Is Big Brother now in the dentist’s office?

I was astonished – and angry – to see this letter posted on Gab.  Click the image for a larger view.

I was absolutely dumbfounded at the thought that any medical practitioner would use the law to threaten its customers.  If it’s authentic, this letter appears to represent nothing more or less than legalized extortion.  “Pay us money for services you may not even need, or else!”  However, I don’t know if the letter is real or not.  It isn’t signed, and there’s no return address on the letterhead – both of which I’d expect on that sort of communication.

I looked up Smiles4Keeps online.  It appears to be a dental practice in Pennsylvania, with three offices, and its Web site uses the same logo as that shown above.  There’s no indication of which of its three offices may have sent that letter.  Can any readers in or near Bartonsville, Scranton or Wilkes-Barre confirm whether or not this letter is the real thing?  If it is, then the practice needs to hear from a lot of very angry customers – and so do Pennsylvania lawmakers!  If it isn’t, then the practice needs to know that someone’s spreading disinformation about them.

If you can help clarify the situation, please post in Comments below.  Thanks.


EDITED TO ADD:  OK, it’s authentic.  Courtesy of commenter Brigid, we find that the practice posted an explanation – but NOT an apology – on its Facebook page.  Personally, I find their arguments unconvincing and self-serving.  Others may differ.  Suffice it to say, if I’m ever in that vicinity, I’ll seek children’s dental care from anyone EXCEPT Smiles4Keeps!


  1. Yeah, that's rather disturbing. I can't say I'm terribly surprised if this turns out to be authentic. The dental lobbyists sure earned their fees with this one.

  2. ObamaCare added mandatory dental coverage for children to your Medical!!! insurance policy. First notice we got was when we were told our daughter was now on the service of Dr NeverHeardOfYouBefore DDS…

    Kicker is, I pay for Dental insurance for my whole family anyway. When I called BigMedInsGroup they told me it was an ACA requirement, no option to refuse coverage if I provided proof of insurance…

  3. However, I don't know if the letter is real or not.

    Given that no lives seem to be at stake that would be a good moment to consider whether it needs posting NOW or whether it can await confirmation.

  4. PA is awful to homeschoolers,midwives, home birthers and Amish. Basically anyone who 'opts out.' It is unsurprising that they'd come down hard on anyone bucking their system, or that this unscrupulous practice would take advantage.

  5. Sorry, that dental office is full of crap. Yes dentists are by law "mandated reporters" of "suspected child abuse". Not getting your kid's teeth cleaned is not "child abuse" nor is it "neglect" (the term used by the dental office).

    Even an old retired attorney, with about 10 minutes of research on the internet, can come to that conclusion.

    Failure by a parent to have a child's serious dental problem treated could be reported by the dentist. But to imply that not getting regular checkups is "neglect" is crazy.

  6. Act 31 mandates that applicants for licensure by any of the health-related licensure boards and the State Board of Funeral Directors must demonstrate that they have completed 3 hours of Dept. of Human Services-approved training in child abuse recognition and reporting. Nothing in that act refers to what is described in that letter.

  7. Dear Smiles 4 Keeps,

    We have arranged alternative care for our childrens' dental health. It is none of your business with whom. If you should carry through with your intention to notify child protection authorities falsely that we are endangering our progeny's well-being, we *will* end up owning your practice.

    You have been warned.

  8. The elder care industry has been pulling the same scam for years.

    They keep escalating the care needs for your loved ones, manipulating your emotions, and if you don't pony up, report you to the government for elderly abuse.

    Basically, once you start taking power of attorney for your elder parent or working with something as innocuous (and useful!) as Visiting Angels they have you on an escalating cost ladder for quite a while.

    As a result, it costs 100s of thousands of dollars for the elderly to die, slowly and painfully

  9. Don

    Appreciate more info on the elder situation. Not there yet with the power of attorney, but it’s coming 🙁

  10. I’m a pediatric dentist in Toronto and while I would never send a letter such as this I certainly empathize with the practitioner and find the facebook response reasonable. The people to blame in this situation is not the dental office but again…ta dah…big government. The goverment places the onus of responsibility for children’s care on the dentist and in Ontario this responsibility last’s 10 years past a given child’s 18th birthday. This means if a 28 year old shows up at my office and says I failed to protect him/her from dental neglect when he/she was 4 years old I would be liable. You all need to recognize that dental neglect is a real thing and I am not talking about not getting cleanings. I have many kids in my office with pain/infection from untreated rotting teeth and parents who aren’t interested in getting this treatment done. Sometimes they want second opinions and other times they claim to be going to a different dentist but in actuality refuse to seek treatment. The government has deemed this unacceptable and has mandated by law that the dentist confirm treatment is being completed or must call social services. Believe me when I tell you that us dentist do not want to be put in this position. We are forced to act on behalf of the child and not the parent to ensure needed treatment (again not cleanings) gets done. You need to take a deep breath and recognize a) that neglect is real and b) that the dentist has no choice in the matter according to the letter of the law.

  11. "You need to take a deep breath and recognize a) that neglect is real and b) that the dentist has no choice in the matter according to the letter of the law."

    "You also need to recognize that I'm a rent-seeker who is using the same argument that eco-loons used for 'sue-and-settle" with the EPA. That's why I'm a member of the Canadian Dental Association, so there's deniability."

  12. " we *will* end up owning your practice."

    Until a lawyer gently points out that the second most common feature of laws like this is "good faith immunity" for reporters, and usually anonymous reporting allowed.

  13. "You need to take a deep breath and recognize a) that neglect is real and b) that the dentist has no choice in the matter according to the letter of the law."

    You also need to take a deep breath as I am going to take this baseball bat and hit you in the mouth, asswipe.

  14. Dentists are mandatory reporters, that is a fact. It is also a fact that there is a "good faith immunity" for mandatory reporters. Failure to bring your child into the practice for regular professional cleanings and checkups is NOT neglect. So threatening to report you for child neglect under the mandatory reporting law is, legally, "Abuse of power under color of law." It is illegal for law enforcement to do it, it is illegal for mandatory reporters to do it. Furthermore, it is a crime in furtherance of another criminal act – extortion.

  15. Notice that they’ve now hidden (or deleted) all one-thousand-plus comments on the “explanatory” post regarding the letter. Rather telling…

  16. Whomever is in charge of that practice needs to consider that there are some folks who react shall we say poorly to threats levied upon them. It is hardly inconceivable to imagine that should they persist they might find that their place of business has suddenly been turned into a smoking hole in the ground. And the burning question is will it happen in dead of night or during business hours.
    Petty tyrants who twist and pervert the law to their own ends need to be reminded that those they attempt to intimidate may seek alternate methods of retaliation.

  17. tshanks78… you just used the Nuremberg Defense.

    If you're so upset by this policy, if you really "do not want to be put in this position", maybe you're in the wrong line of work.

    If you're trying to justify it, you're definitely in the wrong line of work.

    Government poisons everything it touches. Never evaluate a "law" by the good it's supposed to do, but by the harm it will do when it is inevitably and willfully misinterpreted by the kind of people who are drawn to government work, and unquestioningly enforced at the point of a government gun.

  18. If I ever received such a letter, the reply would consist of equal parts magnesium shavings and iron oxide, at about 3500°, around 3AM, repeated as necessary until I got the feeling the message was well and truly received loud and clear.

    If I were feeling more jovial, the practitioner would need a friendly colleague to avail himself of the sudden need for 28 implants to correct the effects of 3' of steel pipe to his smile. And possibly pins to make his fingers work anything like normally.
    Which might necessitate a change of occupation, but them's the breaks. So to speak.

    And I'm a friendly kind of guy. Imagine what the hair-trigger anger management types would think of doing.

    I'm also pretty sure office managers' salaries don't cover routine expenditures for bullet-resistant vests and remote vehicle starters, as a matter of course. Having to eat soft food for life probably sucks, too. Especially for $12/hr.

    A practitioner's license is not a badge, and random licensees acting as an agent of the state when it's none of their effing business can get forms of corrective therapy in reply they were not anticipating when they put their nanny-pants on.

    Some people, bereft of anything like common sense, need that lesson delivered up close and personally.

    Were I to read of such, personally I'd cheer.

    Yours truly for the practice of better dentistry. And just dentistry.

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