Parent fears add to dental barriers in Florida

Maggie Clark’s reporting on Florida’s Medicaid program for children was undertaken as a project for the Dennis A. Hunt Fund for Health Journalism, a program of the University of Southern California Center for Health Journalism.

Other stories in the series include:

Medicaid in Florida: 2 million kids. $24 billion battle.

Fighting for care in Florida's Medicaid system

An impossible choice: Doctors torn between patients and Florida's Medicaid system

State doctors to be surveyed

Dental debate leaves out kids

2 Million Kids' series spurs support and quest for more data

Medicaid settlement: Florida will work harder to ensure health care for children

As Bradenton mom Megan Johnson knows after searching for months to find a dentist for her four-year-old daughter Keriana, finding dentists willing to treat Medicaid-enrolled children is difficult. But even when parents make a dental appointment, they are wary of a common policy: Parents are barred from sitting in on appointments with their children.

As a blanket policy, many practices that see Medicaid-enrolled children do not allow parents in the appointment, regardless of the child’s age. At the Department of Health in Sarasota County, which provides dental care for more than 7,000 Medicaid patients each year, parents are allowed back for the first dental exam, but are discouraged from observing future visits.

“We need the kids to be focused on what we’re doing, but the parents may think we’re doing something harmful when we’re not,” said Dr. Paul Stein, dental director of the Florida Department of Health in Sarasota County.

“For that reason, we don’t let parents come back.”

While the health department does not restrain children to keep them from moving while in the dental chair, the general policy of exclusion can allow rumors about harmful dentists to swirl.

Such stories make Venice mom Alyssa Cupo Reinbolt reluctant to send her four-year-old daughter to a dentist appointment alone.

“They’re back there by themselves, they’re little, they’re defenseless — I’m supposed to protect her and if something happened, I couldn’t forgive myself,” Reinbolt said.

She finally found a local dentist who will treat her daughter and let Reinbolt stay with her during the appointment, but only after the girl turns five. It will be her first-ever dental visit.

While refusing parents as a policy is common practice in Medicaid practices, it’s virtually unheard of in practices serving upper-income children. A telephone survey of 12 offices in Manatee and Sarasota Counties that do not take Medicaid found no policy barring parents from staying with their children.

While some practices discouraged parents from staying with their children, none had a hard rule against it.

The disparity is an everyday reality for St. Petersburg mom Jennifer C., whose son, as the result of her divorce, is covered by Medicaid while her daughter has private coverage.

“I don’t let my son see where my daughter gets to go because I don’t want him to ask me why he can’t go to the nice office,” Jennifer said.

In one of the offices that would accept her son’s Medicaid coverage, the dentist refused to treat the preschooler because he was too upset from being separated from his mom, she recalled. In contrast, she’s welcomed into appointments with her daughter, who has private coverage.

“It’s a two-sided system,” Jennifer said.

[This story was originally published by the Herald-Tribune.]