CHARLOTTE, N.C. – Nine dentists have been disciplined in connection with a Medicaid fraud case alleging they performed and billed for unnecessary dental work on poor children in North Carolina.

Patients as young as 4 years old had multiple teeth pulled and root canals performed during single appointments at Medicaid Dental Center clinics in Charlotte, Winston-Salem, Asheville and Raleigh, according to federal and state documents.

At least two children received 16 pulpotomies, also known as “baby root canals,” and 16 steel crowns during at the same visit. A lawyer who represents several of the families said children were strapped to a board to keep them from moving their arms and legs.

“It was a very traumatic experience for the children and their parents,” said attorney Darren Dawson of Greenville.

“These were children who were 4, 5 and 6 who were told by their moms and dads that they were going to visit with trusted professionals. Suddenly, they’re in there for three hours and coming out with a mouth full of steel.”

In a settlement announced Wednesday, Medicaid Dental Center, a privately-owned chain of North Carolina dental clinics, agreed to pay $10 million to the federal government to resolve allegations that it performed and billed for unnecessary dental work on children.

Clinic owners and dentists Letitia Ballance, of the Charlotte area, and Michael DeRose of Pueblo, Colo., are also serving three years’ probation, starting in 2005, by the North Carolina Board of Dental Examiners.

The seven other dentists who worked for the clinics received written reprimands in 2005 that will remain permanently in their North Carolina files and with the National Practitioner Data Bank.