The Kool Smiles lawsuit most people mean is the January 2018 federal case in which the chain’s management company, Benevis, agreed to pay $23.9 million plus interest to resolve False Claims Act allegations that its clinics billed Medicaid for medically unnecessary dental work on children. Around that settlement sit two wrongful death suits from an Arizona clinic, a Texas mass action brought by hundreds of families, and a corporate story that ends with the Kool Smiles name retired and its clinics operating under new local brands.
The $23.9 Million Federal Settlement
The U.S. Department of Justice announced the settlement on January 10, 2018. The government alleged that between January 2009 and December 2011, Kool Smiles clinics knowingly submitted false Medicaid claims for medically unnecessary services performed on children.1U.S. Department of Justice. Dental Management Company Benevis and Its Affiliated Kool Smiles Dental Clinics Pay $23.9 Million
The procedures at issue were baby root canals (pulpotomies), tooth extractions, and stainless steel crowns. Prosecutors also alleged the clinics billed for root canals that were never actually performed. Medicaid data from Texas and Virginia showed Kool Smiles using stainless steel crowns on children aged eight and under far more often than other dental providers in those states.2PBS. Kool Smiles Performed Unnecessary Procedures on Children, DOJ Says
The federal government took more than $14 million of the recovery; participating states took more than $9 million. Benevis denied wrongdoing, calling the dispute a matter of “professional disagreements between qualified dentists in determining the appropriate level and cost of the care,” and the settlement carried no admission of liability.3Bloomberg Law. Benevis, Kool Smiles Agree to $23.9M False Claims Settlement
How the Case Started: Whistleblowers and the Bonus System
The investigation began with five qui tam whistleblower lawsuits, four of which were consolidated in the District of Connecticut. Three former Kool Smiles employees who served as relators — Adam Abendano, Poonam Rai, and Robin Fitzgerald — shared more than $2.4 million of the federal recovery.1U.S. Department of Justice. Dental Management Company Benevis and Its Affiliated Kool Smiles Dental Clinics Pay $23.9 Million
At the center of the whistleblowers’ account was a compensation system that paid dentists cash bonuses tied to the volume and cost of procedures they performed. Dentists who missed those targets were disciplined.2PBS. Kool Smiles Performed Unnecessary Procedures on Children, DOJ Says Michael Greenwald, a Connecticut dentist and one of the whistleblowers, described “appalling practices,” including the use of papoose-like restraints to immobilize children during treatment.4Hartford Courant. Dental Chain Will Pay $24M to Settle False Billing Claims Over Unnecessary Work on Children
Two Children Who Died After Visits to the Same Arizona Clinic
Two wrongful death suits arose from a single Kool Smiles clinic in Yuma, Arizona.
Zion Gastelum, Age Two
On December 16, 2017, two-year-old Zion Gastelum underwent root canals and crowns on six baby teeth under general anesthesia at the Yuma clinic. He died four days later at Phoenix Children’s Hospital.5CBS News. Health Care’s Stealthy Private Equity Takeover His parents’ malpractice lawsuit, which named the clinic and its private equity investor FFL Partners, alleged that Zion was left unattended in a recovery room, that a staff member silenced a pulse oximeter alarm, and that the oxygen tank in the room was either empty or malfunctioning.6KCRA. Family Suing After 2-Year-Old Boy Dies Following Common Dental Procedure He suffered fatal brain damage from oxygen deprivation.7ABC30. Parents Sue After 2-Year-Old Dies While Getting Crowns
The suit also named anesthesiologist Aaron Roberts, whom the family alleged left Zion at the foot of a dental chair while managing another sedated child. The Arizona Dental Board of Examiners faulted Roberts for failing to follow proper procedures and placed his anesthesia permit on three years of probation, permitting him to practice only under the supervision of another licensed anesthesiologist.8Cronkite News. Arizona Dental Board Fails to Hold Dentists Accountable The Board also concluded that the conduct of the dentists and staff at the clinic “fell below the standard of care.”9Burg Simpson. Burg Simpson Files Medical Malpractice Case Against Kool Smiles The case settled in 2021 on confidential terms, with the defendants denying liability.5CBS News. Health Care’s Stealthy Private Equity Takeover
Liseth Lares, Age Four
Roughly two years earlier, in January 2016, four-year-old Liseth Lares died after a visit to the same Yuma clinic. According to attorney Marco Mercaldo, who represented her family, Liseth had cavities and a dental abscess. She developed a fever after her visit, was brought back to the clinic, and was sent home after what Mercaldo described as a “relatively cursory exam.” She later died of an infection.10ABC13. Two Children Mysteriously Die After Trip to Dentist’s Office The family’s wrongful death suit was set for trial in February 2019.11NBC4i. Arizona Dental Office Sued for Wrongful Death After Girl, 4, and Boy, 2, Die After Visits
The Texas Mass Litigation
Separate from the federal case, hundreds of Texas families sued Kool Smiles over unnecessary and painful dental work performed on their children — crowns, extractions, and root canals — allegedly without proper sedation and then billed to Medicaid. The litigation began in January 2013 with 15 parents suing three Kool Smiles affiliates and four dentists, and grew to cover roughly 618 minor children across 20 related cases.12Courthouse News Service. Kids’ Dental Clinic Settles With 618 Parents
In March 2015, the Texas Multidistrict Litigation Panel consolidated the cases for pretrial proceedings before Judge Noe Gonzalez in Hidalgo County. Plaintiffs sought punitive damages for fraud, gross negligence, and conspiracy against Benevis LLC, Kool Smiles PC, and several individual dentists. By November 2015, the parties had agreed in principle to a global settlement. The dollar amount was never publicly disclosed. Because the plaintiffs were minors, the court appointed ad litem attorneys to represent the children’s interests, and a gag order barred the parties from discussing terms for 60 days.12Courthouse News Service. Kids’ Dental Clinic Settles With 618 Parents
What Happened to the Company
Kool Smiles was backed by a succession of private equity owners. An amended complaint in the federal fraud case alleged that Friedman Fleischer & Lowe (FFL), seeking to boost returns, mandated business requirements it knew would lead to false Medicaid claims across the chain.13Private Equity Stakeholder Project. PESP Report on Dental Service Organizations14Mergr. Tailwind Acquires Benevis15Lincoln International. Benevis Has Been Acquired by New Mountain Capital16Proskauer. Proskauer Represents New Mountain Capital in Section 363 Credit Bid Acquisition of Benevis
The Kool Smiles name has since disappeared. Clinics were rebranded under local-sounding names, including Pippin Dental in Indiana, Cortland Dental in Massachusetts, Elstar Dental and Jubilee Dental in Texas, Dorsett Dental and Manzana Dental in Arizona, and Pine Dental in Maryland and Virginia. Melissa Rumley of the HHS Office of Inspector General said that “a provider’s rebranding does not inhibit or affect the potential investigation,” and that the OIG continues to use data analytics to investigate fraud in federal healthcare programs regardless of branding changes.17Dentistry Today. Kool Smiles Dental Quietly Changes the Names of Its Clinics
Benevis continues to operate. As of 2026, the company supports more than 120 dental offices across the United States under its various rebranded names, offering general dentistry, oral surgery, and, in some locations, orthodontics.18Benevis. Benevis Home The Kool Smiles brand no longer appears on the company’s website or at any of its clinic locations.19Benevis. Benevis Locations