I never went back. I found an older dentist and every patient in the office was a retiree, which made me feel confident they knew what they were doing (I'm sure they've got a lot of hard cases). I asked about the possible cavity and they said they saw nothing, everything is fine.
That's all just to say that the young dentists likely have a lot of debt between school and office build outs, and I wouldn't be surprised if they're up-selling services to try and get their practice out of it. I wouldn't trust them any more to be honest about practices just because they're young.
It's frustrating but I agree that new builds or expensive locales seem to amplify this effect. Established shops in less fancy areas tend to leave me feeling much better and are almost always quicker while being more thorough.
Another part of the problem, as it has been described to me, is that so many dentists are perfectionists, and they find minor non-issues to be glaring. Like if I have a discoloured filling in a molar... is replacing it really warranted just for cosmetic purposes?
I will also add that, a visit to most dentists where you clarify up-front that you have no insurance can be a very different experience.
When they have something costly to do, they even say that if the dentist alone pays for their all their trip expenses.
it had clean new office and lots of fancy tech that to scan my teeth that i hadn't seen at my little hole-in-the-wall old dentist. i was optimistic.
they tell me that I needed four fillings and a root canal, and i was a surprised because i'd been going to a dentist every six months and nobody had mentioned anything like that. but hey, that must be the advantage of all those fancy scanners. right?
they walked me down to the "payment center" which was an office holding four employees whose job was to come up with payment plans to cover dental work. that's when i knew that the whole place was a racket.
Highly capitalized, expensive leasehold improvements plus obscure pricing and surprise charges seem to be the typical playbook of that business model.
Reliable doctor-owned dental practices seem to be increasingly hard to find, at least here in the urban Southeastern US
I don't remember exactly what was done last time and only knew when they pulled up the xrays and I saw the date of the last one. They hygienist sits you down and just does it as if it is normal. I googled and found what you mentioned.
I am low risk for cavities. Those exact words came out of his mouth. I was pissed off after the fact, because I'm paying out of pocket for this, and for fluoride treatment. I have in my records to not give me fluoride treatment but she called it "varnish" which caught me off guard.
I speculate the office got bought out by PE as dentists have changed over the last few years.
They also told my wife she needs a night guard. She's been wearing one for 12 years.
I slowly see why there are people who do not trust medical professionals.
The opinions I trust the most are the doctors that have previously told me that no treatment is necessary and the problem will resolve on its own.
The more often they’ve said that, the more I’d value the opinion, especially if it suggested something invasive.
I think the slider isn't between trusting and not trusting medical professionals - it's between being a passive and active patient. We have to involve ourselves in our care. Educate yourself, get second opinions, connect with fellow patients and national experts. And ffs, do not listen to yt/x/tiktok people for anything.
How we've ended up regulating medicine to the nth degree, but when it's teeth we're like "oh well, lol", continues to mystify me.
I see what you mean.
But I'm a computer programmer, and if someone asked me to find a top quality academic study proving, beyond a shadow of a doubt, that it's a good idea to indent your code - I couldn't point you to one.
I'm always baffled by all the discussions about flossing, as it's something that can be very easily verified empirically: one can just floss for a month, then stop doing it for another month, then resume and get a feeling for how the gums react. If they bleed or burn (lightly), then the efficacy is evident; if not... lucky person! No need for research either way.
In my case, I don't need to floss daily, but I still need to do it regularly. Two weeks without flossing, and I'll definitely feel the burn once I resume flossing.
Just because there's no actual studies for flossing, that doesn't mean that flossing is bad or not-needed per se, but there does need to be more basic-level studies for it. I had bad gum-disease in my 20s, but once I actually started flossing daily, it stopped progressing. So it clearly helped me, but a better study on whether everyone needs to floss and how often should be done.
You don't understand the power of the ADA/flouride lobby.
Even just 20 years ago it was routine to have mercury (toxic heavy metal) placed in your mouth for fillings, evidence said the compounds were stable and no one would fund anything that rocks the boat in the US. They did that for children, but they didn't call it mercury, they called it silver fillings (50% by weight mercury).
Normally flouride has very limited uses prior to government mandates, and was so common that it was largely considered a waste by-product not worth selling.
I've yet to find an evidence based study or information on why government require flouride ingestion in any population center above 30,000 when studies have shown its just as effective topically. A study out of african really put the nail in the coffin on this one.
Side effects include lethargy, neurological damage, cognitive decline, hypertension, acne, seizures, and gastrointestinal issues.
It also damages your kids brains more than an adult brain (seemingly lowering IQ permanently), can't be filtered out except by specialized filters that cost a lot (and rapidly become less effective over time).
If they get too much which is very simple indeed, this can happen since its in everything (even bottled water and sodas, GRAS and no label needed under a certain concentration that's well above the toxic limits of new studies).
Nursery Purified bottled Water for infants is a primary source of business.
https://www.readyrefresh.com/medias/sys_master/images/images...
Makes you wonder what's really going on, and why they have to drug broad swaths of the population under the guise that it helps fight dental decay (through ingestion), when most of those studies have been debunked outside the US.
When cities don't have the funding, they magically get the funding for it. When local municipalities don't keep the levels up, they go after them heavy handed, and they disappear from public view.
https://ntp.niehs.nih.gov/whatwestudy/assessments/noncancer/...
You’ll soon learn that dental practices are increasingly private equity owned and the dentist have profitability KPIs that factor into their employment and compensation
What is being taught in schools has no relation to reality. Sure, it may somehow influence it, but it won't dictate how each dentist or clinic will work, as they are probably free to and work do almost as they please.
Not too long ago there was a wonderful research story by a journalist of good dental health (as diagnosed by multiple university professors) going across the US for a check up at tens of clinics, and seeing what work will be offered to them.
This journalist has encountered just a few few honest dentists saying no work at all is needed, or something very minor, all the way up to dentists saying he needed work in the tens of thousands of dollars, with the worst offender being in NYC as far as I remember wanting ~$30K for his services.
Unfortunately I can't locate the story right now. If anyone can, please link us.
I didn't yet find the right one, but this one is not too bad either https://www.usatoday.com/in-depth/news/investigations/2020/0...
Let's just say that it feels like quite a high percentage of dentists don't strictly adhere to the Hippocratic Oath.
I've never had a single cavity or needed braces. I happen to be blessed with very good teeth. I told him to fuck off (unfortunately not in so many words) and never went back.
That was 10 years ago. Still no cavity or any issues at all.
I ended up going the direction of looking for dentists unlikely to have debt and found a former army dentist and have been thrilled with how much less "well, let's do it all just in case" she is than my previous dentist (who had a TVs on the ceiling of every room and a new piece of major equipment every time I went).
X-rays are just a revenue stream. Funnily enough Americans I know who experience dentistry in places like Scandinavia are often confused as to how little is done, despite outcomes being better overall.
I dunno what exactly he did, but him applying the anesthetic sucked way worse, but I didn't feel anything whatsoever during the root canal itself. So I'm definitely asking my regular dentist next time if he knows of any anesthetic methods that involve injecting it really slowly and it hurting, and if not if he could maybe have some conversations with his colleague about that.
So I guess nothing super helpful, other than the knowledge that the way the anesthetic is done has a LOT of influence on how well it works.
Patients regularly push back on some treatments I've recommended, and I've always enjoyed the discussion. If a dentist is offended, then something is not right
And thanks for the Readers Digest article. A bit of a blast from the past with that publication for me but well written and clearly makes its point about the inconsistencies of dental practice.
1) Just yesterday I went to a an acclaimed dental school (UNC) for low cost dental care. They not only gave me a panoramic x ray but also a full set of bite-wing x rays. I read this and I want to break the world apart this morning.
2) When I was a child I kep needing root canals. It turned out our dentist was making these all up and was later found passed out from laughing gas in his office.
Uhh.. dude should've been in jail for that imo
I understand that radiation effects are cumulative but is this overexposure source worth fighting against as a patient?
Find new professionals when that happens. There are plenty of professionals that understand that not everyone is willing to just do whatever without more understanding and are happy to explain further when questioned.
A more likely scenario is that dentists are employed by a dental clinic (even if you see the same dentist every time). The dental clinic wants to maximize profit for shareholders, so they invented the "routine dental X-ray" guideline. The guideline is then imposed on the destists as a "performance quota". E.g. if you have 300 patients assigned to you, you are expected to prescribe at least 150 panoramic X-rays to you patient pool. Drop below the quota, and there goes your performance bonus, which you may otherwise be totally worth of.
Of course, there will also be cases where the dental clinic is owned by a single greedy dentist.
I was under the impression that the digital machines they use these days are:
1. localised 2. very, very low dose
The importance of the distinction is a lifetime of non-ionizing radiation is not known to cause any adverse effects while any instance of ionizing radiation is known to damage cells, even when it's a low amount in a controlled area. The debate people have with the former is whether or not it might even causes a problem in the first place while the debate with the later is where the best balance on the damages vs advantages is.
In retrospect, the policy should be to let the parent stay. The risk to me is no worse than the risk to my kid. It's easy enough to explain why the tech should go behind a shield.
Yes, it's an incredibly small amount of radiation for you because you're only in there for one X ray maybe once a year.
For someone who operates the Xray maybe a half dozen times in a day (or more), every day, that number changes dramatically. It's still likely fine, but it's far better to be safe than sorry.
Nothing wrong with eating bananas, but I wouldn't want to eat 20 a day for all sorts of reasons.
No joke. That is a major money maker. There is minimal cost per-use and your insurance pays $200 for it (my last one was $186.00 for instance). The dentists would be crazy not to recommend them as of often as possible.
Fluoride "rinses" are likely up there too. Rinse for a few seconds and they charge the insurance $50 or something for it.
Interestingly, I lived in Central Europe for a while and all my private dentists just used visual inspection for teeth. I never had an issue with that, all decay was spotted in time and in many cases earlier than with the x-ray only method, because more attention was paid to how the teeth look up-close, at all angles.
However, the visual inspection takes more time and skill. One might argue x-ray is the cheaper and quicker option. Though it costs more to the patient in many cases. Ah, the world of dentistry.
And that is in high cost Norway.
If _much_ lower than 200 USD per visit in a very wealthy country, then I assume:
(a) dentists don't make very much money. Less than 100K USD?
(b) most of the work is done by poorly paid dental assistants (20 USD per hour or less).
Running a high quality dental clinic is expensive, both for equipment and staff. How can it be so cheap in Norway?
I get an annual dental checkup (military) with the around-the-face x-ray machine. The first thing the dentist does is to compare it to last year's scan. The x-ray allows them to spot all sorts of things they would otherwise miss, especially since I don't think I've ever seen exactly the same dentist twice. Teeth move. Teeth wear down or chip. Sometimes this can be spotted by eye but the x-ray record is more reliable and more easily communicated between offices.
As for radiation, if you are worried about an annual dental x-ray then you better not fly in an airplane, live in Colorado, or hang around too long near the bananas at the grocery store.
Incentives are 100% misaligned and even good actors are forced to shorten your lifespan/quality of life to make somebody money
The X-rays I can probably avoid the next time, but I feel the cleanings do really help. I used to have bad plaque build up on my incisors but keeping up with the cleanings and improving flossing technique keeps it at bay.
Flossing daily isn't necessary if you're an adequate manual brusher. Relatively few people are adequate manual brushers.
Buy a good electric toothbrush, floss periodically.
I used to do this periodically because I hated doing it. But as a result, plaque would build up. Especially on the front bottom incisors.
Eventually added it to my daily routine after the nth time being told to floss daily. And now my dental cleanings are more like spot checks.
I suppose it’s anecdotal and unique to everyone though. Something about mouth flora.
Anecdote. I went my whole life not-flossing, having occasional procedures until every molar had work done to it. I started flossing daily and the need for procedures stopped.
The saying goes that you only need to floss the teeth you want to keep.
If you think about it, a toothbrush will only clean 3 sides of a tooth. Top, outer side, inner side. Not the 2 sides facing neighbour teeth.
How on earth is it very important to clean those 3 sides but not the remaining 2? That just doesn’t make sense. If you think flossing is not useful, to be coherent, you must believe toothbrushing is not useful.
On the flip side, learn how to do flossing right to not hurt your gums. The floss must follow the shape of the tooth, and not be straight. (Ie. move along a U path.) Flossing in a straight line does more harm then good.
https://www.health.harvard.edu/mind-and-mood/good-oral-healt...
https://www.consumerreports.org/toxic-chemicals-substances/d...
It's demonstrable that something like a bean skin, lodged in your teeth, will erode the teeth touching it.
That's not a meaningful standard for any health intervention. If I'd apply everything to my body that wasn't proven to hurt I'd spend a hundred bucks every morning and two hours in the bathroom. If "it doesn't hurt" was sufficient basis for a recommendation our doctors would tell us to swallow homeopathic medicine every morning.
It seems pretty obvious that anything you apply has to have at least some measurable impact, otherwise you're basically in the same category as the supplement industry.
Inserting floss between your teeth pushes them slightly apart. I wonder if that could have any negatives?
This is a systemic review. A RCT would absolutely find a difference. The whole point of this satire is to point out that there's not always studies on what you want to know. "No randomised controlled trials of parachute use have been undertaken"
Flossing has absolutely been studied. Professional flossing seems effective at combating gum disease. Telling people to floss doesn't seem to be. It's unclear why (is it just compliance effects? are people educated on how to floss still ineffective? etc.)
Only reason I'm being pedantic here is because if the study was in-fact looking at parachutes from helicopters, it could actually be plausible that parachutes had no improvements when used with helicopters. Most, if not all pilots, don't wear parachutes because there's not enough time to jump out of a crashing helicopter to deploy one and the blades would probably hit you anyway (unlike a plane which you could glide for some time, helicopters are notoriously more likely to fall straight like a brick)
I don't do the dentist recommended 2/week but if I stop flossing for over a month I notice significant decrease in my gum health. It becomes excruciatingly painful to brush and this stage and my mouth is full of blood afterwards.
So I'm sticking to flossing pretty often now.
According to my dentist, you can damage your gums by brushing them too hard. I don't floss so he didn't address that, but in both methods, force is being applied to delicate tissue.
The point of brushing and flossing is to remove food particles. You don't have to abuse your teeth or gums to do that.
https://www.theatlantic.com/magazine/archive/2019/05/the-tro...
Oddly, I only had wisdom teeth on one side, and not the other. So only 2 teeth were removed.
https://www.webmd.com/oral-health/wisdom-teeth-removal-neces...
I haven’t decided yet since they cause me no problems now and so far I’m to keep them relatively clean, but I have known several elderly family members who eventually needed molars removed because they hadn’t/couldn’t clean them well enough and it was a very difficult surgery for them.
This may be specific to location, but would it be the same dentist recommending the treatment as performing the surgery? Here (BC, Canada) everyone I've known who's had wisdom teeth removed had it done by a specialist, not the dentist that suggested it (which presumably cuts down on self-serving recommendations).
https://www.cochrane.org/news/featured-review-how-often-shou...
In my experience they always find something that they "have time to take care of right now if you want". I've heard anecdotes of folks going to get second opinions that reaches a different conclusion.
Then I mentioned I had pain around the crown whenever I ate something sweet or sour. The dentist took another look and said "oh yeah the crown is cracked"
So now I know I either have a cracked crown or I don't. Great service.
> For instance, a 2021 systemic review of 77 studies that included data on a total of 15,518 tooth sites or surfaces found that using X-rays to detect early tooth decay led to a high degree of false-negative results. In other words, it led to missed cases.
The article isn't just saying you're getting unnecessary radiation. It's also saying that relying on x-rays lets dentists be lazy about finding problems while also billing you for unnecessary work.
Also, this may be a good application for AI. I would assume this is an issue with dentists being able to read X-rays carefully and not that the X-rays are unable to capture the signs.
Europe takes a clinical risk (e.g. caries risk) based approach combined with a patient age factor. To have annual X-Rays in Europe you would have to have some sort of dental issue that puts you in that high-risk category, and even then, the clinic would keep you under review and lengthen the periods as soon as it was clinically possible to do so.
This has always been the case, even before the latest scientific evidence on the potential harms of X-Rays.
Everything you said could be true and ironically, you'd actually be making an argument that routine dental work is backed by evidence.
The percentage of people who do all the things you said has to be below <5%, if not even lower.
The entire dental industry is only in business because of sugar and ignorance. Fortunately for them, the overall vanity level of society is increasing, so they'll likely make up for it with whitening sessions and veneers.
Hard to balance at night, but a humidifier using distilled water near the sleeping area will slow the rate of drying.
The same is true of alcohol-based mouthwash and alcohol itself. Anything that routine damages cells is going to be a carcinogen.
Because it's unrelated to the article, doesn't have a source, has multiple typos, and even if it's true, I'm not going to give up hot beverages and food just to avoid (what I assume they're implying to be) a tiny increased mouth and throat cancer risk.
Here in Europe I never heard a dentist recommend that (yearly check-ups yes, of course, but they're manual - and accurate)
Tell me you are American, without telling me you are American.
