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Old 09-23-2013, 06:19 AM   #61
Granny square
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Exactly. Common sense has left the building. If you work with kids you have to treat them differently than adults.

An yes my dentist works on screaming babies. I picked him because occasionally I had to take kids that I was working with to him. His staff was excellent in dealing with children. I was years away from having any but I respected his respect of even tiny people.
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Old 09-23-2013, 08:17 AM   #62
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Originally Posted by Granny square View Post
Exactly. Common sense has left the building. If you work with kids you have to treat them differently than adults.

An yes my dentist works on screaming babies. I picked him because occasionally I had to take kids that I was working with to him. His staff was excellent in dealing with children. I was years away from having any but I respected his respect of even tiny people.
To be fair the OP's child is an infant and not quite a child. It can be much easier to work on a screaming 3 year old than it is to be working on a screaming 15 month old. Of course (some) children or babies have to be treated differently, hence the behavior management charge.
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Old 09-23-2013, 09:27 AM   #63
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I think I have a lovely general dentist who speaks kindly to little ones, offers stickers as rewards, and who knows kids sometimes need parents. I think that someone who specializes in kids should be no different.

I work predominately with kids and never thought to charge for not yelling at them, having a surprise box, and letting mom or dad stay with them.
I agree!! I love our family dentist! He is very patient with kids and his staff and hygienists are just the best. They do everything they can to make a visit to the dentist a pleasant one. They even go so far as to give my kids (when the others were little and I still have a 2 year old as well) time to "ride" up and down in the chair each visit and "count" teeth (a short, "fake" exam, LOL!) before they become patients and they give out stickers and a goodie bag along with a stop by the prize bin.

Being a family of 5, it makes sense for all of us to be scheduled together so my husband and I can swap out watching kids in the waiting room and the office is always accommodating, even going so far as to come out and play with them if my husband's and my appts. overlap by a few minutes. I just can't say enough good things about my dentist and after reading this thread, I am even more thankful to have found him. If anyone is looking for a good one in northern Ohio (west of Cleveland), let me know!!

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Old 09-23-2013, 11:26 AM   #64
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My guess is the charge is for the clamp used to keep the child's mouth open. If so, I wonder if the response would have been the same if the bill had said "mouth clamp" instead of "behavior management". Maybe the term just seems offensive.

That clamp cost money and is either disposable (and you're paying for the entire cost + markup) or needs to go through some kind of disinfection procedure (and you're paying for that labor in addition to the usage of the device, chemicals, etc). It seems logical that it wouldn't be a "standard" tool built into the preset cost of the procedure.
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Old 09-23-2013, 11:34 AM   #65
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I would think that your dentist would have allocated the extra time/minutes and tools (like the clamp?) before the appointment happened. Maybe they expected/calculated your insurance company as paying for it. (If medicaid covers it - its a little surprising yours does not?).
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Old 09-23-2013, 12:13 PM   #66
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I would definitely be making a call on Monday and finding out exactly what "behavior management" means and why they think it's appropriate to charge it for a 15 month old! What was she supposed to do, have no problem with such a grown-up procedure?? I'd want an outline of what that was for, and then consider finding yet another dentist if this one expects a little one to make no noise with something scary going on.
No way i would pay the $35 behaviour management fee! Are they joking? She's 15 months old! i'd march over to that office on monday, pay the fee (MINUS THE BEHAVIOUR MANAGEMENT FEE) and simply explain how ridiculous they are being. You helped hold her, what exactly did they do different to calm your 15 month old? seriously!
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Old 09-23-2013, 12:19 PM   #67
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No way i would pay the $35 behaviour management fee! Are they joking? She's 15 months old! i'd march over to that office on monday, pay the fee (MINUS THE BEHAVIOUR MANAGEMENT FEE) and simply explain how ridiculous they are being. You helped hold her, what exactly did they do different to calm your 15 month old? seriously!
The "behavior management" is probably the clamp (which is likely disposable.) Why is every so up in arms over this?
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Old 09-23-2013, 12:24 PM   #68
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The "behavior management" is probably the clamp (which is likely disposable.) Why is every so up in arms over this?
Probably because her child is only 15 months old. What did they expect from a baby??
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Old 09-23-2013, 12:26 PM   #69
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Probably because her child is only 15 months old. What did they expect from a baby??
But the use of a clamp requires a charge.
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Old 09-23-2013, 12:32 PM   #70
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Probably because her child is only 15 months old. What did they expect from a baby??
Honestly, that they wouldn't do any procedures at all. Most kids don't need work done at fifteen months. They aren't eating a lot that makes for cavities, they haven't had time to develop cavities, and anything they get, usually can wait until the child is older - or even until those first baby teeth leave the mouth. So unless its trauma - like yours - they really avoid working on kids that age.

My girlfriend's kids have genetically lousy teeth and had to have a lot of work done under sedation at young ages - she had $1500 worth of anesthesia plus operating room time. These are hippie children who drank no soda, drank very small amounts of juice and no refined sugar in their diet at all - but when your enamel doesn't exist in places on your baby teeth, they need to be capped. And insurance wouldn't cover it because "children that age don't need it."
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Old 09-23-2013, 12:58 PM   #71
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Originally Posted by Granny square View Post
Interesting information. Seems pediatric dentists could charge all kids when things like voice modulation are billable.

Lol, I could make big bucks if I charge behavioral for such ridiculous things.
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Sheesh this is crazy! I work in the health care industry and deal with difficult people every day. I don't get paid extra to do it because its my J.O.B. to do so! At my DD's last visit, the xray piece made her gag and throw up. If we saw the same dentist as the OP we probably would have been charged something ridiculous for that too! OP best wishes! Hope you get it taken care of!
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It does seem ridiculous to me. Training for what, verbal redirection? I could see using this charge for nitrous oxide, pre-medicating with valium (requiring monitoring of vital signs), or some sort of restraint (requiring frequent assessment of circulatory status and pressure points). But verbal redirection while MOM holds the hands down? That requires no special training of a dentist or a dental assistant. They didn't pull out any special pediatric dentistry "tricks of the trade" from what I've heard from the OP. Just because it is justifiable under the AAPD's definition doesn't mean it is ethical, especially not without a quote beforehand. Patient care requires verbal redirection often. Even in my line of work in the ICU. And we don't bill for that there either.
No one has said the fee in question related to voice modulation. That was one example of a recommended technique; the guidelines didn't say anything about billing. We don't know exactly what aspect of the appointment generated the fee.

And unless a parent cleaned up the vomit themself, I don't see why that would be a ridiculous charge.

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Exactly. Common sense has left the building. If you work with kids you have to treat them differently than adults.
I think common sense has left the building when people take any rant at face value and as an objective description of the situation. I don't see any discussion as to how this practice has built its fee structure compared to an adult practice. If you're going to compare anything, it would have to be based on what transpired at THIS appointment versus a standard appointment. As others have pointed out, it could be for the clamp itself.
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Old 09-23-2013, 01:07 PM   #72
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It would bother me, the dentist was a pediactric dentist. They know they work on kids. Unless of course it was stated in new patient paperwork that they would charge it and then if they told me as my daughter was getting work done that they would be charging it, then I'd get it. But then if you are going to charge me, you hold her down.

Someone mentioned earlier that their doctor doesnt suggest their kids going to the dentist until they are 4. Mine suggests they go as soon as they have teeth. The dentist (who is a pediactric dentist) doesn't really do much the first 3 or 4 times we go, just plays around in the mouth to get them used to it. Didn't charge much for those first few visits.

If I get a filling in the back or work done on a back tooth, they use a clamp to hold open my mouth. I don't get charged extra for that.
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Old 09-23-2013, 01:47 PM   #73
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I would not pay for it! If it is a clamp and it is a disposable one, no way the Dentist paid 35.00 dollars for it.
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Old 09-23-2013, 02:08 PM   #74
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Originally Posted by goofyintoronto View Post
Probably because her child is only 15 months old. What did they expect from a baby??
Its not about what they "expect", its about what they used during the procedure. If they used something that cost them money then obviously they are going to charge the patient for it. Would you prefer if they just charge more for infants in general, is it the actual itemizing of the procedure that has you bothered?


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I would not pay for it! If it is a clamp and it is a disposable one, no way the Dentist paid 35.00 dollars for it.
Have you ever looked at your dentist's or doctor's itemized bills? Does it really surprise you that things are way over-priced?
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Old 09-23-2013, 02:10 PM   #75
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I would not pay for it! If it is a clamp and it is a disposable one, no way the Dentist paid 35.00 dollars for it.
Not sure that logic works out... even supposing the dentist "paid" $2 for it, the breakdown of that $35 is more like:

Disposable Clamp: $2
Putting it on, and knowing how to do so properly: $33
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