Pennsylvania mom Trey Hoyumpa is taking a stand against Dental Bullying. Image from Facebook. by Terri LaPoint Health Impact News Is Medical Kidnapping now spreading to the dental profession? Parents all over social media are in an uproar over a letter posted by a Pennsylvania mother from her children's dentist office. Smiles4Keeps Pediatric Dentistry sent a letter to a mother threatening to call Child Protective Services if she did not schedule a dental appointment for her child. The dental office staff has responded to the post and comments with a post of their own, defending their actions as being their legal obligation. Instead of quieting public fears, the response appears even more disturbing to parents, who are accusing the dental office of "bullying," and "blackmail." Here is the letter posted on Facebook that Trey Hoyumpa allegedly received in the mail on March 19, 2018, from the Bartonsville, Pennsylvania, Smiles4Keeps office: dentist letter threatens medical kidnapping

dentist letter threatens medical kidnapping

Trey Hoyumpa isn't smiling. Neither are the hundreds of other parents who have been sharing the post and commenting.

Parental Concerns over Office Policies

Image from Smiles4Keeps website. According to the mother's post, there are several practices that the dentist office maintains that concerned her, any of which could account for her choosing not to continue taking her children to that particular dentist:

Parent does NOT go into patient area with their child. 2- Parent does NOT meet dentist. (They meet hygienists.) 3- Only one appt for procedures (fillings) per day. If Parent has more children, they must come on a different day. 4- They will report you if you don’t respond to them.

There are many good, loving parents who refuse to allow their children to be seen by any doctor, dentist, or health provider unless they are able to accompany their children, not wanting to leave their children alone inside a medical office. For some, that policy alone is reason enough to decide never to go back. How are parents to protect their children if someone, even someone they have never met, is permitted unfettered access to them? Does she really need to justify or explain to the office why she chose not to take her children back?

Dental Office Responds Publicly on Facebook

Dr. Ross Wezmar is the founder of the dental clinic according to their website. Image source. As the photo of the letter circulated on social media, the public responded with phone calls to Smiles4Keeps and posts on the practice's Facebook page. On Wednesday, the office responded (see full post here). The post begins with a link to a policy from the American Academy of Pediatric Dentistry (AAPD):

On March 19, a Facebook post inspired a series of comments from others in the Facebook community. We appreciate feedback from our patients and potential patients. However, the online conversation failed to remain focused on facts. Smiles4Keeps wishes to clarify the following points: • The letter in question refers to dentists’ legal obligation to report dental neglect to the proper authorities. In its Guideline on Oral and Dental Aspects of Child Abuse and Neglect, the American Academy of Pediatric Dentistry defines the term and clarifies its importance. The full document is available for review here: http://www.aapd.org/media/Policies_Guidelines/G_Childabuse.pdf. Here is an excerpt:
Dental neglect, as defined by the American Academy of Pediatric Dentistry, is the “willful failure of parent or guardian to seek and follow through with treatment necessary to ensure a level of oral health essential for adequate function and freedom from pain and infection.” Dental caries, periodontal diseases, and other oral conditions, if left untreated, can lead to pain, infection, and loss of function. These undesirable outcomes can adversely affect learning, communication, nutrition, and other activities necessary for normal growth and development.

The policy also includes important points that Smiles4Keeps neglects to mention, such as the fact that there can be other factors involved in why a family may not bring in a child for a dental appointment, such as: "family isolation, lack of finances, parental ignorance, or lack of perceived value of oral health." The policy paper states:

The point at which to consider a parent negligent and to begin intervention occurs after the parent has been properly alerted by a health care professional about the nature and extent of the child’s condition, the specific treatment needed, and the mechanism of accessing that treatment.

The assumption of neglect, according to the policy, should not be made without evaluating many other factors. Even so, the AAPD fails to take into account that a parent may simply not like the way they were treated at that dental office or may choose to go elsewhere or make a different medical/dental decision.

Dentist Demands Name of New Dentist if Family Chooses to Leave

Smiles4Keeps clarified their position on a parent choosing a different dentist:

If a parent or guardian chooses to take a child who requires treatment to another provider, we ask for the name of the new treating dentist so we can record the information in the patient’s record. We remain responsible for the patient until the parent relays the name of the new dentist. We welcome the opportunity to support other medical and dental providers with the hope that all children receive the appropriate care they require in a timely manner.

Upon request and written permission of the child’s parent or guardian, we transfer records to the new treating dentist.

Parent Reacts Against Dentist Threats - Stands for Parental Choice and Patient Privacy

That response does not set well with many who read it, including Trey Hoyumpa. She addressed this point in her response on the dentist office Facebook page this morning, a response which resonates with many parents: >I don’t have to tell you where I go with my children nor do I have to tell you my plans for their future care.... What I do with my kid’s teeth after I LEAVE your office is none of your business. >You ARE NOT the caregiver of my child WHEN I SAY that you are no longer the care giver, and NOT when YOU tell me so. Is Smiles4Keeps attempting to tell their clients that they do not have the right to change providers at will? An American value that many of us may take for granted is the right to "vote with our feet," taking our business elsewhere if we do not like something about a place of business. For example, if the service at Lowe's is inadequate or the prices are too high, we can choose to leave and shop at Home Depot or our local hardware store. If we disagree with the policies at Target or Walmart, we have the liberty to choose not to go there. If we walk into a McDonald's or Starbucks and don't like the treatment we received, we are free to leave. No company or provider has a right to our business. In a free market economy, we owe no explanation to anyone as to why we choose not to do business with any particular company or individual. Yet, when it comes to medical providers, the freedom of Americans to choose seems to be dwindling.

Losing Children for Not Making Regular Dental Visits? - What About Death and Abuse in Foster Care?

Smiles4Keeps linked to "one unfortunate case" where a child died from an untreated tooth abscess. (In that case, the mother tried hard to get him treatment, but had difficulty finding a provider who would accept Medicaid. ER doctors did not appear to treat him adequately. Link here.) The dental office staff wrote:

In all 50 states, physicians and dentists are mandated reporters. This means that they are required to report suspected cases of abuse and neglect to social service or law enforcement agencies in order to prevent such tragedy. This is not unique to us. These laws are in place to protect children.

However, nowhere is there any indication that the child about whom the letter refers is in any true danger or in any pain. Are dentists to become "mandated reporters" simply because a parent chooses not to bring their children in for regular dental checkups every six months, or because parents may choose a different dental practice that is not approved by the current dental practice? Is this really grounds for Child Protection Services to come in and remove children from their families and start an investigation? There is ample federal and state data showing that children in foster care are at least 6 times more likely to be abused, molested, raped, or killed in foster care than they would be if left in their own home, even if that home is less than desirable. See:

Foster Care Children are Worse Off than Children in Troubled Homes – The Child Trafficking Business

We also know from our experience with numerous families whose stories have been covered by Health Impact News that children's legitimate medical and dental needs are often ignored by the foster care providers and Child Protective Services. It seems a very poor argument to try to justify saving one or two children from a possible death from "dental neglect" by placing countless other children in harm's way "just in case."

Threats over Teeth Cleanings

Trey Hoyumpa is far from alone when she refers to Smiles4 Keeps as a "bully." She penned strong words for the dental provider and wrote of others who have allegedly been bullied by the practice:

There are many of us who will not allow bullying in our community. You are a bully. You prey on the poor and you insult their parenting and you threaten to report to the authorities. You think something like that is friendly and helpful in the community??? It rips people up, it destroys them and…and then you make them come to your office and beg to not make a CPS call…"what can I do so you don’t call???" I’ve actually heard people say that TO YOUR CLERKS…who responded with a "you can come in and get their teeth cleaned, then we won’t do anything this time around." SERIOUSLY?! I think I’m don’t [sic] here.

What You Can Do

Smiles4Keeps has 3 offices in Pennsylvania. They are on Facebook and Twitter. Bartonsville Smile Center is the location that sent the letter to Trey Hoyumpa. 3565 Route 611, Bartonsville, PA 18321 (570) 629-1142 The letter Hoyumpa received appears to be a standard form letter, with the contact information for all 3 locations listed at the bottom of the page. Scranton Smile Center is located at: 313 Mulberry Street, Scranton, PA 18503 570-346-7760 Wilkes-Barre Smile Center is located at: 900 Schechter Drive, Wilkes-Barre, PA 18702 570-822-4181 Are there other dentists or doctors who are sending such letters to parents? Let us know in the comments. Originally published at MedicalKidnap.com and Health Impact News https://medicalkidnap.com/2018/03/22/mom-stands-up-to-dental-bullying-when-dentist-threatens-to-call-cps-over-missed-dental-appointment/

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