As a family practice Small Smiles originated from a dental office that was opened in 1928 in
Pueblo, Colorado. Initially Small Smiles was a family-owned business headed by the
Italian American DeRose family of Pueblo and a
Denver, Colorado dentist named William Mueller. Bruno DeRose, the founder of the practice, had graduated from dental school in 1928. The DeRose Dental Clinic opened that year. In 1961 Edward DeRose, the father of Michael DeRose began practicing dentistry. In 2000, the Small Smiles company began expanding throughout the United States. As of May 20, 2004, the Colorado clinics had 25 dentists. Two were pediatric dentists and the others were general dentists. According to a phone survey from the
Colorado Springs Gazette, aside from Small Smiles, few other Colorado Springs dental offices took patients who were on Medicaid. By 2004,
The Colorado Springs Gazette reported that Small Smiles used
papoose boards almost 7,000 times in one 18-month period. According to Colorado state records, As a result, a Colorado Board of Dental Examiners appointed committee established a new Colorado state law forbidding the usage of papoose boards for children unless a dentist has exhausted other possibilities for controlling a child's behavior, and if the dentist uses a papoose board, he or she must document why the papoose board was used in the patient's record. In September and October 2006 the assets of Forba Dental Management aka FORBA, LLC were acquired from the DeRose family by a group of investors led by the
Carlyle Group,
Arcapita Bank, and American Capital Strategies. Sanus Holdings, LLC was created for purchasing FORBA, LLC's assets. Sanus Holdings later became Small Smiles Holding Company, LLC. The sales price was reported to be $435 million. A revolving line of credit was opened by
CIT Group. and in September 2006, A Pediatric Dental Advisory Board was established in 2007 to assist Chief Dental Officer Stephen Adair in meeting quality of care standards. In 2007, reporter
Roberta Baskin of
WJLA-TV in
Washington, D.C., and her crew filmed the opening ceremony and operations at a newly opening Small Smiles clinic in
Langley Park, Maryland. Her crew filmed video of screaming children, bound with papoose boards, as technicians performed dental work. She filmed the lead dentist discussing production goals and stating that his clinic's dentists perform many baby root canals per day. Interviews with several former employees who either resigned or were fired after speaking out against the company's practices revealed other abuses, including dental staff conducting
X-rays on children even though they were not certified to do so. The film and the investigative report aired on television led to legal action unfolding. In April 2008, Michael A. DeRose and Letitia L. Ballance settled with the United States and North Carolina to resolve False Claims Act allegations that their Medicaid Dental Center (MDC), previously known as Smile Starters and Carolina Dental Center, made false or fraudulent Medicaid claims. MDC agreed to pay $10,050,000 and to not contest that their dentists performed unwarranted pulpotomies and placed stainless steel crowns. A
Kentucky woman named Debbie Hagan started a blog, "Dentist the Menace," which criticized the use of papoose boards at Small Smiles. Her blog included lists of documents, media accounts, other reports, and Hagan's research. Journalists used Hagan's blog to research the issue. Authorities from the State of New York contacted Hagan as part of their investigation of Small Smiles. On November 14, 2008, FORBA Holdings, LLC brought a lawsuit against Hagan, In January 2010, the
US Justice Department settled
False Claims Act allegations against FORBA Holdings, LLC. Under the settlement, FORBA will pay $24 million plus interest to the US and several states. The investigation was spurred by three
qui tam lawsuits filed by former employees in Maryland, Virginia and South Carolina in late 2007 and early 2008. The US Justice Department found that FORBA was liable for: Under the agreement, FORBA entered into a
corporate integrity agreement with the Office of the Inspector General of the
Department of Health and Human Services. Investigations into individual dentists continue with the company's cooperation. Currently operating under a corporate integrity agreement with the
U.S. Department of Health and Human Services, Church Street's network of associated dental centers continues to serve low-income families, and recently began opening new clinics and featuring new services such as orthodontics and adult care. In February 2012, the company filed for
Chapter 11 Bankruptcy Protection. As of December 2012, Small Smiles treated about 500,000 children each year. In December 2012
NBC News revealed it had investigated 63 Small Smiles clinics over a preceding three-year period and discovered continued accusations from former employees, parents, and government investigators that the clinics performed below standard and unnecessary procedures on children.
Chuck Grassley, a member of the
U.S. Senate, said that the company was scamming taxpayers and causing abuses to children in order to generate revenues. David Wilson, the CEO, said in a statement:Patients are at the center of everything we do at CSHM. CSHM LLC supports our affiliated dental centers so that they can continue to provide access to quality dental care. Our dental centers serve approximately one million patient visits per year, primarily to children in communities with under-served access to dental care.After Channel 4 Action News
WTAE-TV began an investigation on Small Smiles, the
U.S. Senate filed a report saying that taxpayer dollars were wasted in Small Smiles and recommended that its Medicaid access be terminated. The report accused Small Smiles clinics of performed unnecessary dental work and performing procedures too quickly. The 1,500-page report was prepared by Grassley and
Max Baucus. This bipartisan report of the US Senate further advised Small Smiles Dental be excluded as a Medicaid provider. CSHM LLC stated that "We do not believe that this report adequately reflects the current operations of CSHM LLC (CSHM or the Company)." In 2014, the
Inspector General's Office announced that the management company Church Street Health Management will no longer be allowed to use Medicaid,
Medicare, and other health programs of the federal government. CSHM, LLC filed for
Chapter 7 bankruptcy on February 5, 2015. ==Governance==