Hudson La Petite Dentistry surrenders license after investigation

HUDSON, Wis. — A former Hudson pediatric dentist was being investigated on accusations of unnecessarily pulling children’s teeth, billing fraud and overuse of laughing gas when he surrendered his license to practice last month.

Documents obtained through a public records request show Dr. Andy Mancini was being investigated in seven different cases by Wisconsin’s Department of Safety and Professional Services.

Andy Mancini
Andy Mancini

The alleged violations included engaging in practices that constitute a substantial danger to patients, according to records.

Cases investigated by the state agency resulted in criminal charges and a civil suit brought by the state for falsified Medicaid claims.

An attorney for Mancini, who lives in Woodbury, Minn., previously said he would not comment on legal matters involving his client. Mancini denied all allegations in a Wisconsin Dentistry Examining Board document outlining the permanent surrender of his license in Wisconsin.

Dozens of allegations

A 2016 memo from the state alleged 37 separate complaints, including multiple reports of unnecessary tooth extractions, billing problems, children being held down, “aggressive procedures” and a threat to a child.

Among the allegations outlined:

  • Patients were billed for treatments that weren’t performed.
  • A child was held down while “kicking, pinching and clawing to get out of the seat during an extraction procedure,” during an unnecessary extraction procedure that a parent was not allowed to sit in on.

A dentist from the Department of Human Services Office of the Inspector General conducted an audit — generated by patient complaints — that revealed:

  • Mancini used the sedative nitrous oxide, or laughing gas, at levels sometimes reaching a 70 percent concentration of nitrous oxide-to-oxygen, about double the recommended concentrations of 30-40 percent nitrous oxide for children.
  • Patient files included “grossly mislabeled” X-ray files. The audit noted that Mancini would take the same six X-rays each time he’d see a patient. Medicaid, the report notes, reimburses for up to six X-rays on any date of service.

In a November 2016 interview with investigators, Mancini denied performing unnecessary work, but admitted to the possibility of billing errors “due to the incompetence of previous staff.”

Mancini told investigators he allowed parents in the room while he’s performing exams, but discourages family from being present during procedures “because it can be distracting” and can lead to anxiety for patients.

Kirsten Reader, assistant deputy secretary of the Department of Safety and Professional Services, said Mancini voluntarily surrendered his license April 10. She said that happened during the investigations — the outcomes of which could have led to revocation of his license.

Parent complaints

The latest allegations didn’t surprise former La Petite client Rebecca Viebrock of Hudson

She said that after being initially impressed with La Petite’s kid-friendly atmosphere, she found herself having to return over and over.

“I practically lived at that place,” she said.

She grew skeptical, but she said her questions about X-rays and cavities were met with defensiveness from Mancini.

Viebrock said La Petite was one of the only dentists in the area that took state insurance. Without La Petite — where she also received dental care — Viebrock said she and her children are left without options in the area.

Stillwater resident Ashley Foley said she’s also in search of answers after learning about allegations of questionable care at La Petite. She said she took her children there for two years beginning in 2012 and never questioned the multiple tooth-pullings Mancini recommended.

Two of those involved her daughter’s front baby teeth, which have sat empty since the child was about 2. Foley said the girl is now 5 years old and must wait at least two more years before her adult teeth come in. Meanwhile, Foley said her daughter is in speech therapy and covers her mouth in shame when she smiles.

“What if this didn’t need to happen?” she said.

This content was originally published here.

The Real Truth About Dentistry – TeethRemoval.com

An intriguing long form piece appears in the May 2019 issue in Atlantic titled “The Truth About Dentistry: It’s much less scientific—and more prone to gratuitous procedures—than you may think,” written by Ferris Jabr, see https://www.theatlantic.com/magazine/archive/2019/05/the-trouble-with-dentistry/586039/. This article has a lot of people talking including dentists, physicians, and patients who have experience with dentists throughout the Internet on forums and Twitter (see https://www.whitecoatinvestor.com/forums/topic/the-truth-about-dentistry-critical-longform-piece-in-the-atlantic/). The main shortcoming with this article in the Atlantic is it relies on an anecdotal story which forms the basis of the entire article. There are several themes to the article that will be discussed below along with additional themes not mentioned that are involved to form the real truth about dentistry.

1. Dentistry is a Business and some Dentists, just like in other Professions, are Bad Apples.

The article describes a dentist Lund who overtreats patients by performing more expensive procedures that are not necessary in order for him to make more money and does this for many many years. Dentist Lund’s way of making extra money is by having patients with cavities receive root canals with incision and drainage when cavities are the proper treatment.

I had a brother inlaw that was a dentist. I mention how the dentist is always trying to sell me on something. He said to me “We are a business too”. That was all I needed to know…..

— Patrick Husting (@patrickhusting)

“Years ago, at a routine dental cleaning, the wife was diagnosed with 18 asymptomatic ‘small cavities’  that needed to be fixed. So we got a 2nd opinion, lo and behold, no cavities. Somebody apparently needed a new boat.” – portlandia via whitecoatinvestor.com

2. There is a Unique Power Dynamic in Dentistry that is Unlike Other Relationships

Many aspects of the dental experience have resemblances to torture experiences. When a dentist is standing over a patient inserting sharp instruments into their mouth they often feel powerless. Perhaps because of this the vast majority of patients who see a dentist do not get a second opinion from another dentist. This is unlike medical doctor visits where seeing a second doctor for another opinion is more commonplace. Furthermore the vast majority of patients are not reading medical and dental literature on their own and discussing it with their dentists if there were any disagreements.

dentist mouth - The Real Truth About Dentistry
This image is from Pixabay and has a PIxabay license

3. Dentists Have very Little Checks and Balances on Their Practice

The article presents a story of a young dentist Zeidler who buys the practice of of retiring dentist Lund who had overtreated patients for years. After several months Zeidler suspects there is a problem because he was only making 10 to 25% of the prior dentist Lund’s reported income. Zeidler also encounters many of the patients of the practice and notices a large number of them have had more extensive treatment performed than needed. Zeidler spends nine month’s pooring over Lund’s patient records. The records demonstrate vast amounts of overtreatment. Thus the overtreatment by the dentist went unchecked for many many years and it was not until the dentist retired and the patients and records were seen by someone else that the overtreatment was detected. Most dentists have individual private practices which is unlike medical doctors who usually work for a hospital or organization with more oversight.

4. There is Little Scientific Evidence to Back Dental Treatments

The article discusses oral health studies performed by Cochrane which is a well respected evidence based medicine organization that conducts systematic reviews. Nearly all of the studies performed in the field of dentistry by Cochrane have shown either: 1) there is no evidence that the treatment works or 2) there is not enough evidence to say one way or the other that the treatment works. What to do in regards to dealing with healthy asymptotic wisdom teeth is one of these treatments in dentistry where there is a lack of scientific evidence to support either preventative removal or watchful waiting.

5. Dentists are Paid Based on Treatment and Not Prevention which is being made Worse Due to Large Student Loans

The reality is if everyone had healthy teeth and no need for dental treatment besides occasional cleanings, exams, and x-rays dentists would not make much money. The pay structure for dentists rewards procedures and treatments. Dentists today graduate from school with a large amount of debt and they also want to buy an individual practice to run. This can lead them in debt of well over $500,000 which can push them to recommend treatments and procedures that are not really needed to try to pay this debt off.

6. There is a Lack of Focus on Quality Improvement due to a Culture of Cover-Up

Everyone can agree that patients want high quality care at an affordable price. However dentists are hesitant to make real strides towards quality improvement due to fear of being sued and increased liability insurance premiums. Human error can never be completely eradicated and human nature is not perfect. Humans have varying anatomy that can’t always be anticipated. Thus protocols should be in place for dealing with things such as sexual assault in the dental office and to address what one should do when the wrong tooth is extracted. Similarly protocols should be in place to best identify what to look for on panoramic radiography to determine if a wisdom tooth is at high risk of damaging a nerve and if cone beam computed tomography or coronectomy should be performed. Similarly protocols should be in place when a sharp or needlestick injury occurs in the dental office. In addition protocols should be in place for when a dental instrument breaks and is left in a patient during a procedure. It seems that dentists could be sharing data with each other about what goes on in their practice and they could be addressing sensitive issues instead of pretending that they don’t and won’t again occur.

This content was originally published here.

Pasco Man Accused of Practicing Dentistry Without License

WESLEY CHAPEL, Fla. — Pasco County Sheriff’s Office deputies arrested Jose Mas-Fernandez, 33, for allegedly practicing dentistry without a license.

“Why people would go to someone like this, we don’t know. We can only speculate, but it is against the law. You have to have a license,” said PSO Community Relations Director Kevin Doll. “You have to be licensed by the state, and this individual obviously did not have that.” 

The arrest was the result of a joint investigation between the Sheriff’s Office and the Florida Department of Health.

Authorities said Mas-Fernandez offered to pull teeth for both an undercover detective and an undercover health department investigator. He reportedly offered to provide antibiotics for $150 and numbing medication for $20.

Inside Mas-Fernandez’s apartment, investigators found dental equipment and medication. Doll said he told detectives the supplies came from Cuba.

PSO’s documents state that after his arrest, Mas-Fernandez admitted to performing dental work, like teeth cleanings and extractions, out of his home. It’s unclear how many people he may have treated.

“Any medical doctor who’s not licensed working on your body can be very dangerous,” said Doll. “That’s why we suggest anybody who did see this individual to go to a real dentist and have their teeth checked out.”

Doll said Mas-Fernandez told detectives he worked as a dental assistant at Land O’ Lakes Dental Care. The office was closed Friday.

According to Brad Dalton, press secretary for the state health department, the DOH received 1,051 complaints of unlicensed activity during the fiscal year of 2018-2019. The department issued 593 cease-and-desist orders during that time.

Dalton said of those, 67 complaints and 36 cease and desist orders were related to the practice of dentistry. The DOH said Mas-Fernandez received one of those cease and desist orders.

The DOH reminds the public that being treated by an unlicensed medical professional could result in injury, disease, or death. License information for health care practitioners can be found at: www.flhealthsource.gov/ula.

This content was originally published here.

Everyday Superhero: Dr. Andrew V., Cosmetic Dentistry – My Jaanuu

We asked Dr. Andrew Vo – a dentist, spin instructor and Captain in the United States Army – for his best self care tips, even when life and work throw a lot at you.

Where are you from? Huntington Beach, CA

What is your favorite part about your job?

I love to change negative experiences a patient may have had into positive ones, building a long and lasting relationship with each and every one of my patients and using my profession to truly change lives for the better.

Why did you choose cosmetic dentistry?

I originally chose cosmetic dentistry because I wanted to help people smile, to help build more confidence, and to help patients live the life that is worth living. In addition to cosmetic dentistry, I also love working on pediatric patients. I decided to go back to school this June to specialize in pediatric dentistry. When I first started my journey in dentistry, I first worked with children and I miss working with them so much. I want to learn more about treating children, become an advocate for pediatric health, and create future mission trips with a foundation of knowledge.

What does self care mean to you?

Taking care of yourself both physically and mentally in order to take care of your loved ones.

You’ve got a lot going on, how do you practice self care?

Being in the fitness community (GritCycle and Equinox) and teaching indoor cycling for these companies, I am so blessed to have met such incredible people. Everyone has challenging days, but these two communities are filled with love, positivity and joy, which helps me practice self care.

Have you always known how to practice self care? If not, how did you find your balance?

I love food, and sometimes the foods that I consume aren’t the best choices. At one time in my life, I was overweight, unmotivated and depressed. I found my balance and changed my life when I found fitness and the people that inspired me to live a better and healthier life.

Why is it important for healthcare professionals to take time for self care?

We all get busy with our jobs and often times we make up excuses not to exercise because we don’t have time or to eat healthy because it takes too long. It is never too late to change, just take one step at a time and you will eventually get there.

How long have you been cycling? What made you decide to become an instructor?

I have been cycling for the past 12 years and decided to become an instructor because I wanted to make a difference and share my story. I wasn’t always in shape and healthy. It was when I hit rock bottom and had to make a choice to either keep going down the dirt road or be proactive and commit to living my best life. It wasn’t easy, but I got there. I love teaching indoor cycling to help people realize that they are loved, that they are accepted, and that it is NEVER too late to change for the better.

Hear more from our Everyday Superheroes here and here.

This content was originally published here.

Fredericksburg Dentist, 81, Combines Old-Fashioned Customer Service With New Dentistry Approaches – NBC4 Washington

As a dentist, Dr. John Willhide combines old-fashioned customer service from the last century with the ever-changing technology of this one.

His dental practice has continued to change and evolve during the 51 years he’s worked in Fredericksburg. Instead of shying away from new products and procedures as some others his age might do, Willhide embraces them.

“I mean, look at this stuff,” he said, motioning toward sophisticated equipment and appliances that create crowns, straighten teeth and open airways to improve breathing during sleep. “This technology was not around 20 years ago. It’s great technology, and it’s one of the things that keeps me interested in dentistry.”

It also keeps the 81-year-old still working well past the normal retirement age. He and six employees at Heritage Dental work 32 hours a week, Monday through Thursday.

“I’ve never reached the point that I said, ‘This is it.’ I like the feeling of coming to work,” Willhide said. “I like to be productive, and I like to help people.”

An experience of Cheryl Stamper illustrates that his commitment to customer service is almost as rare as hen’s teeth.

Nine years ago, Stamper’s daughter, Amanda, had a cheerleading accident on New Year’s Eve that knocked out her two front teeth. Amanda was 16 at the time and understandably upset.

Stamper couldn’t get an appointment with their dentist, so she called Willhide on the recommendation of a co-worker and got immediate treatment.

“He and his office were just amazing,” said Stamper, a nurse who lives in Essex County and works in Fredericksburg. “It was kind of traumatic, as you can imagine, but Amanda just trusted him right away. She had many, many more procedures in the coming years, and he was always there for her 24/7.”

Willhide shared his cell and home numbers and told the family to call whenever they needed him — which they did. He also talked with Amanda about college choices, putting in a good word for his alma mater, the University of Virginia, from which he graduated before dental school at what was then known as the Medical College of Virginia. He wrote a reference for Amanda and introduced her to communications specialists at the Pride Institute, a national facility for which he teaches classes to new dentists on how to manage their practices.

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“He just went above and beyond,” Stamper said, adding that the whole family became his patients. “I can’t say enough good about him.”

Alex Jones, a Bowling Green patient, put it this way: “He’s a gentleman, and the people he has around him are very courteous and professional. If he was running for something, I’d vote for him.”

Willhide’s dental office is a one-stop shop for some procedures.

When a patient’s tooth becomes inflamed or infected and requires a root canal, he performs the endodontic treatment, then a technician gets the tooth ready for restoration. The crown — a cap that covers the tooth — is measured, cut from a piece of purple porcelain, baked in a kiln and glazed to match the rest of its owner’s teeth before it’s cemented into place.

It’s all done in Willhide’s office during one appointment of two to three hours. The system, called CEREC, doesn’t totally replace the need for labs because some crowns can’t be made that way, but it’s been a game-changer. Technician Janean Brown has become a wizard at using the system’s wand to make the necessary measurements and get the porcelain prepped for design, Willhide said.

About two years ago, Heritage Dental bought the CEREC system, which costs about $100,000, according to the manufacturer’s website.

‘Life and Death’: Price of Shutdown Mounts for Federal Contractors

The political cost of the ongoing government shut down remains to be seen, but the human cost for federal contractors like Donna Kelly becomes clearer with each new bill she opens. News4’s Cory Smith reports Kelly depends on her paycheck for medication.

“It had been on my Christmas wish list for about 10 years,” Willhide said, adding he took a leap of faith when he believed the timing and technology were right.

In addition, he straightens teeth with clear-aligner devices that have replaced the old metal braces of old. He also works with patients suffering from sleep apnea, a serious sleep disorder in which breathing repeatedly stops and starts, by providing appliances that move the jaw forward slightly to prevent obstruction. The mouthpieces are less cumbersome than CPAP machines — continuous positive airway pressure devices — that patients tend not to wear because of their bulk, he said.

Willhide is one of about 15 dentists in Virginia approved by the Department of Veterans Affairs to provide appliances for former soldiers, sailors and Marines with sleep apnea.

That’s especially important to Willhide, a Green Beret who served with the Army’s 10th Special Forces Group for four years. Sleep doctors in the region diagnose the ailment, then send patients to dentists who measure them for the custom-made devices.

“I like to think we’re an arm of the attack on sleep apnea,” the dentist said, adding that 40 million people nationwide suffer from the problem. “I think it is one of the most important things we do.”

Willhide isn’t the only doctor in town who offers these appliances and services, but there can’t be many who’ve trained with the Ritz-Carlton Hotel Co. Several years ago, the dentist and three staff members went to Orlando to study with the staff known for its top-of-the-line service at luxury resorts.

Nancy Pelosi Goes Back to Her Trinity Roots

Nancy Pelosi got her first taste of politics during her college days at Trinity College in Washington, D.C. News4’s Barbara Harrison was at the university for Pelosi’s town hall with MSNBC.

Sheryl Brown saw the results of their efforts in 2016, when she was named teacher of the year at Harrison Road Elementary School. She’s been a patient of Willhide about 14 years, first going to him when she had several abscesses and a mouth full of problems after not seeing a dentist for years.

“I almost passed out at the thought of even going to a dentist,” she said.

Willhide spent about five years getting her teeth straightened and whitened and dealing with her gum disease. She continues to see him three times a year, but never mentioned her teaching award, which was published in The Free Lance-Star.

“Dr. Willhide and his staff saw it and sent me a beautiful bouquet of flowers at the school,” she said. “Everybody was like blown away.”

The staff also offers gift cards for patient referrals or movie tickets when someone sits in the waiting room longer than expected. If a patient has a death in the family, Willhide offers a book about grief and healing, and those who come into the office feeling under the weather get a gift bag filled with cold medicine, cough drops and a can of soup.

“It’s about the patient as a whole, not just the teeth,” said Rushella Waters, the financial coordinator of the practice. “We practice faith openly here, and the patients know that. They know Dr. Willhide is a caring person, and they love him, they eat him up.”

This story originally appeared in the The Free Lance-Star, http://www.fredericksburg.com/

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This content was originally published here.

Biological Dental Hygiene: A Whole Body Approach to Oral Health – International Academy of Biological Dentistry and Medicine

By Carol Wells, RDH Think of a visit with your usual dental hygienist, and you probably think: Yeah, I’ll get my teeth cleaned and a little lecture about flossing, and that’s it. Every appointment is just like another – though each patient’s dental needs are not. Fortunately, there are growing numbers of hygienists who think …

This content was originally published here.