dentists who were forced to pay upwards of $24 million in restitution for TORTURING children and defrauding the federal government. Do you work for Small Smiles?

You are trying to somehow blame the parents in this scenario. Something is wrong with you. Yes . . . we should be more lenient on the dentists who are providing unnecessary, PAINFUL procedures on toddlers and more strict on parents who feed their children candy. You should run for President so we can adopt such a reasonable, ethical social sytem and health care program.


OHHH, I get it, blame everyone else. No one needs to take responsibility for anything. I did not say that the dentists were innocent. NOT.
But the parents need to take some responsibility.
I know someone who got really serious with his kids and tooth brushing after they got an $1800 bill for his two boys and their 11 cavities with no dental insurance.
Amazing how you take matters into your own hands when it's your wallet.
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