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No Bark, No Bite

Disreputable dentists get off easy

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When kids wouldn't behave, he choked them, slapped them and banged their heads against chairs. He'd often haul them out of their seats by their necks or yank them forward by hooking his fingers under their upper front teeth.

No, this isn't another column about some thug with a three-page rap sheet. This is about Dr. David Moore, pediatric dentist extraordinaire, and what went on in his Billingsley Road office.

In one case described in a report by the North Carolina State Board of Dental Examiners, Moore pulled a girl "off of the dental chair by her head and neck and slammed her against the window in the operatory." In another, he choked a boy and left marks on the child's neck and face. A third child also emerged from his office with marks on his cheeks and arms after Moore strapped him to a chair and used a mouth prop that caused unnecessary bleeding.

That's just a small sample of how the low-income children who visited Moore's Small World Clinic, which specialized in Medicaid patients, were treated. The rest of the story doesn't get much better. According to the dental examiners' report, Moore left children unattended while they were under intravenous sedation and failed to note his reasons for sedating them in their records. Though he didn't have a general-anesthesia permit, he administered general anesthesia to other children and left them unattended as well.

Why knock your patients out? My guess is that it's a heck of a lot easier to perform hours of unnecessary work when they're out cold.

That's where the Medicaid fraud comes in. Moore repeatedly billed the government for work he didn't do and failed to justify work that he did, an investigation by the dental examiners revealed.

A rational person would assume that Moore's dental career was kaput, but rational people apparently don't sit on the dental examiners board. As punishment, the board revoked Moore's license for six months starting Jan. 13. When he gets it back in July, they plan to get really tough with him by putting him on probation.

Here's how that harebrained scheme is supposed to work. According to an agreement Moore signed with the board, if he doesn't beat up kids, illegally gas them, work on them alone or bar their parents from the examining room, he gets to keep his license. The board plans to enforce this by training his staff -- who will be hired and paid by him -- to keep an eye on him. Moore will be required to establish a fund for each staff member that covers their salary for up to six weeks -- not six weeks, but up to six weeks. They'll get the money if they fink him out, but only if the board later finds he broke the law. How they'll pay the rent until they find a new job isn't covered in the agreement.

What happened at Small World Clinic is just the latest example of the dental examiners board's laissez-faire attitude toward fraud and patient abuse by Charlotte dentists. Two and a half years ago another investigation by WCNC-TV's Stuart Watson found that two other pediatric Medicaid Dental Centers in Charlotte were barring parents from the examining room, strapping down children as young as 4 for hours, and drilling and capping eight to 16 teeth at a time, procedures that the board found were often unjustified or unnecessary.

After more than two years of inaction, the board finally wrote letters of censure to six of the doctors. The two owners of the clinics, Drs. Letitia Ballance and Michael Derose, were put on that infamous probation. If they bill Medicaid for more than six crowns in a single day, neglect to get parents' permission before the procedure or commit fraud again, they could lose their dental licenses for six whole months. Wow. That's tough.

Part of the problem here is that like doctors, dentists police themselves in North Carolina, with results that can be frightening. The six dentists who serve two-year terms on the dental examiners board are elected by the other dentists licensed in this state. (A hygienist and regular citizen also serve on the board, but they don't get to vote or sit in on disciplinary hearings.)

This creates a sticky situation. Laying the smackdown upon your fellow dental practitioners isn't the way to maintain your popularity or your seat on the board. Make too many enemies and it could come back to haunt you when you leave. And since the board is the final word, why stick your neck out when you could stick up for a colleague who handles poor kids no one wants to work on anyway? It's not like there's a lot of money in that Medicaid stuff, and dentists have to make a living somehow.

Right?

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