Children tend to fear the unknown, and visiting the dentist is no different.
Following the voluntary surrender of Jacksonville dentist Dr. Howard Schneider's license and pending class-action suitafter accusations that he mistreated young patients, some parents are worried about leaving children alone in the care of medical professionals. They have taken to cautioning others via social media about their children's experience with health care providers.
One such post has been particularly active, with 158 responses on Facebook sharing one man's experience with a Gainesville dentist, and how he disagreed with the practice's policy.
On May 11, Max Danford, 59, of Archer, Florida, took his 10-year-old grandson, Eli Danford, to visit Dr. Bertram Hughes of Family and Cosmetic Dentistry in Gainesville to fill a cavity. He said he was concerned when Hughes’ office staff refused to let him accompany his grandson into the exam room.
“He was nervous, as everyone is when they visit the dentist," Danford said. "He wanted me to go back with him.”
Danford said Hughes and his staff told him it was office policy not to allow adults in the exam room with children, but he said they did not explain why their policy is this way.
After an exchange of words, according to Danford, Hughes advised him and his grandson to leave the office. The cavity remained unfilled.
Danford turned to Facebook to voice his concerns about his grandson’s visit with Hughes. He posted to a Facebook group called Gainesville Word of Mouth and attracted more than 150 comments, some from parents who had expressed similar concerns with Hughes and other pediatric or family dentists in the area.
Donna Hicks of Gainesville, was among the many parents who commented on Danford’s Facebook post. She wrote that her husband had a similar experience with Hughes’ office.
Hick’s husband, Mike, took their 3-year-old son, Daniel, and 9-year-old daughter, Laila, to Hughes in April 2015 for a regular dental cleaning. This was the first time their son had ever been to see a dentist.
“My son is only 3. He can’t tell me what happened in the room,” Hicks said. “Even in a doctor’s office you are allowed back with your child.”
Danford said he filed a grievance against Hughes with his insurance company, Staywell, on May 12. Liberty Dental Plan, a subcontractor for Staywell, said no such claim had been filed as of July 1. Danford filed a grievance with Staywell again, on July 1, about his dissatisfaction with what he said was the rude treatment he and his grandson received from Hughes and his office staff.
In a letter dated July 8, Staywell said it would review the grievance filed by Danford and respond within 60 days of receiving the request. Danford had not heard from Staywell about the grievance at the time of publishing. The letter went on to say Danford has the right to ask for a Medicaid Fair Hearing.
Hicks said she has not yet filed a claim against Hughes, but plans to do so.
The Florida Department of Health collects any complaints filed against a health care provider. Hughes has no public complaints or disciplinary actions on file, according to the department's website. Hughes also has no complaints filed with the Better Business Bureau or Florida Board of Dentistry.
The Florida Board of Dentistry is the state agency that leads investigations surrounding complaints. According to Moore Communications Group Senior Director, Liz Shawen, the Florida Board of Dentistry does not collect data surrounding these complaints because it is not a violation for dentists to not allow parents to be present during their children's dental exams.
According to the the Florida Department of Health's fiscal year 2013-2014 annual report, it received 977 complaints against dentists for reasons unknown. This number is the fourth highest number of complaints filed with the department, following medical doctors, certified nursing assistants and registered nurses.
Dr. Hughes, who has practiced dentistry for 25 years, declined to be interviewed for this story, but he did provide comment via e-mail:
"Due to HIPPA concerns we really aren’t able to completely discuss the gentleman’s post," he wrote. He [Danford] is not telling you the full story, nor did he post a truly accurate account of events. Due to privacy laws, it's often difficult for healthcare providers to respond to one-sided accounts posted on various sites on the internet."
No Global Policy
Pediatric dentist and national spokesperson for American Academy of Pediatric Dentistry, Dr. Carlos Bertot, said there is no state or federal guideline that requires any dentist to allow or deny a parent to be present during a procedure; it is up to the individual dentist.
“The primary reason for not allowing the parent back or to be present during the delivery of care is because, in general, children will behave better and be more cooperative in the parent’s absence,” Bertot said.
He said the same can be said about teachers, caregivers and counselors.
However, Bertot said he does allow parents to accompany their children during procedures, if necessary.
After reaching out to a dozen dentist's offices in North Central Florida, half say they allow parents to be present during routine dental procedures. Two offices said they do not allow parents to be present for reasons including parents getting in the way of the dentist and needing the child's full attention. The other four offices did not respond.
Dr. Rondre Baluyot of Oaks Family Dentistry in Gainesville, who does allow parents to accompany their children into the exam room, said it’s important for parents to know the dentist has the authority in the exam room. This ensures the procedure goes well. If both the parent and the doctor try to give the child direction, it can confuse the child and prolong the procedure.
“I try to be a partner with the parent,” Baluyot said.
Baluyot offers "happy visits" for his young patients to feel out the atmosphere of the office. The visits are specifically designed to desensitize a first-time dental patient and lessen their fear of the dentist.
He is known for his character voices, a technique he uses to keep the visits fun and relaxing for his young patients. Baluyot’s office staff will, on occasion, dress up as Disney characters, such as Frozen’s Elsa.
Dr. Julie Russo, president of the Florida Academy of Pediatric Dentistry, said pediatric dentists have two additional years of training and are specially trained in behavior management techniques. The techniques vary and are used to help children cope during their dental visits.
"All patients are different and one method may work well for one child, by may not work with another. Once a parent chooses a pediatric dentist for their child, office policies and procedures should be discussed prior to the first dental appointment," Russo said.
According to the AAPD’s Guideline on Behavior Guidance for the Pediatric Dental Patient, "Relationship and communication problems between parents and doctors, such as perceived lack of care or not taking enough time to explain a procedure, have played a prominent role in the initiation of malpractice actions." The guideline also states, "Occasionally, the presence of a parent has a negative effect on the communication between the child and the dentist. Each practitioner has the responsibility to determine communication and support methods that best optimize treatment."
Bertot said parents should trust their instincts and if something doesn’t sit well with them; they should seek out another dentist.
"At the end of the day, it’s all about the patient and what is best for that patient.”