In Depth

WJLA-TV, Washington, D.C., & Roberta Baskin: ‘Drilling for Dollars: Children’s Dentistry investigation’

Opening with video of a 4-year-old boy restrained in a dental office and screaming in pain, “Drilling for Dollars” is difficult to watch, even for the experienced investigative news team that produced it.

Investigative reporter Roberta Baskin of Washington, D.C.’s Allbritton Communications-owned ABC affiliate WJLA-TV broke the story of children on Medicaid being subjected to abusive dental practices. She started working on the story after receiving a tip from one of the clinic’s fired dental assistants who objected to the treatment.

“It is so disturbing,” said Ms. Baskin, who also won a 2008 News & Documentary Emmy for regional news story. “How much do you show in getting attention? Kids are being tortured. [T]he makeup artist … could barely talk, she was so upset, and a producer in editing burst into tears.”

The piece focused on Small Smiles dental clinics in Langley, Md., and Washington, D.C., and uncovered how staff members are rewarded with bonuses for “upgrading” young patients from checkups to major dental work such as root canals and fillings, which are reimbursed by Medicaid. The clinics are part of a Colorado-based national chain with more than 60 locations.

The investigative team found that assistants who were not licensed were performing X-rays on the children, and that children were not being properly protected from the radiation. Meanwhile, parents were not allowed in examination rooms and were told that federal patient-privacy practices prohibited them from being there; there is no law preventing a parent from being with a child during a medical procedure.

“The most money Medicaid pays is for a procedure, and baby root canals are the profit center, worth about $214,” Ms. Baskin said. “The piece had a three-word focus: profit over compassion. That’s really the whole story. An Arab bank in Bahrain invested in Small Smiles. They were drilling for oil and drilling for baby teeth.”

One challenge in reporting the story came because it took place in a medical setting and releases were needed from the parents in order to show the children in the report. Some refused because they were self-conscious about being on Medicaid.

Through a former Small Smiles employee, Ms. Baskin was able to obtain a policy manual that contradicted some of the things clinical directors told her in interviews.

“Four out of five dentists refuse to take Medicaid children, because the government reimburses a lot less than private insurance. That’s why I wondered why Small Smiles could be so profitable,” Ms. Baskin said. “They tried to get in fast, and keep a child calm, not terrorize them. Their defense is these families won’t come back. That’s why they do such aggressive treatment.”

Over a five-month period, the station did 12 stories on the dental clinics. The Langley Park facility was shut down and some managed-care companies stopped doing business with Small Smiles outlets in Maryland. In North Carolina, there was a large court settlement after patients sued over the allegation that unnecessary dental work was performed in order to make a profit.