Small Smiles Dental Centers

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Small Smiles Dental Centers was a private chain of dental clinics in the United States that primarily served children from low‑income families. Its parent company was Church Street Health Management (CSHM), based in Nashville, Tennessee. In the early 2010s it was the largest dental management company in the U.S. and at times the biggest chain for children. By March 2014 it had 53 offices and served hundreds of thousands of children each year. By September 2021, the chain appeared to have only one location left in Reno, Nevada.

The chain faced multiple accusations of providing unnecessary dental work and of restraining young patients during treatment. In January 2010 the company, then known as FORBA Holdings, settled False Claims Act allegations with the U.S. Department of Justice for $24 million. In January 2011 FORBA changed its name to Church Street Health Management, named after the corporate address. The company filed for Chapter 7 bankruptcy on February 5, 2015.

Small Smiles clinics operated under several names, including Children’s Dental Clinic, Indian Springs Dental Clinic, Oklahoma Smiles, Small Smiles Dentistry, Texas Smiles, and Wild Smiles. The business traces back to a dental office opened in 1928 in Pueblo, Colorado, started by the DeRose family and a Denver dentist. It grew through the 1990s and 2000s, expanding to many states. In 2006 the DeRose family sold their stake, and FORBA’s assets were bought by investors led by the Carlyle Group, Arcapita Bank, and American Capital Strategies, with the company moving its operations to Nashville.

Media investigations in the mid‑2000s highlighted practices such as the use of papoose boards on children. Lawsuits and settlements followed, and in 2010 the Justice Department settled the False Claims Act claims. In 2014 federal authorities said the management company could no longer participate in Medicaid and other federal health programs, and the company filed for Chapter 7 bankruptcy in 2015. A Pediatric Dental Advisory Board included leading dental educators and clinicians.