Investigation: Understanding Medicaid, Pediatric Dentistry and Child Protective Services
Sometimes government entities designed to help the poor and needy misunderstand their need to help parents who are taking alternative approaches to health. This article is written because mothers on medicaid who refuse unnecessary dental treatments on their children may end up with having CPS (Child Protective Services) called on them. This does not happen when you refuse treatment from a family dentist in the hopes of a better alternative.
The problem occurring with Medicaid has to do with low reimbursement rates for dentists. In plain words, in many states, but not all, Medicaid dentists do not get paid a lot per treatment. In order for a Medicaid dentist to make money, they need to run many patients through their system as fast as possible. This is why dental students are familiar with the term, Medicaid Mill. (Ref. http://forums.studentdoctor.net/threads/why-do-dentists-accept-medicaid.948007/ )
The Medicaid dentist gets upset at the patient refusing treatment and the loss of income. To assure income is guarenteed and the patient complies with the agressive treatmen program CPS might be contacted to force compliance and treatment.
Below is a resource written by a parent who has helped many other parents faced with CPS
The Medicaid dentists push for profit means unnecessary dentistry happens all the time.
The Right Dentist May Protect Your Family - A Comprehensive and Helpful Guide
Many parents instinctively avoid the dentist if they have a very young child with tooth decay. They fear judgment or even worse, being reported to the authorities if they refuse the recommended treatment. But, finding the right dentist can actually protect your family if a report is ever made to the authorities based on tooth decay alone. If your child has tooth decay, working just as diligently to find the right dentist for your family as you do preparing wholesome meals can pay off. With some time and diligence, you can find the right dentist. Below you'll find a comprehensive guide to finding the right dentist, questions to ask, how having a good dentist can protect your family, and understanding what may place someone at a higher risk for being reported.
1. ) If a call is ever made to child protective services or any other protective organization based on cavities alone, being able to provide the worker with your child's dentist's contact information, proof of regular visits, and the dentist confirming that he/she does not recommend drilling and filling at the moment, ensures the case to be closed almost immediately.
2. ) If a call is made and you do not have a regular dentist, it can leave a parent scrambling to find one and little time to do so and increases the chance of working with a more invasive dentist. It's not uncommon for a date to comply date to be set and if the parent does not comply, court proceedings will begin. And even if you comply, it's not a guarantee that the court will drop the case. This is why having your child under good dental care protects your family, because if you do, it won't get to this point.
3.) Calling local dentists and asking specific questions generally provides a good scope of the dental practice and if they are minimally invasive.
4. ) Explain that you have a young child who think may have some cavities, and you would like to know their protocol on young children who have cavities that are not painful that would need sedation to drill and fill. If the person you're speaking with starts talking about the wonderful sedatives they use, this is an obvious sign this may not be the practice for you.
5.) As a general rule of the thumb, I avoid pediatric dentists. There are good pediatric dentists, but do keep in mind that it may be more common for much more invasive dentistry to be recommended by pediatric dentists than family dentists who see both children and adults. This again has to do with their income stream being attached to the number of procedures done.
6. ) Check the Holistic Dental Association's database as well as the International Academy of Biological Dentistry. Do a google search in your city and other nearby cities within a 2 hour radius. It's not uncommon for holistic and biological dentists to not see children until the age of three, but if you explain your issue and that you're just looking for a consult only, someone to help you keep an eye on things, this often helps you get in the door. Contacting your local chapter of the Weston Price Foundation is also a good way to find a family friendly dentist who is more geared to less invasive treatments. http://www.westonaprice.org
7. ) Understand that the presence of tooth decay in a young child, even very severe decay and the acknowledgement of the decay by your dentist does not put you in jeopardy. A biological, holistic, or minimally invasive may acknowledge the decay, but agree with "wait and see" or recommend fillings at a later date as they understand the very real risks of sedating a young child. Getting this treatment plan in writing protects your family.
8. ) Know when to choose your battles. Most parents are very excited about what they've learned about enamel remineralization and healing teeth naturally and want to share it. I say share it with your personal dentist, but not always your child's dentist. The professional opinion about tooth remineralization vary greatly among dentists and is deeply rooted in what they learned during their years in dental school. Questioning the dentist on why teeth cannot remineralize can be threatening to some dentists.
9. ) Let the dentist know that you want the absolute best for your child, would never let your child be in harm's way, that you are your child's biggest advocate. Also let your dentist know that you are taking active steps to prevent the tooth decay with good oral care and good nutrition. Being an advocate also means not exposing your child to sedation if it's not needed. In 2012 studies found an absolute link to sedation in children 3 years and younger and attention deficit hyper activity disorder, developmental delays, and mental problems. This is a very real risk and it's important to really weigh the risks. Is it worth sedating a child for non-emergency dental work if the tooth is functional and not causing pain? While your dentist may not agree with remineralization, many agree with this.
10.) If your child is on medicaid or other state funded insurance recipient, I highly recommend finding a private dentist that does not accept these types of insurance. I understand money is probably very tight, but encourage you to do whatever you can to put some savings aside to find a different dentist. Try and pick up some extra shifts at work, take a temporary second job, whatever it takes. In my experience, by far the most invasive work recommended often comes from these dentists.
11. ) Understand what puts you at a greater risk for having a report made and be mindful of who you share details about your personal health or schooling choices. There are some obvious ones, for example if your child has very visible decay. But, there are less obvious ones, if you don't vaccinate your children, if you home school, even your income level coupled with the tooth decay can unjustly provoke a phone call.
12. ) If you disagree with the dentist's treatment plan, do not make it a battle, do not be argumentative. Be polite, ask questions, and if the dentist asks when you're going to have the work done ( if you set the right tone, they often don't ), kindly tell him/her you're going to get a second opinion.
13. ) Try and think outside the box and don't lose heart. Minimally invasive dentists come in all kinds different forms. In our quest to find the right dentist, we've seen 6 different dentists and traveled to two states. All but one were minimally invasive or at least respectful of a parent's wishes to avoid sedation. Asking the right questions on the phone before you make the trip can really be the secret to what helps you find the right dentist. In the end, I didn't decide who the right dentist was, my son did. He felt comfortable and at ease and I knew this would be his dentist.
In the end, don't live in fear. With some effort, time, and asking good questions, you can find a dentist who also believes that protecting our children from unnecessary treatment is important. These are the dentists that want your children to have a good lifelong relationship with their dentist and not be fearful for them. They see the big picture and not their pocketbook. If you are on medicaid, don't be afraid to visually examine your child's mouth for obvious signs of tooth decay. White or brown spots for example. If you think your child has decay or severe decay, seek out a non-medicaid dentist to do the exam. That will keep you out of harms way.
"I've always known deep down that teeth can heal naturally. When my own daughter began having dental issues, I went on a mission! Already been down that path, and being very scarred from the dental experiences I endured, I knew I couldn't put my child through it. I found Dr. Weston Price's research and my instincts told me this was it! Ramiel has now written a book, drawn from Price's findings, but specifically directed at restoring dental health. The result is a very comprehensive book that lays it all out. He is honest. And the truth is an incredible eye-opener! The protocol works. Get this book, especially if you have children."-Mrs. Brown, Canada
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