SPRING HILL — The 35-year-old patient had perfect teeth, but her jaw hurt. She went to see dentist Miranda Smith, who told her the only way to fix her problem was to pull her teeth — all of them — and get fitted for dentures. The patient was understandably reluctant, as she didn't have a single cavity.
After her teeth were gone, her jaw pain persisted. The dentures didn't fit right. Smith's response, according to a criminal complaint: Medicaid won't pay for more procedures. If the woman wanted more dental work, she'd have to pay out of pocket.
That patient's story and others like it were released Friday in a 21-page affidavit charging Smith, 46, with more than $140,000 in Medicaid fraud and detailing multiple horror stories at her Smiles and Giggles Dentistry at 17020 County Line Road.
Kids put under sedation for cavities they didn't have. Unlicensed employees performing work the dentist should have done. One woman's new dentures caused sores, and she had to "push her tongue back" because the teeth didn't fit. "That's just the way your mouth is," Smith told her, according to the report.
The criminal charges, however, stem from billing for fraudulent services. From Jan. 1, 2010, through Dec. 31, 2012, she billed $144,000 for services never rendered, sedation services she was not licensed to provide and X-rays never given. The case was investigated by the Medicaid Fraud Control Unit with the Florida Attorney General's Office.
Smith was booked into the Pasco County jail Thursday evening and released a few hours later after posting $20,000 bail. She was at home Friday when a reporter knocked on the door, but she declined to talk. Her husband, Donald R. Smith, defended her and said the charges originated from two disgruntled, racist employees.
"She's been fighting this for three years," he said. "Nine employees and their families are out of work because of this."
He said Smith is owed more than $300,000 in back pay from Medicaid. She has been compliant, he said, handing over more than 8,000 patient records and spending thousands of dollars on attorney fees to fend off the accusations.
Her lawyer, Christopher Torres, denied all of the charges. He said that many of the allegations have already been disproved on the administrative level. The criminal charges, he said, won't stand.
"They're trying to take all of the allegations in the administrative complaints and use them to substantiate the fraud," he said.
If convicted, Smith could face up to 10 years in prison and up to $10,000 in fines.
According to her biography page on the practice's website, Smith graduated from Howard University Dental College with a doctor of dental surgery degree in 1996.
She completed the Florida Dental Board exam in 2000 and worked in West Palm Beach and Spring Hill before opening her practice in July 2009.
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The practice's motto, according to the website, is "superior service, quality care."
According to the complaint, one Medicaid patient was told she needed dentures because her "bones were not strong enough." She had eight upper teeth pulled on one visit, and eight lower on another. The woman told investigators that those 16 teeth were all she had had left.
She said an assistant, not the doctor, did the impressions for the dentures and all of the adjustments. Sometimes the assistant would leave the room, she said, to "show the doctor" her work.
The dentures never fit properly and dug into her gums.
Another woman said that after Smith pulled her teeth, a man came in and sewed her gums up.
"It should be noted that there is no male dentist at Smiles and Giggles," the report said, "so Smith directed a nondentist to stitch a patient's mouth."
On May 16, the Florida Department of Health's Board of Dentistry voted to suspend her license.