Small Smiles Responds to ABC's Investigation

Clinic sends ABC News a detailed response about the investigation.

Nov. 7, 2007 — -- Michael Lindley, the chairman and CEO of Forba, which owns the Small Smiles dental clinic, responded to ABC News' investigation into Small Smiles' patient practices. You can read Lindley's response, as well as Forba's statement, below.

Nov. 7, 2007


For over 40 years Small Smiles has been committed to serving a large and underserved population. In just the last year we served over 400,000 children and received less than 50 complaints, or 0.01 percent.

We take very seriously ANY allegations which call into question our commitment to deliver quality care. On October 3, we launched an internal investigation into the allegations at the Langley Park, MD and Washington D.C. centers. The story does not accurately reflect the facts and our responsible approach to patient care.

Michael Lindley

Chairman and CEO, Forba

November 7, 2007

Our Company's Values – and the Facts:

For over 40 years Small Smiles has been committed to serving a large and underserved population. The network of affiliated dental centers has grown from one location to 63 in 18 states and the District of Columbia. The network of affiliated centers is staffed by over 250 compassionate dentists representing some of the most prestigious dental schools in the United States.

Together, we have served millions of patients and in just the last year alone, over 400,000 with less than 50 patient concerns raised or only 0.01 percent of our case files. We are proud of our service and take pride in serving children of all ages who may not otherwise be able to get dental care because they are on Medicaid or SCHIP and providers can be difficult to locate.

Against this backdrop, we were excited by the prospect of a balanced interview with a local ABC News affiliate in Washington, D.C. – and thus gave WJLA unrestricted access to our dental centers, staff, statistical information and parents willing to discuss the challenges they face every day in finding high quality dental care.

The reports that emerged were beyond disappointing. They were shocking and twisted the facts with alarming footage that does not tell the whole story - generally, and specifically to the two dental centers in suburban Maryland and in Washington, D.C.Indeed, beginning with the first interviews in October when questions were raised we launched our own internal probe. Subsequently, we cooperated at all times, providing accurate and current data and statistics. At one point we even offered senior management for interviews that never materialized.

Here are the facts the reporter ignored:Small Smiles has no official policy in place for the use of a medical stabilization device. The use of such device is up to each individual dentist in consultation with the parent. On average a medical stabilization device is used 4-6% of the time and in accordance with AAPD guidelines. Additionally, the child is NEVER treated with a medical stabilization device without the parent's written informed consent which is made available through a separate consent form that illustrates the procedure.

Small Smiles has no policy that prohibits parents in the treatment area. Allowing a parent in the treatment area is up to the treating dentist in collaboration with the parents based on their belief of the best way to treat the child. Such a family-friendly policy encourages our dentists to allow parents in the treatment area to be part of the patient's treatment experience.

Allowing a parent in the treatment area is not a HIPAA violation. The sign posted in the lobby at one of the clinics in a story does not explicitly say that it is a HIPAA violation for parents to accompany their child into the treatment area. It is unfortunate that one of the dentists quoted in the reports misspoke. But there is no policy barring parents joining their children.

It is true that Small Smiles does not have pediatric dentists in their DC area locations. The work performed at Small Smiles is basic dentistry performed by general dentists with any complicated cases, or cases that need to be performed in the operating room, being referred out to a specialist.

We have no reasons to believe that parents were told services were needed that actually were not. This would be counter to everything we stand for as an organization if it were true. Treatment planning is done by each individual dentist in a manner that is consistent with what is best for each individual child. A single treatment planning issue we do encourage is the use of sealants consistent with AAPD and Medicaid guidelines.

Patients are scheduled to accommodate their calendars for adequate treatment and education. At every Small Smiles center an operative appointment is scheduled for an hour and each hygiene appointment is scheduled for 45 minutes.

We do work with our centers to help patients minimize their scheduling and transportation challenges. The opportunity to perform hygiene services and restorative work in the same visit helps parents get the services they need for their children. With our centers experiencing an overall broken appointment rate of close to 50%, it also means the child is much more likely to get the necessary treatment completed if it is accomplished in one visit.

The requirement for a dental assistant to have a certificate to perform x-rays is a state by state requirement. Washington D.C. has no such requirement. Maryland does. The story does not identify which site is being referenced in relation to this claim but if it was happening in Langley Park, MD it clearly should not have been. We are following up on this to ensure full compliance, not only in MD but in other states with similar requirements. Furthermore, all centers are fully equipped with radiation safety gear to handle children from one year of age to young adults.

We take very seriously ANY allegations which call into question our commitment to deliver quality care. That is why we are taking such extraordinary steps to share with you our values, our commitments and to do so in as transparent a way as possible.Every Small Smiles Dental Center has a compassionate staff with the same goal in mind – to give America's kids the smiles they deserve.

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