Wednesday, June 27, 2012

The Morning Drill: June 27, 2012

Good Wednesday morning!

On to today's dentistry and health headlines:

Texas Attorney General Files Suit Over Dental Medicaid Fraud

A year-long WFAA investigation into questionable Medicaid dental payments has resulted in the Texas Attorney General filing lawsuits this week.

Greg Abbott charges that a Dallas dentist and his corporate entities bilked taxpayers out of millions for fraudulent orthodontic work on poor families.

Dallas dentist Richard Malouf amassed a multi-million dollar mansion, corporate jets and luxury vehicles through his dentistry, News 8 has found.

He and his former firm, All Smiles, declared bankruptcy following a series of reports detailing how he and other dentists around Texas gamed the welfare system by billing for unnecessary dental work.

WFAA found that over the past few years, Texas has paid out more in Medicaid orthodontic claims than all other 49 states combined.

All Smiles billed Medicaid for at least $15 million over two years, which is twice as much as the entire state of Illinois. The Attorney General’s lawsuits, filed in Austin Monday, seek to recoup “two times the amount of the overpayments.”

WFAA’s findings have spurred outrage among lawmakers and hearings in Austin and Washington D.C.Madelayne Castillo, a former All Smiles employee, and Dallas orthodontist Dr. Christine Ellis filed separate whistleblower lawsuits in April and May alleging fraud by Malouf and his corporations.

Both lawsuits remained sealed while the Attorney General’s office investigated the claims. On Monday, Abbott’s office joined those lawsuits by refiling them in the state’s name.

Study Supports Partial Excavation of Deep Dental Lesions

Stepwise excavation of deep carious lesions results in better outcomes than complete excavation, researchers reported at the International Association of Dental Research (IADR) 90th General Session and Exhibition, being held in Iguacu Falls, Brazil.

In the stepwise method, clinicians partially excavate the lesion, leaving some carious dentin over the pulp. They seal the cavity and then return later to complete the excavation and place a permanent restoration.

Overall, 30.1% of the restorations placed after stepwise excavation failed after 3 to 5 years compared with 38.9% of those placed after complete excavation.

The research adds to a growing body of evidence that lesions can be restored without removing all the carious material.

In fact, lead author Lars Bjørndal, DDS, PhD, from the University of Copenhagen in Denmark, was surprised that the partially excavated group did not show even greater success compared with the completely excavated group.

"I had expected a larger difference because previous older and less controlled studies have indicated a difference of around 50%," he told Medscape Medical News by email. "But as a trial design becomes more and more controlled — this is a pattern that is very often noted — the difference between interventions is not that large."

Corporate dental chains see big profits in adults who can't afford care

Surviving on a meager $1,300 a month, 87-year-old Theresa Ferritto
fretted about the cost when her dentist told her she needed two teeth

She figured an oral surgeon would be too expensive. So she
decided to try out a dental chain that promoted steep discounts in its
advertisements. She went to an Aspen Dental office just outside

Ferritto said Aspen Dental wouldn’t just pull the teeth
but insisted on a complete exam. She was bewildered when they finally
handed her a treatment plan four pages long. Total price: $7,835.

could not afford it, but Aspen Dental signed her up for a special
credit card, with monthly payments of $186 for five years. She blames
herself for signing the papers.

“I made a big mistake going there,” she says. “I should have known better.”

Dentist’s plea deal in son's death irks Coalinga chief

Coalinga's police chief says Fresno County prosecutors gave preferential treatment to a dentist who got a plea deal for injecting his mentally-challenged son with a fatal dose of morphine.

"Fourteen months of police work -- for what? A plea deal?" Cal Minor said.

Minor said Coalinga dentist Allen Clare should have been charged with second-degree murder or, at minimum, manslaughter in the death of his 35-year-old son, Patrick Clare, last year.

Instead, prosecutor Robert Romanacce allowed Clare, 68, to plead no contest Monday in Fresno County Superior Court to a state business and professions code violation. According to the plea form, Judge Jon Nick Kapetan has indicated that Clare would get probation.

It was a swift conclusion to a case in which Clare wasn't even charged until last week, more than a year since his son died in April 2011.

Clare's attorney said the death was an accident that happened while the father tried to give his son emergency care for an abscessed tooth.

But Minor argues that the dentist improperly administered morphine, which he wasn't licensed to use, then left the son alone for two hours although he was in apparent distress.

Minor said his department has become a target of ridicule over the case.

Enjoy your morning!

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