Thursday, April 4, 2019

The Smiles Are Gone for Kool Smiles

Kool Smiles? Kool What? The dentistry chain recently changed its name after enduring a spell of bad publicity.  The Northeast Mississippi Daily Journal reported yesterday:


Kool Smiles has changed its name to Sunnybrook Dentistry in Mississippi while trying to mask its connections to the embattled national family dental clinic corporation.

In Tupelo, the Sunnybrook dental clinic is in the same location as Kool Smiles was formerly located and has the same providers, dentists Drs. David Moore and Victoria Graham. Nationally, Kool Smiles and its Georgia-based Benevis parent company have been the subject of investigation after a child died under anesthesia at a Kool Smiles in Arizona and the company settled a federal Medicaid fraud lawsuit for $23.9 million.

A March press release sent to the Daily Journal by a public relations firm made no mention of the clinic's connection to Kool Smiles. The public relations firm also misrepresented Graham’s credentials, saying she was a pediatric dentist, a specialization that requires additional training beyond dental school to achieve. Mississippi Board of Dental Examiners records say she is licensed as a general dentist....

In 2013, a federal false claims was filed against Kool Smiles. The company was accused of fraud in eight states including Georgia and Louisiana, by upcoding dental work and performing unnecessary work for Medicaid patients. Reporting by the Atlanta Journal-Constitution described root canals on baby teeth without proper anesthesia, while keeping parents out of the room to keep hidden the child’s suffering. Dentists were encouraged to restrain reluctant patients with papoose boards, where they’re wrapped in a cocoon-like fabric.

In December 2017, a 2-year-old boy died after being placed under anesthesia at a Yuma, Arizona Kool Smiles.

Mayfield, who had been appointed to the Georgia Board of Dentistry in 2016, resigned from the board under pressure in January 2018 after Kool Smiles settled the Medicaid lawsuit for $23.9 million without admission of guilt..... Rest of article.

Kool Smiles is currently embroiled in a fight with the Mississippi Board of Dental Examiners over its use of general anesthesia in dental offices.  Kool Smiles focuses on providing dental services to children although its dentists are not pediatric dentists in Mississippi.  Kool Smiles dentists use a dental anesthesiologist to place the patient under deep sedation while another dentist operates on the child.  The specialty is not recognized in Mississippi. 

Such practices have drawn heavy criticism from pediatric dentists in Mississippi.  They claim such practices are not safe and endanger the child.  They advocate using general anesthesia only at a hospital or an ambulatory center.  They argue the operating dentist should have a general anesthesia permit if such anesthesia is used in the dental office per Board regulations.

The Board is currently reviewing its regulations and determining whether it should modify its regulations for anesthesia permits. 

18 comments:

Anonymous said...

Is there a hard and fast rule that only pediatric dentists can provide dental services to "children"?

Anonymous said...

"Smiles Is"?

Anonymous said...

Hold on....these places don't meet regulations, so 'The board is considering modifying its regulations'?

Anonymous said...

"Dentists were encouraged to restrain reluctant patients with papoose boards, where they’re wrapped in a cocoon-like fabric."

If restraint chairs are flat-out outlawed in this state (in all psychiatric related venues) why in hell would not 'papoose boards' not also be against the law. This is damned alarming!

There was a time (and it went on for a hundred years) in this state when you could strap an unruly or uncooperative resident into a 'restraint chair' and leave him there for an entire day or night, in order to teach him a lesson.

Anonymous said...

Had go Google "papoose board" as I was ignorant of its existence. My search results were alarming, and you can buy them on Amazon. I wonder what the response would be from Child Protective Services (or whatever it's called here) if a parent used such a device to temporarily restrain an unruly child?

I'm going to assume that it will be unpleasant for everyone involved.

Anonymous said...

Dentistry is largely unregulated compared to other practices. Much like the so called "implant specialist" on corner of northside Dr and north state street. He's no longer practicing and rightly so. There needs to be more regulation of the areas they're trained in. Implants are a big issue currently being abused. Cool smiles is minor compared to what dentist are currently getting away with.

Anonymous said...

Obviously no one is recognizing that if only the WONDER DRUG marijuana was used here, Kool Smiles wouldn’t be in this predicament.

Anonymous said...

It is common to restrain infants and uncooperative children on papoose boards or use other restraints in order to take x-rays, CTs, MRIs, etc. But anything being done to a young child in a dentist's office that requires extreme anesthesia and/or restraints is dangerous and barbaric. Let's run these people out of our state.

Anonymous said...

Yes, 8:39. "Kool Smiles is..." is correct. Kool Smiles is a singular entity, and in American English we treat that as a singular noun. The Brits, on the other hand, would say "Kool Smiles are," just as they'd say "Google are." They treat such collective sounds as plural, whereas in American English we treat them as singular.

Anonymous said...

I will try to help answer a few questions about this topic. General dentists can do all of the same procedures as a pediatric dentist, and we are held to the same standards. The reason places like Kool Smiles exist is due to the fact that a lot of pediatric dentists don’t want to treat Medicaid children. As far as papoose boards go, they should have been outlawed in the 70s. If Medicaid would increase their reimbursement rates, more pediatric dentists would probably be willing to help these children. Kool Smiles will keep going because they have a unlimited supply of patients, and they have a huge budget to fight any legal battle. Hopefully nobody dies in these offices.

Anonymous said...

There is a relatively-new body of law that may or may not apply. Here is a piece of it:

(2) A health care practitioner providing health care services in this state must conspicuously post in their office and affirmatively communicate the practitioner’s specific licensure as defined under this chapter. This shall consist of the following: The health care practitioner shall display in his or her office a writing that clearly identifies the type of license held by the health care practitioner. The writing must be of sufficient size so as to be visible and apparent to all current and prospective patients.

(3) A health care practitioner who practices in more than one (1) office shall be required to comply with these requirements in each practice setting.

Miss. Code Ann. § 41-121-7(2).

PittPanther said...

Root Canal on baby teeth? WTF? Ok that sucker out and move along, is gonna fall out soon anyway.

Anonymous said...

If people really knew how unregulated dentistry is in MS, they would go out of state.

A bad dentist can do untold harm before being stopped here.

Anonymous said...

I will have to agree and disagree about the level of regulation in our state. We have a high level of regulation, but some bad dentists do slip through the cracks. I cant tell you how many times i have had to help people that were harmed by a certain dentist in Brandon. People hear all of his advertising, and they wrongly assume he has good skills. The board has levied huge fines on him, but he still practices. We have plenty of regulations in place. My advice is to ask a few people for recommendations before getting any major dental work. Even better, ask some local oral surgeons or periodontists for their opinion regarding which general dentists to use.

Anonymous said...

Not sure why the Fish shit canned my earlier post....BUT, it is illegal to use restraint chairs today in psychiatric facilities. For most of a hundred years that was the discipline of choice, but now it's outlawed and the State Attorney General is in charge of enforcement. Strap a patient in a chair and leave him/her there until he/she learned to behave or calmed down.

So....why is it legal to use what amounts to the same damned thing to restrain children having dental procedures? How damned inhumane is this!?

Anonymous said...

Dentistry is under regulated and downright scary. People operate on the barter system, trading favors, trips, etc. Cash pricing is determined by how much the person looks like they can pay. Good look doing that at your medical doctor. Doctors can go to jail for overbilling and even underbilling! (Look it up). Also they are not allowed to give “no pay courtesy” to other medical professionals anymore as the lawmakers tell us this creates bias and favoritism amongst patients. About time someone regulated the heck out of these Wild West cowboys.

Lastly look to the opioid crisis in MS. Look at the strict rules from MSBML that have been chronicled on this blog.
Broken femur= 5 Hydrocodone from the doctor.
Pulled tooth=60 oxycodone. Call if you need to come get another prescription.

Anonymous said...

10:12 pm. Dentists are regulated and monitored via the PMP just as medical doctors.
Any patient prescribed more than three days of pain medication must have a PMP run. This is monitored by the board. Problem arises when a patient doctor shops. had a patient hit every dentist in town (with a legit dental problem) before the MS B of N caught up to her.

As for the kool smiles. It's true about the Medicaid reimbursement fees. At times their reimbursements barely cover the cost to perform such a procedure. So you get these Medicaid factories. They pay some dentist a moderate salary. Get kids in and run every conceivable charge to Medicaid.

As a practicing dentist I have always felt that if you feel the need to papoose a child the least you could do is stop yourself and refer out to a dentist that has hospital rights and thus access to an anesthesiologist. I'm not positive on the level of sedation that Kool Smils is operating with but I tend to agree that a child under general anesthesia should be monitored by an anesthesiologist and not a dentist who took a three week course in sedation.


Dentists are regulated all right. But slick ones slip through. For that matter so do doctors. Better hush about that dentist from Brandon. Eyes and ears everywhere and all.

Anonymous said...

Kool Smiles is "slick as snot on a doorknob." I hope all their clinics and other corporate dental clinics in MS are being monitored for fraud and abuse by Medicaid. According to a dentist who works at Kool Smiles, nothing has changed in terms of their "corporate culture" that requires dentists to bill out a certain number of dollars each year. If the dentist falls short, he/she is "brought in" by the powers that be for an "improvement" discussion. If he/she doesn't improve, they're fired. Why the corporation never had to sign a "corporate integrity agreement" after their settlement is beyond me. Most settlements require this.

Regarding the MS Board of Dental Examiners, it is a JOKE. Right now they know of violations regarding general anesthesia in corporate dental offices and orthodontics violations, and said at their meeting yesterday that they're not going to enforce them, as they don't want to be involved in a lawsuit!

They should be more concerned that they, as Board members, will be sued INDIVIDUALLY if a child dies in a dental office during anesthesia, as all these clinics are in violation of the Board's regulations on general anesthesia, the Board has had multiple filed complaints, AND REFUSES TO SHUT THEM DOWN.

Shame on the Board! Shame on Kool Smiles, Mississippi Smiles and Happy Smiles! I can only hope that karma is real.

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