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The 'Irrational' Way Humans Interact With Dentists

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Re: The 'Irrational' Way Humans Interact With Dentists

#41

Post by CWuestefeld »

arethuza wrote: post #4
jakarta wrote: post #2

This article got me thinking about a trip to the dentist I had a few years ago. From when I was 5-18 years old I had the same dentist and between ages 13-18 I had a really impeccable record when it came to not having cavities. Then, when I came back from my first semester of college I had to switch from my old dentist (who specialized in children/teenagers) to a new one. On my first visit, he identified something lik…

When I changed dentist after University the new dentist made an official complaint about the standard of work of the previous one (who I had been with since an early age). For a while my mouth was effectively "Exhibit A" in some kind of professional complaints process.

Given the content of the OP, is it possible that the problem wasn't so bad, that this was all a marketing device, building the relationship between you and the new dentist?

Re: The 'Irrational' Way Humans Interact With Dentists

#43

Post by CWuestefeld »

dminor wrote: post #38
timcederman wrote: post #30

Earlier quoted context omitted.

The main areas I evaluate are: - technique (one of the most important, but generally difficult to interpret without some tuition. However some good indicators are time spent in mouth during procedures, how prepared is the dentist (hunting for tools is worrisome), level of pain, number of times work has had to be fixed) - hygiene (appropriate glove changing, mask, tool use and sterilization). The most obvious things I…

> - equipment (age of equipment, tech levels (not too high - don't forget, you the patient are paying for it). This is also important as digital x-rays use much less radiation and allow for immediate review with the patient. My brother, who is a dentist, used both film and digital in school and found he preferred the resolution of film. No doubt digital will improve though.

Just spoke to my periodontist about this last week. He said he's still using film for two reasons:

1. The digital x-ray plates are rigid. He finds this deforms the soft tissue too much to show a good picture.

2. Scaling. With film, he can take a direct measurement at 1:1 scale off the image. With digital, the scale isn't 1:1 (and variable? I wasn't clear on that), making it more difficult to work with. One imagines this would be a simple problem to solve.

(The bad news is that we were discussing this as he was investigating a 9mm pocket at the root of one tooth. He says I'll at least need a root canal; likely lose the tooth and need an implant. He's sent me to my "regular" dentist for a 2nd opinion -- that gives me more trust.)

Re: The 'Irrational' Way Humans Interact With Dentists

#44

Post by protomyth »

ugh wrote: post #37
protomyth wrote: post #19

A dentist is the closest thing most of us get to a cosmetic surgeon. They can have a large effect on our appearance and have procedures that will probably cause us the most pain out of anything the normal person has done to them. Plus, they hold up an x-ray and say "This is..." not "This might be...". You really owe it to yourself to get a good look at who is doing the work. As an example, as a child I was under gove…

“Plus, they hold up an x-ray and say ‘This is …’ not ‘This might be …’.” Ha! My dentist actually said ‘This might be …’ as we looked together at a X-ray. He said that we could be looking at very, very early caries or just a shadow and that X-ray images are always tricky. I will be X-rayed again at the next routine checkup to see if anything has changed. Incidentally, how common are X-rays in the US? It sounds like th…

Very common - I think it is an insurance requirement to get paid.

Re: The 'Irrational' Way Humans Interact With Dentists

#45

Post by jordan0day »

jakarta wrote: post #2

This article got me thinking about a trip to the dentist I had a few years ago. From when I was 5-18 years old I had the same dentist and between ages 13-18 I had a really impeccable record when it came to not having cavities. Then, when I came back from my first semester of college I had to switch from my old dentist (who specialized in children/teenagers) to a new one. On my first visit, he identified something lik…

Warning: Post is 100% anecdote; Cite at your own risk!

My wife had a similar experience. We both grew up in a small city, and throughout her life she never had a single cavity. She prides herself on the health of her teeth.

In college we both moved to a larger city (which has a more competitive dentistry market), and suddenly dentists were finding cavities every time she went for a checkup.

While it's entirely possible that she didn't have cavities before, and now does all the time, I feel like the competitiveness of the market here has lowered the standard of what actually requires a filling.

That is, in our hometown, a dentist could take a more measured approach -- if something looked like it could develop into a problem but wasn't currently one, they had the leisure of waiting for the next six-month checkup to reevaluate. Here, it seems to be the equivalent of shoot first and ask questions later.

Also, every filling I've ever had never came as a result of actual pain or discomfort, they only occurred because I went in for a regular six-month checkup. Given my wife's experience (going from apparently perfect teeth to requiring fillings at nearly every checkup) I can't help but feel about as confident as a woman at an auto shop hearing "You need your blinker fluid replaced".

Re: The 'Irrational' Way Humans Interact With Dentists

#46

Post by ars »

jerf wrote: post #20

There seems to be a massive disparity in techniques and tools, too, though I am reporting only anecdotally. I recently got dental insurance again after a long time, and for better or worse started going to a dentist again. I picked him via "since I have no other metric to use I might as well pick the closest that takes my insurance". Somehow I stumbled onto an older guy with a lot of experience but who has also kept…

That seems to be "Laser Fluorescence Cavity Detection", brand name "DIAGNOdent" (for all the people asking where to find him, I guess you can ask for this by name).

But it's not a perfect system - detection is about 80% to 90%, http://jdr.sagepub.com/content/83/suppl_1/C80/T1.expansion.h...

Re: The 'Irrational' Way Humans Interact With Dentists

#48

Post by kafene »

jerf wrote: post #36
Eliezer wrote: post #34

Earlier quoted context omitted.

Can you name the dentist if they're in the Bay Area?

Sorry, he's about 2,300 miles away from the Bay Area. :) Hmm, may I take this as further evidence that my absolutely terrible selection metric has indeed blundered onto a good choice? (I'm honestly surprised, I honestly thought I had just been out of the loop.)

Wouldn't happen to be anywhere near Atlanta, would he? :)

Re: The 'Irrational' Way Humans Interact With Dentists

#49

Post by reduxredacted »

There is a little bit of over-simplifying going on in this article, but it was an interesting read, especially for an anti-dentite like myself. The problem is that people don't go to the dentist just to have cavities filled. My first trip to my current dentist happened due to a severely painful toothache (to call it in ache is like calling a broken leg a paper cut). I had my bride do some research of local dentists (whatever she could cram into 5 minutes on google) and went with the guy that I perceived as having the best technology (but really the main criteria was the most open schedule).

What followed was a great experience: after 2 hours of patching things up, my pain was almost completely gone. After a few days of antibiotics, it was gone. The shot required to numb the area didn't hurt (it may have under normal circumstances, but ... "broken leg"). That single correction brought me back on schedule. I had a filling that was sensitive. He replaced it with a "new material", it was more sensitive, so he replaced it again with a different bonding (Neither I nor my insurance were charged) and that sensitivity went away. No cavity filled since then has been sensitive.

I've had a handful of cavities, and I return, reluctantly, but my loyalty lies more in the fact that I had a tangible, identifiable problem (excruciating pain, and later sensitivity) and he troubleshot it until it was fixed to my satisfaction. I wouldn't see another dentist simply because I believe this particular dentist to be predictable. I'll have a problem, he'll fix it. I, like other commentators, have a dentist who uses more than just X-Rays to diagnose cavities. At the moment, I have three spots on the X-Ray and DIAGNOdent that he has said he'd like to "wait on" because he wasn't sure. I had thought -- due to my past experience with tooth pain -- that "waiting on" something like that was asking for trouble, but now I'm wondering if I have a Dentist who understands the limitations of the technology he uses.

Re: The 'Irrational' Way Humans Interact With Dentists

#50

Post by ora600 »

I have about 5 dentists in my immediate family (grandfather, dad, dad's wife, aunt and uncle). My dad is the head of the Perio department in the Hadassah Dental School in Jerusalem. Naturally, I had my teeth checked twice a year like clockwork all my life. I have some gum issues, but never needed a filling.

6 month after moving to the bay area, I went to a local dentist for general checkup. He used the "laser thingy" to find cavities and found no less than eight cavities that required filling. He also took XRays that showed no issues at all. I asked him for copies of the records and XRays so I can send to my father for second opinion. He immediately agreed, but despite weekly reminders, he never sent me the films.

On my first visit back home, I got my teeth checked by my aunt again. I need one filling.

Lessons learned: * US diet accounts for one cavity. * Dentist greed accounts for seven more. * Always ask your dentist for copies of XRay and files and don't return if he will not supply them. It is your right to have those copies of your dental history. * If the XRays don't show the cavities, there are not at a level where you need to treat them yet. You can safely wait until they show up. If you maintain high level of dental hygiene they may never get to the point where they need filling.

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