Policy Regarding Minor Patients

The parent(s) or guardian(s) of a minor patient must fill out the Medical History Form for a minor patient at his or her initial visit, as changes occur, and at each cleaning/exam appointment.  It is important to the health of your child that you update his or her medical history. 

A parent or guardian must accompany the minor patient to all appointments or treatment may need to be denied.  It is sometimes necessary to make treatment decisions during a dental appointment. These decisions need to be made by a parent, not the dentist.  If an adult is not with the minor patient, then treatment decisions made will be what the dentist perceives is in the patient’s best interest. It will be the parent’s/guardian’s responsibility to cover the cost of such treatment. 

The American Dental Association recommends fluoride every 6 months.  Fluoride helps prevent decay by strengthening teeth and can reverse early cavities.  Some insurance providers cover this treatment only one time per year.  However, twice per year is best for your child.  Some insurance providers have age limitations.  However, we recommend what is best for each patient, regardless of age.

The adult accompanying a minor to the appointment is responsible for payment.

A minor may consent to treatment in these situations:

  • If living apart from parents or legal guardians and managing his or her own financial affairs.
  • If the minor is, or has been, married
  • If the minor has borne a child
  • If the minor needs emergency treatment.

Please come with your child to all of his or her dental appointments. 

Thank you,

Dr. Krista Geisler and the Life Smiles Team

Notice of Privacy Practices

"This notice describes how dental and medical history information about you may be used and disclosed and how you can get access to this information. Please review it carefully."

Beginning April 14, 2013 patients are encouraged to read this notice and a record of acknowledgement will be placed in your record.


The patient has a right to receive this notice upon request. This notice is posted through binder format in the reception area. A written copy in English is available.